从业人员金黄色葡萄球菌分离株耐药表型和分子分型研究  

Antibiotic resistance spectrum and molecular typing ofStaphylococcus aureusisolated from catering employees

作　　者：诸葛石养[1] 马海芳[1] 苏爱荣[1] 蓝兰[1] 曾献莹[1] 瞿聪 ZHUGE Shi-yang;MA Hai-fang;SU Ai-rong;LAN Lan;ZENG Xian-ying;QU Cong(Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Guangxi 530028,China)

机构地区：[1]广西壮族自治区疾病预防控制中心,广西南宁530028

出　　处：《现代预防医学》2021年第15期2846-2849,2880,共5页Modern Preventive Medicine

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2020009);广西卫生健康委员会自筹经费课题(Z20190119)。

摘　　要：目的了解从业人员金黄色葡萄球菌分离株耐药表型和分子分型特征,为预防和控制金黄色葡萄球菌耐药性的产生及临床用药提供科学依据。方法对2015年1月至2016年12月从广西餐饮从业人员鼻前庭分离的98株金黄色葡萄球菌进行多位点序列分型(multilocus sequence typing,MLST)和耐药基因分析,并检测其对临床常用抗生素的耐药性。结果98株金黄色葡萄球菌中36株(36.73%)为耐甲氧西林金黄色葡萄球菌(methicillin resistant Staphylococcus aureus,MRSA),62株为甲氧西林敏感金黄色葡萄球菌(methicillin sensitive Staphylococcus aureus,MSSA)。MRSA分为8种ST型,优势流行克隆为ST239(41.67%),MSSA分为15种ST型,主要型别为ST188(25.81%)。MRSA对青霉素和头孢西丁全部耐药,对红霉素(86.11%)、氯霉素(80.56%)的耐药率较高,5重以上耐药菌株占比为63.89%。所有MRSA菌株均检测出耐药基因Bla(Z),Aac(6’)/aph(2’’)(83.33%)和Erm(A)(80.56%)耐药基因检出率也较高;72.58%的MSSA菌株检出BlaZ,MSSA菌株中Aac(6’)/aph(2’’)耐药基因检出率为69.35%,MRSA中Tet(M)和Erm(A)耐药基因检出率明显高于MSSA。结论从业人员鼻前庭分离的MRSA对临床常用抗生素存在高耐药率,MRSA的耐药率明显高于MSSA,MSSA的ST型别表现出较高遗传多样性。临床上应当合理调整抗菌药物使用,减少耐药性菌株的产生。Objective To investigate the antibiotic resistance spectrum and molecular typing of Staphylococcus aureus isolated fromcatering employees,and to provide a scientific basis for the prevention and control of Staphylococcus aureus resistance and the selection of clinical drugs.Methods 98 strains of Staphylococcus aureus isolated from catering employees in Guangxi from January 2015 to December 2016 were collected.Antimicrobial susceptibility of all isolates was evaluated using the Kirbye-Bauer disk diffusion.The Staphylococcus aureus were performed via multilocus sequence typing(MLST)anddrug resistance gene analysis.Results MRSA accounted for 36.73%among all samples.MLST revealed that ST239 was the predominant ST of MRSA which was divided into 8 types.ST188 was the major ST of MSSA which was divided into 15 types.The predominant resistant antibiotics of MRSA isolates were penicillin(100%),Cefoxitin(100%),erythromycin(86.11%),and tetracycline(80.56%).Notably,63.89%MRSA were resistant to more than five antimicrobial categories.The predominant detection rates of resistant genes were BlaZ(94.74%),Aac(6’)/aph(2’’)(83.33%)and Erm(A)(80.56%)in MRSA,and there were BlaZ(72.58%)and Aac(6’)/aph(2’’)(69.35%)in MSSA.The detection rate of Tet(M)and Erm(A)in MRSA were significantly higher than that in MSSA.Conclusion MRSA has a high resistant rate to multiple antibiotics.The drug resistance rate of MRSA was significantly higher than that of MSSA,and the ST type of MSSA showed high genetic diversity.Therefore,clinical application should be reasonably adjusted to reduce the production of drug-resistant strains.

关 键 词：从业人员 药敏实验 金黄色葡萄球菌 分子分型 

分 类 号：R117[医药卫生—公共卫生与预防医学]