甲氧西林敏感金黄色葡萄球菌对喹红霉素敏感性分析及其分子分型特点  

Susceptibility of methicillin-susceptible Staphylococcus aureus to cethromycin and characteristics of molecular typing

作　　者：黄震 胥志超 张波 王红燕 陈重 白冰 潘伟光 李桂秋 徐广健 余治健 邓启文 李多云 HUANG Zhen;XU Zhi-chao;ZHANG Bo;WANG Hong-yan;CHEN Zhong;BAI Bing;PAN Wei-guang;LI Gui-qiu;XU Guang-jian;YU Zhi-jian;DENG Qi-wen;LI Duo-yun(Department of Infectious Disease of Nanshan District People’s Hospital,Shenzhen Key Laboratory for Endogenous Infection,Shenzhen University School of Medicine,Shenzhen 518052,China;Department of Lung Disease of Baoan District People’s Hospital,Shenzhen 518101,China;Healthcare -associated Infection Quality Control Center of Shenzhen,Shenzhen 518052,China)

机构地区：[1]深圳大学医学院附属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 [2]深圳市宝安区人民医院肺科门诊,广东深圳518101 [3]深圳市医院感染质量控制中心,广东深圳518052

出　　处：《中国感染控制杂志》2019年第9期803-807,共5页Chinese Journal of Infection Control

基　　金：深圳市科技计划项目(JCYJ20170412143551332、JCYJ20170307153425389);广东省医学科研基金项目(青年)(B2017019);广东省医学科研基金项目(A2018163);深圳市南山区卫生科技计划项目(2018010、2018035、2018064、2016013);深圳市卫生和计划生育委员会课题(SZXJ2017032、SZXJ2018027);深圳市重点学科;深圳市三名工程经费资助项目

摘　　要：目的了解酮内酯类抗生素喹红霉素对临床分离甲氧西林敏感金黄色葡萄球菌(MSSA)的体外药物敏感性,以及MSSA不同分子分型型别与喹红霉素最低抑菌浓度(MIC)值的关系。方法收集深圳市南山医院2011-2015年不同临床标本分离的MSSA118株,用微量肉汤稀释法及K-B纸片法测定MSSA菌株对喹红霉素及其他9种临床常用抗金黄色葡萄球菌药物的MIC值。采用多位点序列分型(MLST)技术将其分为不同基因型,观察MSSA型别与喹红霉素对MSSA MIC值的关系。结果MSSA对常用抗革兰阳性菌药物利奈唑胺、万古霉素、呋喃妥因、替考拉宁及阿莫西林/克拉维酸均敏感;对喹红霉素中介2株,耐药21株,耐药率19.5%,对红霉素耐药率则高达60.2%。该院MSSA分为32个ST型,20株属于新的ST型,前三的ST型分别为:ST7型15株(12.7%),ST188型12株(10.2%),ST59型12株(10.2%)。结论MSSA对大环内酯类抗生素耐药形势严峻,喹红霉素较红霉素对MSSA更为强效。ST7、ST188、ST59和ST398是该院临床分离MSSA的主要MLST型别。Objective To understand the in vitro susceptibility of cethromycin,a ketolide antibiotic,to clinically isolated methicillin-susceptible Staphylococcus aureus(MSSA)and relationship of different molecular types of MSSA with minimum inhibitory concentration(MIC)value of cethromycin.Methods 118 strains of MSSA isolated from different clinical specimens in Nanshan Hospital of Shenzhen from2011 to 2015 were collected,MIC values of cethromycin and other 9 commonly used antistaphylococcal agents against MSSA were determined by broth dilution method and Kirby-Bauer method.Multilocus sequence typing(MLST)technique was used to classify them into different genotypes,relationship of MSSA type and MIC values of cethromycin to MSSA was observed.Results MSSA was sensitive to linezolid,vancomycin,furantoin,teicoplanin,and amoxicillin/clavulanic acid,2 strains were intermediate to cethromycin,and 21 strains were resistant to cethromycin,resistance rate was 19.5%,resistance rate to erythromycin was as high as 60.2%.MSSA was divided into 32 ST types,and 20 strains were new ST types,the top three ST types were:15 ST7(12.7%),12 ST188(10.2%)and 12 ST59(10.2%).Conclusion Resistance of MSSA to macrolide antibiotics is severe,and cethromycin is more effective than erythromycin in treating MSSA.ST7,ST188,ST59 and ST398 are the main MLST of MSSA strains isolated from this hospital.

关 键 词：甲氧西林敏感金黄色葡萄球菌 酮内酯 喹红霉素 多位点序列分型 

分 类 号：R378.11[医药卫生—病原生物学]