儿童标本中分离MRSA的SCCmec基因分型及耐药性分析  

SCCmec genotypes and drug resistance analysis of isolated MRSA in children

作　　者：张秀芳[1] 柴杰[1] 谭雪峰[1] 郭普[2] ZHANG Xiu-fang;CHAI Jie;TAN Xue-feng;GUO Pu(Department of Clinical Medical Laboratory,the Peoples Hospital of Bozhou,Bozhou,Anhui 236800,China)

机构地区：[1]亳州市人民医院检验科,安徽亳州236800 [2]蚌埠医学院第一附属医院检验科,安徽蚌埠233004

出　　处：《中华全科医学》2020年第10期1718-1721,共4页Chinese Journal of General Practice

基　　金：安徽省重点研究与开发计划项目(1804h08020256)。

摘　　要：目的、了解亳州地区儿童耐甲氧西林金黄色葡萄球菌(methiellin resistant staphylococcus aureus,MRSA)的SCCmee基因分型及其耐药性。方法收集2018年12月-2019年3月亳州市人民医院儿科共6个病区临床分离的89株MRSA菌株,采用PCR方法对其进行SCCmee基因分型;ⅥTEK2compact全自动微生物分析仪进行抗菌药物敏感性试验,并采用WHONET 5.6软件统计药敏结果并进行分析。结果89株MRSA以SCCmec IVa型为主,占55.1%(49/89),其次SCCmee Ⅱ型12.4%(11/89),SCCmec Ⅰ型1.1%(1/89),未分型31.4%(28/89),未见SCCmee Ⅰ型和Ⅴ型;89株MRSA对青霉素均耐药,对红霉素、克林霉素均高耐药,耐药率分别为87.6%、62.9%,对喹诺酮类、庆大霉素甲氧苄啶/磺胺甲恶唑的耐药率均低于10%;而49株SCCmec Ⅳa型对红霉素、克林霉素的耐药率略升高,分别为91.8%.77.6%,对喹诺酮类药物耐药率4.1%,有所下降,而对甲氧苄啶/磺胺甲恶唑、庆大霉素均敏感;以上菌株未发现对万古霉素、利奈唑胺、奎奴普丁/达福普汀及替加环素耐药。结论目前亳州地区儿童分离的MRSA主要以SCCmeeIVa型为主要流行株,对多种抗菌药物呈不同程度耐药。Objective To investigate the SCCmee genotypes and drug resistance of methiellin-resistant staphylococcus aureus(MRSA)isolated from children in Bozhou,Anhui province.Methods From December 2018 to March 2019,89 MRSA strains isolated from 6 pediatrics wards in the People'Hospital of Bozhou were collected.The SCCmec genotypes of MRSA strains were detected by PCR.Antimicrobial susceptibility test was performed by ⅥTEK 2 compact.Statistical analysis was performed using WHONET 5.6 software.Results Among 89 MRSA strains,SCCmec Ⅳa was the main type,accounting for 55.1%(49/89)of the total strains,followed by SCCmec type Ⅱ 12.4%(11/89),SCCmec type 1.1%(1/89),respectively.Untyped 31.4%(28/89)and SCCmee Ⅰ and Ⅴtype were not detected.All MRSA strains were resistant to penicillin and the resistance rates to erythromycin and clindamycin were higher,which was 87.6%and 62.9%respectively.The resistance rates to quinolones,gentamicin and trimethoprim/sulfamethoxazole were less than 10%。The resistance rates of the 49 strains of SCCmee type Ⅳ a to erythromyein and clindamyein were slightly increased,which was 91.8%and 77.6%,respectively,while the resistance rate to quinolones was4.1%,and all of the 49 strains were susceptible to gentamicin and trimethoprim/sulfamethoxazole.None of the MRSA strains were found to be resistant to vancomycin,linezolid,quinupristin/dalfopristin and tigecyeline.Conclusion The prevalence of MRSA isolated from children in Bozhou was mainly SCCmee IVa lype strains,and they showed various degrees of resistance to different anti-microbial agents.

关 键 词：儿童 耐甲氧西林金黄色葡萄球菌 SCCMEC基因分型 耐药性 

分 类 号：R378.11[医药卫生—病原生物学] R446[医药卫生—基础医学]