95例住院患儿耐甲氧西林金黄色葡萄球菌分离株的分子流行病学特征及药物敏感性  

Molecular epidemic characteristics and antibiotic suscepti-bilities of the isolates in methicillin-resistant Staphylococcus aureus from 95 hospitalized children

作　　者：陈虹宇[1] 祖莹[2] 罗庆礼 罗小娟[1] 王丹[4] 李德发[5] Chen Hongyu;Zu Ying;Luo Qingli;Luo Xiaojuan;Wang Dan;Li Defa(Department of Laboratory,Shenzhen Children’s Hospital,Shenzhen 518026,Guangdong,China;Office of Ethics Committee,Shenzhen 518026,Guangdong,China;Anhui Provincial Laboratory of Pathogen Biology,Anhui Provincial Key Laboratory of Zoonoses,Hefei 230032,Anhui,China;Office of Party Affairs Committee,Shenzhen Children’s Hospital,Shenzhen 518026,Guangdong,China;Hospital Administration Office,Shenzhen Children’s Hospital,Shenzhen 518026,Guangdong,China)

机构地区：[1]广东省深圳市儿童医院检验科,广东深圳518026 [2]广东省深圳市儿童医院伦理委员会办公室,广东深圳518026 [3]安徽病原生物学省级实验室和人兽共患病安徽省重点实验室,安徽合肥230032 [4]广东省深圳市儿童医院党办,广东深圳518026 [5]广东省深圳市儿童医院院办,广东深圳518026

出　　处：《右江民族医学院学报》2021年第4期497-502,共6页Journal of Youjiang Medical University for Nationalities

摘　　要：目的研究深圳地区住院患儿耐甲氧西林金黄色葡萄球菌(MRSA)分离株的分子分型及对非β内酰胺类抗菌药物的耐药情况,为临床合理用药提供依据。方法常规方法分离培养获得金黄色葡萄球菌327株,经鉴定,MRSA 95株;利用分子生物学方法对95株MRSA进行了SCCmec分型、多位点序列分析(MLST)和spa分型,利用仪器法分析其对非β类酰胺类抗菌药物的耐受情况。结果95株MRSA共有7种SCCmec基因型,其中SCCmecⅠ型1株,SCCmecⅡ型4株,SCCmecⅢ型17株,SCCmecⅣa型65株,SCCmecⅣb型2株,SCCmecⅣd型4株,SCCmecⅤ型2株。MLST为10种ST型,其中46株为ST59型,占48.42%;另外49株MRSA分别是ST45型13株,占13.68%;ST1型和ST338型各12株,分别占12.63%;ST72型和ST398型各3株,分别占3.16%;ST88型2株,占2.11%;ST25型、ST47型和ST630型各1株,分别占1.05%;还有1株未能分型;eBURSTv3软件分析表明,10种ST型属于6个克隆群,其中CC59约占61.05%(58/95),CC5约占16.84%(16/95),CC45约占14.74%(14/95)。21种spa型,其中t437型51株(53.68%),是最主要的spa型,其次为t114型9株、t116型8株,分别占9.47%和8.42%;ST59-SCCmecⅣa-t437共有33株,约占34.74%,是最主要的流行克隆;其次是ST45-SCCmecⅣa-t116共有7株,约占7.36%。未发现对环丙沙星、庆大霉素、左氧氟沙星、利奈唑胺、莫西沙星、呋喃妥因、奎奴普汀、替加环素和万古霉素耐药菌株;对克林霉素(82.10%)、红霉素(82.10%)、利福平(15.78%)、四环素(41.05%)和复方磺胺甲噁唑(3.15%)等抗菌药物分别有不同程度的耐药。结论深圳地区儿童感染MRSA的优势菌株为ST59-SCCmecⅣa-t437型;MRSA菌株对β内酰胺类、林可霉素类、大环内酯类和四环素类呈多重耐药的比例高;未发现对万古霉素、利奈唑胺等耐药菌株。Objective To explore the molecular types and the resistance of MRSA(methicillin-resistant Staphylococcus aureus)to non-β-lactam antibiotics.These MRSAs were isolated from hospitalized children in Shenzhen area.And this study aims to provide a basis for rational use of antibiotics in clinical practice.Methods 327 SA(Staphylococcus aureus)isolates were collected after being cultured by routine method.Among them,95 isolates were identified as MRSA.By molecular biological methods,these MRSAs were treated with staphyloccoccal cassette chromosome mec(SCCmec)typing,multi-locus sequence analysis(MLST)and staphylococcus protein A(spa)typing.And their tolerance to non-βlactam antibiotics was analyzed by the instrumental method.Results There were 7 kinds of SCCmec genotypes in 95 strains of MRSA,including 1strain of SCCmecⅠ,4 strains of SCCmecⅡ,17 strains of SCCmecⅢ,65 strains of SCCmecⅣa,2 strains of SCCmecⅣb,4 strains of SCCmecⅣd and 2 strains of SCCmecⅤ.The results of MLST showed that there were 10 ST types,among which 46 strains were ST59,accounting for 48.42%.Among the other 49 strains of MRSA,there were 13 strains of ST45(13.68%),12 strains of ST1 and 12 strains of ST338(each accouting for 12.63%),3 strains of ST72 and 3 strains of ST398(each 3.16%),2 strains of ST88(2.11%),1 strain of ST25,1 strain of ST47 and 1 strain of ST630(each 1.05%).And there was one strain that could not be typed.The results of eBURSTv3 analysis showed that 10 ST types belonged to six clonal complexes,among which CC59 accounted for 61.05%(58/95),CC5 accounted for 16.84%(16/95),and CC45 accounted for 14.74%(14/95).Among 21 spa types,there were 51 strains of t437(53.68%)which were the main spa type,followed by 9 strains of t114 and 8 strains of t116,accounting for 9.47%and 8.42%respectively.There were 33 strains of ST59-SCCmec IV a-t437,accounting for 34.74%,which was the most prevalent clone,followed by 7 strains of ST45-SCCMmec IV a-t116,accounting for about 7.36%.No strains were found to be resistant to ciprofloxacin,gentamic

关 键 词：耐甲氧西林金黄色葡萄球菌 葡萄球菌盒式染色体mec分型 多位点序列分析 葡萄球菌A蛋白分型 抗药物敏感性 

分 类 号：R378.1[医药卫生—病原生物学]