耐甲氧西林金黄色葡萄球菌分子特征研究  

Study on the molecular characteristics of methicillin-resistant Staphylococcus aureus

作　　者：王金波[1] 李海英[1] 张亚妮[1] 孙敏[1] WANG Jinbo;LI Haiying;ZHANG Yani;SUN Min(Department of Clinical Laboratory,Baoji People′s Hospital,Baoji,Shaanxi 721000,China)

机构地区：[1]宝鸡市人民医院检验科,陕西宝鸡721000

出　　处：《检验医学与临床》2021年第12期1728-1732,1735,共6页Laboratory Medicine and Clinic

摘　　要：目的了解该地区2018年1月至2019年12月耐甲氧西林金黄色葡萄球菌(MRSA)的分子分型特点、耐药基因和毒力基因的携带特征,为后续MRSA分子分型研究提供科学依据。方法采用布鲁克质谱鉴定系统对临床分离的MRSA进行细菌鉴定并行药敏试验,使用PCR技术对MRSA的管家基因、耐药基因和毒力基因进行检测并进行分组分析。采用WHONET5.0等软件对MRSA的临床分布等临床特点和药敏结果等进行统计分析。结果2018年1月至2019年12月临床分离的MRSA菌株共124株,其中来自于创面等分泌物标本50株,痰液、灌洗液标本27株,尿液等标本31株,胸腔积液等无菌体液标本7株,血液标本等9株。124株MRSA进行药敏结果分析,发现对青霉素G、苯唑西林、红霉素、克林霉素和四环素的耐药率均较高,对喹诺酮类抗菌药物的耐药性亦处在较高水平,但是对利奈唑胺、万古霉素、替考拉宁和奎奴普丁/达托霉素均100%敏感,有1株对呋喃妥因耐药。结论MRSA菌株对多种抗菌药物具有较高的耐药性,应加强MRSA预防观念的强化培训和监督院内感染措施的执行,以减少院内MRSA感染的发生。Objective To study the molecular typing characteristics of methicillin-resistant Staphylococcus aureus(MRSA)in this region from January 2018 to December 2019,and the carrying characteristics of drug resistance genes and virulence genes,so as to provide scientific basis for subsequent molecular typing studies of MRSA.Methods The mass spectrometry identification system of Bruker was used to identify clinically isolated MRSA and drug susceptibility tests were executed.The housekeeping genes,drug resistance genes and virulence genes of MRSA were detected using PCR and group analysis was performed.Statistical analysis was performed using WHONET5.0 on the clinical characteristics and drug sensitivity results.Results A total of 124 strains of MRSA were clinically isolated from January 2018 to December 2019,including 50 strains from wound and other secretions,27 strains from sputum and lavage fluid,31 strains from urine,7 strains from pleural effusion and other sterile body fluids,9 strains from blood.124 strains of MRSA were found to have high resistance rates to penicillin G,oxacillin,erythromycin,clindamycin and tetracycline,and high resistance to quinolones,but were 100%sensitive to linezolid,vancomycin,teicolanin and quinupristin/daptomycin,and 1 strain was resistant to furantoin.Conclusion MRSA strains have high resistance to a variety of antimicrobial agents.It is necessary to strengthen the training of prevention concept of MRSA and supervise the implementation of nosocomial infection control measures,so as to reduce the incidence of nosocomial MRSA infection.

关 键 词：耐甲氧西林金黄色葡萄球菌 耐药 多位点序列分型 毒力基因 

分 类 号：R378.11[医药卫生—病原生物学]