聊城地区脓毒症患儿感染病原菌的分布及MRCNS耐药基因检测  

Distribution of pathogens and detection of resistance genes in methicillin-resistant coagulase-negative Staphylococcus in children with sepsis in the Liaocheng area

作　　者：闫焕利 李洪双[1] 彭富栋[1] 史静[1] YAN Huan-li;LI Hong-shuang;PENG Fu-dong;SHI Jing(Department of Neonatology,The Second People's Hospital of Liaocheng,Liaocheng 252600,Shandong,China)

机构地区：[1]聊城市第二人民医院新生儿科,山东聊城252600

出　　处：《中国病原生物学杂志》2020年第4期462-465,共4页Journal of Pathogen Biology

摘　　要：目的探讨聊城地区脓毒症患儿的病原菌分布,并对耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的耐药基因进行检测。方法2013年2月-2019年2月在本院确诊的脓毒症患儿186例,采血和新鲜粪便,使用ATB微生物鉴定系统鉴定感染病原菌种类,使用纸片扩散法做药敏试验,采用PCR法检测MRCNS的耐药基因。结果186例脓毒症患儿的血及粪便共培养出216株病原菌,其中35例患儿同时培养出2种以上菌株。革兰阳性菌139株,占64.35%。其中的110株葡萄球菌中金黄色葡萄球菌17株,凝固酶阴性葡萄球菌(CNS)93株,占43.06%。革兰阴性菌77株,占35.65%。真菌3株,占1.39%。93株CNS中MRCNS 78株,其中耐甲氧西林松鼠葡萄球菌5株,耐甲氧西林表皮葡萄球菌39株,耐甲氧西林溶血葡萄球菌18株,耐甲氧西林人葡萄球菌10株,耐甲氧西林木糖葡萄球菌6株。78株MRCNS对青霉素、头孢噻肟、美罗培南等的耐药性较高,对万古霉素、利奈唑胺敏感。78株MRCNS中mec A基因阳性74株,erm基因阳性69株,aac(6′)/aph(2")基因阳性61株,TEM-1基因阳性75株,阳性率分别为97.87%、88.46%、78.21%和96.15%。结论聊城地区脓毒症患儿感染病原菌以MRCNS为主,其耐药性与其携带的耐药基因有关。Objectives To investigate the distribution of pathogens in children with sepsis in the Liaocheng area and to detect the resistance genes of methicillin-resistant coagulase-negative Staphylococcus(MRCNS).Methods Subjects were 186children who were definitively diagnosed with sepsis at this Hospital from February 2013to February 2019.Blood and fresh feces were collected.An ATB microbial identification system was used to identify the pathogens in children with sepsis.The disk diffusion method was used to test the drug sensitivity of pathogens and to screen for MRCNS.The drug resistance genes of MRCNS were detected using PCR.Results A total of 216strains of pathogens were cultured in blood and feces samples from 186children with sepsis.Seventeen of those strains(7.87%)were S.aureus and 93(43.06%)were coagulase-negative Staphylococcus(CNS).Seventy-seven of the 216strains(35.65%)were Gramnegative bacteria.Three of the strains(1.39%)were fungi.Of the 93CNS strains,78(83.87%)were MRCNS,including 5strains(2.31%)of methicillin-resistant S.sciuri,39strains(18.06%)of methicillin-resistant S.epidermidis,18strains(8.33%)of methicillin-resistant S.haemolyticus,10strains(4.63%)of methicillin-resistant Staphylococcus,and 6strains(2.78%)of methicillin-resistant S.xylosus.The resistance of 78MRCNS strains to penicillin,cefotaxime,cefoperazone,ceftriaxone,imipenem,and meropenem was 100%,and their resistance to vancomycin and linezolid was 0.00%.Of 78MRCNS strains,74(97.87%)contained the mec A gene,69(88.46%)contained the erm gene,61(78.21%)contained the aac(6')/aph(2")gene,and 75(96.15%)contained the TEM-1gene.Conclusion The main pathogen causing sepsis in children in the Liaocheng area is CNS,a Gram-positive bacterium.The drug resistance of CNS is related to MRCNS carrying drug resistance genes.

关 键 词：脓毒症 病原菌 耐甲氧西林凝固酶阴性葡萄球菌 耐药基因 

分 类 号：R378[医药卫生—病原生物学]