耐甲氧西林金黄色葡萄球菌SCCmec基因分型及耐药性分析  

SCCmec typing and analysis of the drug resistance of methicillin-resistant Staphylococcus aureus in this Hospital

作　　者：俞娟[1] 戴璐 YU Juan;DAI Lu(Clinical Laboratory, Nantong University Hospital, Nantong, Jiangsu 226001, China)

机构地区：[1]南通大学附属医院检验科,江苏南通226001

出　　处：《中国病原生物学杂志》2017年第11期1066-1069,共4页Journal of Pathogen Biology

基　　金：国家自然科学基金项目(No.81301484)

摘　　要：目的分析耐甲氧西林金黄色葡萄球菌(MRSA)SCCmec基因型别及耐药性,为不同感染型别菌株的有效治疗及耐药性控制提供指导。方法收集本院2016年1-12月患者各类送检临床标本,分离MRSA,对菌株进行SCCmec基因的多重PCR扩增,K-B法分析SCCmec基因型菌株耐药情况,根据标准判定结果。结果本院2016年1-12月患者各类临床标本中共分离出MRSA 282株,携带SCCmec基因151株,占53.55%,其中143株携带SCCmecⅢ型基因,8株携带SCCmecⅡ型基因。携带SCCmecⅢ型基因MRSA病区分布:ICU病房81株(占56.64%),外科病房39株(占27.27%),内科病房16株(占11.19%),门诊病房7株(占4.90%)。携带SCCmecⅡ型基因MRSA病区分布:ICU病房5株(占62.50%),外科病房2株(占25.00%),内科病房1株(占12.50%),门诊病房分离的MRSA菌株未检出SCCmecⅡ型。携带SCCmecⅢ型基因的MRSA标本来源:痰液93株(占65.03%),血液37株(占25.87%),腹水9株(占6.29%),尿液3株(占2.10%),伤口分泌物1株(占0.70%)。携带SCCmecⅡ型基因MRSA标本来源:痰液5株(占62.50%),血液3株(占37.50%),患者腹水、尿液标本以及伤口分泌物标本分离的MRSA菌株未检出SCCmecⅡ型。携带SCCmecⅢ型MRSA对氨苄西林、阿莫西林、哌拉西林、头孢拉啶、头孢吡肟和利福平的耐药率分别为100.00%、67.83%、53.85%、60.13%、26.57%和8.39%,对万古霉素敏感;携带SCCmecⅡ型MRSA对氨苄西林、阿莫西林、哌拉西林、头孢拉啶、头孢吡肟和利福平的耐药率分别为100.00%、75.00%、37.50%、25.00%、12.50%和12.50%,对万古霉素敏感。结论 MRSA临床分离株基因型以SCCmecⅢ型为主,主要分离自医院的ICU病房及患者的痰液和血液标本。临床治疗MRSA感染时应首选万古霉素,但应合理选用,避免耐药性发展。Objectives To type SCCmec and to analyze the drug resistance of methicillin-resistant Staphylococcus aureus in order to guide the effective treatment of infection with different types of methicillin-resistant S.aureus and to control its drug resistance. Methods Clinical data on patients from each department of this Hospital were collected from January to December in 2016,and 151 strains of methicillin-resistant S.aureus were isolated.The SCCmec genes of strains were amplified with multiple PCR reactions.After PCR,products were analyzed using gel electrophoresis.The drug resistance of methicillin-resistant S.aureus with two types of SCCmec was analyzed using the K-B method,and the results were judged in accordance with the 2015 guidelines of the CLSI Results Typing of SCCmec from methicillin-resistant S.aureus revealed that SCCmec type III was 280 bp in length and that SCCmec type II was 398 bp in length.One hundred and forty-three strains of methicillin-resistant S.aureus with SCCmec type III were detected,and 8 strains with SCCmec type II were detected.Eighty-one strains（56.64%）of methicillin-resistant S.aureus with SCCmec type III were isolated from ICUs,39 strains（27.27%）were isolated from Surgery,16 strains（11.19%）were isolated from Internal Medicine,and 7 strains（4.90%）were isolated from Outpatient Services.Five strains（62.50%）with SCCmec type II were isolated from ICUs,2 strains（25.00%）were isolated from Surgery,and 1 strain（12.50%）was isolated from Internal Medicine.No strains with SCCmec type II were isolated from Outpatient Services.Ninety-three strains（65.03%）of methicillin-resistant S.aureus with SCCmec type III were isolated from sputum,37 strains（25.87%）were isolated from blood,9 strains（6.29%）were isolated from ascitic fluid,3 strains（2.10%）were isolated from urine,and 1 strain（0.70%）was isolated from wound secretions.Five strains（62.50%）of methicillin-resistant S.aureus with SCCmec type II were isolated from sputum and 3 strains（37.507%）were i

关 键 词：耐甲氧西林金黄色葡萄球菌 SCCmec基因 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]