医院获得性金黄色葡萄球菌mecA基因的表达及耐药性分析  

The expression of the mecA gene in hospital-acquired Staphylococcus aureus and the resistant analysis

作　　者：李海燕[1] 杨松鹏[2] 曹婷婷[1] 姚反修[1] 刘红[3] Li Haiyan;Yang Songpeng;Cao Tingting;Yao Fanxiu;Liu Hong(Department of General Practice,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Chin;Department of Gastrointestinal Surgery,Zhengzhou Central Hospital Affiliated of Zhengzhou University,Zhengzhou 450052,China;Department of Respiratory,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院全科医学科,河南郑州450052 [2]郑州大学附属郑州市中心医院胃肠外科,河南郑州450052 [3]郑州大学第一附属医院呼吸内科,河南郑州450052

出　　处：《河南医学研究》2018年第18期3282-3285,共4页Henan Medical Research

摘　　要：目的分析医院获得性金黄色葡萄球菌(HA-SA)中mecA基因的表达和耐药性。方法收集2015年5月至2016年8月在郑州大学第五附属医院治疗的HA-SA肺炎患者中分离出的金黄色葡萄球菌(SA),应用聚合酶链反应(PCR)对HA-SA进行mecA基因扩增,采用纸片扩散法(K-B法)测定12种抗菌药物的耐药情况。结果分离出HA-SA 70株,其中医院获得性耐甲氧西林金黄色葡萄球菌(HA-MRSA) 57株,mecA基因均阳性;医院获得性甲氧西林敏感金黄色葡萄球菌(HA-MSSA) 13株,有3株携带mecA基因。HA-MRSA和HA-MSSA对万古霉素、替考拉宁、利奈唑胺均敏感,对复方新诺明耐药率相近,分别为61.4%和51.6%。对青霉素、苯唑西林、头孢西丁、利福平、庆大霉素、克林霉素、红霉素、左氧氟沙星耐药率比较,差异有统计学意义(P<0.01)。结论 MRSA在HA-SA肺炎患者中发病率高。HA-MRSA的耐药性高于HA-MSSA。mecA基因在HA-SA对β-内酰胺类药物耐药中起主要作用。Objective To analyze the expression of mecA gene in hospital - acquired Staphylococcus aureus （ HA - SA） and the drug resistance. Methods The patients with HA - SA pneumonia treated in the Fifth Affiliated Hospital of ZhengzhouUniversity- from May of 2015 to August of 2016 were collected. Staphylococcus aureus （ SA ） was isolated, then mecA gene amplification of HA - SA was executed by polymerase chain reaction （ PCR）, and the resistance of 12 kinds of antibacterials was detected by disc diffusion method （ K - B ）. Results Seventy- strains of HA - SA were isolated, including 57 strains of hospital - acquired methicillin - resistant Staphylococcus aureus （ HA - MRSA） with positive expression of mecA gene, 13 strains of hospital - acquired methicillin - sensitive Staphylococcus aureus （ HA - MSSA）, in which 3 strains with positive expression of mecA gene. HA- MRSA and HA -MSSA were sensitive to vancomycin, teicoplanin, linezolid, and the resistance rates were 61.4% and 51.6% respectively. There were statistically significances in resistance rates to penicillin, oxacillin, cefoxitin, rifampicin, gentamicin, lindamycin, ery-thromycin and levofloxacin between HA - MRSA and HA - MSSA （ P 〈 0. 01 ）. Conclusions MRSA has a high morbidity in patients with HA - SA pneumonia. The resistance of HA - MRSA to drug is obviously higher than that of HA - MSSA. mecA gene in HA - SA plays a major role in the drug resistance of β - lactam.

关 键 词：金黄色葡萄球菌 MECA基因 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]