金黄色葡萄球菌抗菌药物敏感性及ST分型特点分析  

Antibiotic Sensitivity and Molecular Typing of 328 Staphylococcus aureus

作　　者：陈俊文 李多云[1] 王红燕[1] 陈重[1] 白冰[1] 郑金鑫[1] 涂浩鹏 潘伟光[1] 徐广健 廉婕 程航[1] 孙翔 余治健[1] 邓启文[1] CHEN Jun-wen;LI Duo-yun;WANG Hong-yan;CHEN Zhong;BAI Bing;ZHENG Jin-xin;TU Hao-peng;PAN Wei-guang;XU Guang-jian;LIAN Jie;CHENG Hang;SUN Xiang;YU Zhi-jian;DENG Qi-wen(Department of Infectious Diseases and Shenzhen key lab for endogenous infection,Shenzhen Nanshan Hospital,Guangdong Shenzhen 518052)

机构地区：[1]深圳大学南山医院感染科及内源性感染诊治研究重点实验室,广东深圳518052

出　　处：《深圳中西医结合杂志》2018年第16期9-13,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：深圳市卫计委科技计划项目资助课题(201606049和201506093);深圳市区级课题资助(2016012;2016013;2016018);深圳市三名工程项目资助课题(SMGC20170529)

摘　　要：目的:分析本地区金黄色葡萄球菌抗菌药物敏感性及ST分型特点,揭示金黄色葡萄球菌在本地区的临床规律。方法:收集深圳大学南山医院2010-2015年临床分离金黄色葡萄球菌,其中138株为耐甲氧西林金黄色葡萄球菌(MRSA),190株为甲氧西林敏感金黄色葡萄球菌(MSSA)。经BD phonixtm 100公司全自动药敏鉴定系统及琼脂稀释法测定其药敏,聚合酶链式反应(PCR)方法检测其管家基因进行多位点测序分型(MLST)分型,并分析其药敏与MLST的关系。结果:328株金黄色葡萄球菌标本主要来源于痰液、咽拭子、气管分泌物、血液、伤口拭子和脓液,MRSA的检出率为42.07%,阿米卡星、红霉素、环丙沙星、四环素、妥布霉素的耐药率分别为48.12%、95.62%、50.37%、65.94%、50.37%,MLST主要流行型别为ST239、ST59、ST1。MSSA红霉素、四环素、妥布霉素的耐药率分别为73.65%、40.42%、40.11%,主要型别为ST7、ST59、ST398、ST188。无万古霉素,利奈唑胺,替加环素,替考拉宁耐药株。结论:本地区金黄色葡萄球菌的标本来源于呼吸系统,MRSA对呋喃妥因,奎奴普汀,利福平敏感,MSSA对呋喃妥因,奎奴普汀,利福平,阿卡米星,环丙沙星敏感,ST239–MRSA、ST7–MSSA、ST398–MSSA、ST88–MSSA、ST120–MSSA多重耐药(3种或3种抗菌药物以上耐药)。Objective To analyze the antibiotic susceptibility and ST genotypic characteristics of Staphylococcus aureus in this area and reveal the clinical regularity of Staphylococcus aureus in this region. Methods Clinical staphylococcus aureus isolated from our hospital from 2010 to 2015 was collected.138 were methicillin-resistant Staphylococcus aureus（MRSA）and 190 were methicillin-sensitive Staphylococcus aureus（MSSA）.The drug susceptibility was determined by BD phonixtm 100 fully automated drug susceptibility identification system and agar dilution method.The MLST gene was detected by PCR for MLST typing,and the relationship between drug susceptibility and MLST was analyzed. Results 328 strains of Staphylococcus aureus were mainly derived from sputum,throat swab,tracheal secretions,blood,wound swabs and pus.The detection rate of MRSA was 42.07%,amikacin and erythromycin.The resistant rates of ciprofloxacin,tetracycline,and tobramycin were 48.12 %, 95.62 %, 50.37 %, 65.94 %, and 50.37 %,respectively.The main epidemics of MLST were ST239,ST59,and ST1.The resistance rates of MSSA erythromycin,tetracycline,and tobramycin were 73.65%,40.42%,and 40.11%,respectively,and the major types were ST7,ST59,ST398,and ST188.No vancomycin,linezolid,tigecycline,teicoplanin-resistant strains. Conclusion Staphylococcus aureus specimens from this region originate from the respiratory system,MRSA is sensitive to nitrofurantoin,quinupristin,rifampicin,MSSA is nitrofurantoin,quinupristin,rifampicin,amimycin,ciprofl oxacin Star-sensitive,multi-drug resistance of ST239-MRSA, ST7-MSSA, ST398-MSSA, ST88-MSSA,ST120-MSSA（more than 3 or 3 antibiotic resistance）^15.

关 键 词：耐甲氧西林金黄色葡萄球菌 甲氧西林敏感金黄色葡萄球菌 药敏分布 多位点测序分型 

分 类 号：R378.1[医药卫生—病原生物学]