99株表皮葡萄球菌早孕宫颈拭子与外环境分离株耐药性及SCCmec分型研究  

Analysis of antimicrobial resistance and staphylococcal cassette chromosome mec(SCCmec)in 99 Staphylococcus epidermidis strains isolated from early pregnancy cervical swabs and external environment

作　　者：宋衍燕[1] 肖文静 杨琳 郝民[1] 邵希凤[1] 王恒伟[1] 王海滨[1] 孙灵利[1] Song Yanyan;Xiao Wenjing;Yang Lin;Hao Min;Shao Xifeng;Wang Hengwei;Wang Haibin;Sun Lingli(Beijing Chaoyang District Center Disease Control and Prevention,Beijing 100013,China;Beijing Chaoyang District Maternal and Child Health Care Hospital,Beijing 100013,China)

机构地区：[1]北京市朝阳区疾病预防控制中心,100013 [2]北京市朝阳区妇幼保健院,100013

出　　处：《中华微生物学和免疫学杂志》2019年第3期185-191,共7页Chinese Journal of Microbiology and Immunology

摘　　要：目的了解2015—2016年从北京市朝阳区早孕宫颈拭子和外环境中分离的99株表皮葡萄球菌的耐药性与耐药基因携带情况以及SCCmec型别。方法对99株表皮葡萄球菌,采用K-B法对头孢西丁、微量肉汤稀释法对万古霉素、达托霉素、青霉素、红霉素、复方新诺明、四环素、环丙沙星、克林霉素、庆大霉素、氯霉素进行药敏试验,采用PCR法对ermA、ermB、ermC、msrA、norA1、norA2、sul1、sul2、sul3、aac(6′)/aph(2″)、ant(4′,4″)、ant(6)、tetM耐药基因和SCCmecⅠ、Ⅱ、Ⅲ、Ⅳa、Ⅳb、Ⅳc、Ⅳd、Ⅴ型别基因进行检测,毛细管凝胶电泳法进行结果确认,SPSS进行数据分析。结果99株mecA阳性表皮葡萄球菌对万古霉素100%敏感、对达托霉素93.94%敏感,对青霉素、红霉素、头孢西丁、复方新诺明、四环素、环丙沙星、克林霉素、庆大霉素、氯霉素耐药率依次为97.98%、85.86%、79.80%、52.54%、27.27%、43.43%、36.36%、23.23%、11.11%;norA1、norA2、ermA、ermB、ermC、msrA、sul1、sul2、sul3、aac(6′)/aph(2″)、ant(4′,4″)、ant(6)、tetM携带率分别为100%、93.94%、0.00%、3.03%、17.17%、57.58%、50.51%、12.12%、4.04%、30.30%、8.08%、4.04%、25.26%;99株mecA阳性表葡葡萄球菌SCCmecⅠ、Ⅱ、Ⅲ、Ⅳa、Ⅳb、Ⅳc、Ⅳd、Ⅴ分离率分别为5.05%、0.00%、43.43%、10.10%、0.00%、3.03%、3.03%、19.19%,并有4.04%(4/99)的菌株携带两种SCCmec型别,12.12%(12/99)菌株未分型。结论99株mecA阳性表皮葡萄球菌中未发现万古霉素耐药菌株。mecA阳性表皮葡萄球菌多重耐药基因携带率为89.90%。菌株大环内酯类、磺胺类、氨基糖苷类抗菌药物耐药机制以携带msrA、sul1、aac(6′)/aph(2″)耐药基因为主。SCCmec分型以SCCmecⅢ型为主。SCCmecⅢ型和未分型菌株的多重耐药基因携带率分别为88.37%和75%,其他SCCmec型菌株均100%携带多重耐药基因。Objective To analyze the antimicrobial resistance,distribution of resistance genes and staphylococcal cassette chromosome mec(SCCmec)in 99 strains of mecA gene-positive Staphylococcus epidermidis strains isolated from early pregnancy cervical swabs and external environment in Beijing Chaoyang District from 2015 to 2016.Methods Kirby-Bauer disk diffusion method was performed to detect the susceptibility of the 99 Staphylococcus epidermidis strains to cefoxitin.Microbroth dilution method was used to test their susceptibility to vancomycin,daptomycin,penicillin,erythromycin,compound sulfamethoxazole,tetracycline,ciprofloxacin,clindamycin,gentamicin and chloramphenicol.PCR was used to detect drug resistance genes of ermA,ermB,ermC,msrA,norA1,norA2,sul1,sul2,sul3,aac(6′)/aph(2″),ant(4′,4″),ant(6)and tetM and to analyze the SCCmec types ofⅠ,Ⅱ,Ⅲ,Ⅳa,Ⅳb,Ⅳc,Ⅳd andⅤ.The results were compared with those of capillary electrophoresis.SPSS was used for data analysis.Results All of the 99 mecA-positive Staphylococcus epidermidis strains were sensitive to vancomycin and 93.94%of them were sensitive to datomycin.The resistance rates to penicillin,erythromycin,cefoxitin,compound sulfamethoxazole,tetracycline,ciprofloxacin,clindamycin,gentamicin and chloramphenicol were 97.98%,85.86%,79.80%,52.54%,27.27%,43.43%,36.36%,23.23%and 11.11%.The strains that carried the genes of norA1,norA2,ermA,ermB,ermC,msrA,sul1,sul2,sul3,aac(6′)/aph(2″),ant(4′,4″),ant(6)and tetM accounted for 100%,93.94%,0.00%,3.03%,17.17%,57.58%,50.51%,12.12%,4.04%,30.30%,8.08%,4.04%and 25.26%,respectively.Among the 99 strains,5.05%,0%,43.43%,10.10%,0.00%,3.03%,3.03%and 19.19%belonged to SCCmecⅠ,Ⅱ,Ⅲ,Ⅳa,Ⅳb,Ⅳc,Ⅳd andⅤ,respectively,and 4.04%(4/99)were positive to two SCCmec types.The types of 12.12%(12/99)of the strains were unidentified.Conclusions All of the 99 strains of mecA-positive Staphylococcus epidermidis were sensitive to vancomycin.Among them,the strains carrying multidrug resistance genes accounted for 89.90%.Th

关 键 词：表皮葡萄球菌 MECA MSSE MRSE 耐药基因 SCCMEC 

分 类 号：R446[医药卫生—诊断学]