广州市HIV感染者鼻腔携带MRSE与MSSE菌株的耐药谱及遗传特征比较  

Comparison of drug-resistant spectrum and genetic features between MRSE and MSSE strains from nasal carriage among HIV-positive patients in Guangzhou

作　　者：江慧敏 李凌华[2] 李丽雅[2] 蔡卫平[2] 熊倩灵 李树凡 黄星谕 叶家萍 姚振江 JIANG Hui-min;LI Ling-hua;LI Li-ya;CAI Wei-ping;XIONG Qian-ling;LI Shu-fan;HUANG Xing-yu;YE Jia-ping;YAO Zhen-jiang(School of Public Health,Guangdong Pharmaceutical University,Guangzhou,Guangdong 510310,China;不详)

机构地区：[1]广东药科大学公共卫生学院,广东广州510310 [2]广州市第八人民医院感染科,广东广州510060

出　　处：《现代预防医学》2020年第12期2282-2286,共5页Modern Preventive Medicine

基　　金：2018年广东省大学生创新创业训练项目(201810573040);广东省科技计划项目(2014A020213013);广东药科大学‘创新强校工程’资助项目(2016)。

摘　　要：目的比较广州市HIV感染者鼻腔携带耐甲氧西林表皮葡萄球菌(methicillin-resistant Staphylococcus epidermidis,MRSE)与甲氧西林敏感表皮葡萄球菌(methicillin sensitive Staphylococcus epidermidis,MSSE)的耐药谱及遗传特征。方法于2017年6-8月,对广州市某医院艾滋病门诊1001名HIV感染者鼻腔分离的表皮葡萄球菌进行药物敏感性试验及毒素基因、耐消毒基因、耐药基因检测。结果分离鉴定出422株表皮葡萄球菌,包括309(73.22%)株MRSE,113(26.78%)株MSSE。MRSE菌株对青霉素、头孢西丁、红霉素、四环素、莫西沙星、复方新诺明这6种抗生素的耐药率高于MSSE,差异均有统计学意义。MRSE菌株的多重耐药率达77.99%,高于MSSE(36.28%)。MRSE菌株毒素基因pvl的检出率为9.06%,耐消毒基因qacA/B、smr的检出率分别为53.72%、11.33%,耐药基因aac(6’)-aph(2’)的检出率(63.75%)最高。结论广州市HIV感染者鼻腔MRSE的检出率和多重耐药率高,MRSE耐药情况较MSSE严重;耐消毒基因qacA/B和耐药基因aac(6’)-aph(2’)的检出率高。Objective This study aimed to compare the drug-resistant spectrum and genetic features between Methicillin resistant Staphylococcus epidermidis(MRSE)and Methicillin-sensitive Staphylococcus epidermidis(MSSE)strains from nasal carriage among HIV-positive patients in Guangzhou.Methods From June to August 2017,all Staphylococcus epidermidis isolated from 1001 HIV-positive patients from an AIDS clinic in Guangzhou were tested for antibiotics sensitivity,toxin genes,disinfection-resistance genes and drug-resistance genes.Results A total of 422 strains were identified as Staphylococcus epidermidis,including 309(73.22%)MRSE and 113(26.78%)MSSE.Compared with MSSE,MRSE increased the drug-resistance risks of penicillin,cefoxitin,erythromycin,tetracycline,moxifloxacin,trimethoprim-sulfamethoxazole(P<0.05).The multi-drug resistance rate of MRSE strains(77.99%)was higher than MSSE(36.28%).For the MRSE strains,the detection rate of toxin gene pvl was 9.06%,and the detection rate of disinfection-resistant genes qacA/B and smr were 53.72%and 11.33%respectively.The detection rate of the drug-resistant gene aac(6’)-aph(2’)(63.75%)was the highest among detected gene.Conclusion The nasal detection rate and multi-drug resistance rate of MRSE are high among HIVpositive patients in Guangzhou.The drug-resistance of MRSE is much more severe than that of MSSE.The detection rates of the disinfection-resistance gene qacA/B and the drug-resistance gene aac(6’)-aph(2’)are higher than others.

关 键 词：HIV 耐甲氧西林表皮葡萄球菌 甲氧西林敏感表皮葡萄球菌 分子特征 

分 类 号：R378[医药卫生—病原生物学]