耐甲氧西林金黄色葡萄球菌耐药性分析及SCCmec分型  

Drug resistance analysis and Staphylococcal cassette chromosome SCCmec genotypes of methicillin resistant Staphylococcus aureus

作　　者：邹玉涵[1] 刘庆中[2] 张骥[1] 周凌琴 陈超[1] 闫佩毅[1] 金姝[1] 

机构地区：[1]上海市普陀区人民医院检验科,上海200060 [2]上海交通大学附属第一人民医院检验科,上海201620 [3]上海市普陀区中医医院检验科,上海200062

出　　处：《国际检验医学杂志》2018年第2期159-162,共4页International Journal of Laboratory Medicine

基　　金：普陀区卫生系统自主创新科研资助项目(普KW15101)

摘　　要：目的了解上海市普陀区人民医院耐甲氧西林金黄色葡萄球菌(MRSA)耐药情况及SCCmec型别,为预测耐药菌株的发展趋势、为临床预防和治疗MRSA感染提供理论依据。方法收集该院2012年1月至2016年12月临床分离的MRSA共380株,采用微量肉汤稀释法进行体外药敏试验,采用多重聚合酶链反应检测SCCmec型别。结果所有菌株对利奈唑胺、万古霉素均敏感,敏感率为100.0%;对利福平、复方磺胺甲噁唑耐药率较低,分别为5.0%和7.6%;对红霉素、左氧氟沙星、四环素高度耐药,耐药率分别是100.0%、94.2%、93.4%和90.0%;对青霉素耐药率为100.0%。380株MRSA有SCCmecⅡ型281株(73.9%),SCCmecⅢ型59株(15.5%),SCCmecⅣa型5株(1.3%),另有35株(9.2%)未能分型。结论上海市普陀区人民医院分离的MRSA标本以SCCmecⅡ型为主,具有多重耐药的特征,不同SCCmec型别的耐药谱有所差异。Objective To investigate the drug resistance situation and Staphylococcal cassette chromosome mec(SCCmec)genotypes of methicillin resistant Staphylococcus aureus(MRSA)strains isolated from Shanghai Putuo District People′s Hospital in order to provide a theoretical basis for predicting the trend of drug resistant bacterial strains and clinical treatment and prevention of MRSA.Methods Three hundreds and eighty clinically isolated MRSA strains in this hospital were collected from January 2012 to December 2016.The in vitro drug susceptibility test was performed by adopting the broth microdilution method.The SCCmec genotypes were examined by adopting the multiplex polymerase chain reaction.Results All strains were sensitive to linezolid and vancomycin,the sensitivity rate was 100.0%;the resistance rates to rifampicin and cotrimoxazole were lower,which were 5.0%and 7.6%respectively;but the strains were highly resistant to erythromycin,levofloxacin and tetracycline,with the resistance rate of 100.0%,94.2%,93.4% and 90.0%.The resistance rate to penicillin was 100.0%.Among 380 strains of MRSA,there were 281 strains(73.9%)of SCCmecⅡ,59 strains(15.5%)of SCCmecⅢand 5 strains(1.3%)of SCCmecⅣa,other 35 strains(9.2%)of MRSA could not be classified.Conclusion MRSA strains isolated in the Shanghai Putuo District People′s Hospital are mainly the type SCCmecⅡ,which has the multi-drug resistant characteristics,and the drug resistance spectrum of different SCCmec genotypes is different.

关 键 词：耐甲氧西林金黄色葡萄球菌 耐药性 SCCmec基因 

分 类 号：R446.5[医药卫生—诊断学]