澳门特别行政区医院耐甲氧西林金黄色葡萄球菌SCCmec基因分型及相关基因检测  

Genotypes of SCCmec and related genes in methicillin-resistant Staphylococcus aureus in a hospital of Macao Special Administrative Region

作　　者：叶千红[1] 吴许文[2] 李沛樟 倪金良[2] YE Qian-hong;WU Xu-wen;LI Pei-zhang;NI Jin-liang(School of Health Sciences and Sports,Macao Polytechnic Institute,Macao Special Administrative Region 999078,China;不详)

机构地区：[1]澳门理工学院健康科学及体育高等学校 [2]澳门镜湖医院检验科,澳门特别行政区999078

出　　处：《中华医院感染学杂志》2021年第22期3366-3370,共5页Chinese Journal of Nosocomiology

基　　金：澳门理工学院研究基金资助项目(RP/ESS-05/2017)。

摘　　要：目的了解澳门耐甲氧西林金黄色葡萄球菌(MRSA)的耐药及金黄色葡萄球菌盒式染色体(SCCmec)分型情况,并对其进行mecA、杀白细胞素(PVL)基因检测。方法收集2017年9月-2018年4月澳门镜湖医院临床样品中分离的金黄色葡萄球菌非重复株,共173株;Vitek-2检测其对16种常用抗菌药物敏感性;头孢西丁纸片法确定MRSA表型;聚合酶链反应(PCR)检测mecA、PVL及SCCmec基因Ⅰ~Ⅴ型。结果 173株金黄色葡萄球菌MRSA表型阳性51株占比29.48%,其中49株携带mecA基因、20株携带PVL基因,年龄≥55岁组MRSA感染率高(P<0.05);51株MRSA对16种药物的药敏结果,对奎奴普丁、利奈唑胺、万古霉素、替加环素、呋喃妥因全部敏感,庆大霉素、环丙沙星、左氧氟沙星、莫西沙星、红霉素、克林霉素、四环素、利福平的敏感率为27.5%~98%;不同SCCmec型MRSA之间耐药比较,无统计学差异;51株MRSA以SCCmecⅣ型22株为主,其次为SCCmecⅡ型11株、SCCmecⅤ型9株、SCCmecⅢ型6株、3株MRSA未能分型。结论澳门金黄色葡萄球菌MRSA及PVL基因检出率比2016年有所下降,SCCmecⅣ型是澳门主要流行型,SCCmec分型与MRSA耐药无关,PVL基因与MRSA耐药及SCCmec分型无关。OBJECTIVE To understand the drug resistance of methicillin-resistant S.aureus(MRSA) and genotypes of Staphylococcus aureus cassette chromosome(SCCmec) so as to detect the genes of mecA and leukocidin. METHODS A total of 173 non-repetitive strains of S.aureus isolated from clinical samples were collected from a comprehensive Kiang Wu Hospital in Macao between Sep 2017 and Apr 2018. The drug susceptibility testing was performed for 16 types of commonly used antibiotics by Vitek-2, the phenotypes of MRSA were determined by using Cefoxitin disk method, and mecA,PVL and SCCmec geneⅠ-Ⅴ genotypes were detected by means of polymerase chain reaction(PCR). RESULTS Among 173 strains of S.aureus, 51 were tested positive for MRSA phenotypes, accounting for 29.48%, 49 of which carried with mecA gene, and 20 carried with PVL gene. The incidence of MRSA infection was significantly higher among the patients aged no less than 55 years old(P<0.05). The result of drug susceptibility testing of 51 MRSA strains for 16 types of antibiotics showed that all of the strains were sensitive to quinupristin, linezolid, vancomycin and tigecycline, and the drug susceptibility rates to gentamicin, ciprofloxacin, levofloxacin, moxifloxacin, erythromycin, clindamycin, tetracycline and rifampicin ranged between 27.5% and 98%;there was no significant difference in the drug resistance among the MRSA strains with different SCCmec genotypes. 22 strains of SCCmecⅣ genotype were dominant among the 51 strains of MRSA, followed by 11 strains of SCCmecⅡ genotype, 9 strains of SCCmecⅤ genotype, 6 strains of SCCmecⅢ genotype and 3 strains of MRSA with unknown genotype. CONCLUSION The detection rates of MRSA and PVL gene are declined in Macao as compared with those in 2016, the SCCmecⅣ genotype is prevalent in Macao, the genotyping of SCCmec is not associated with the drug resistance in the MRSA strains, and the PVL gene is not associated with the drug resistance in MRSA or the genotyping of SCCmec.

关 键 词：耐甲氧西林金黄色葡萄球菌 金黄色葡萄球菌盒式染色体 MECA 杀白细胞素 澳门 

分 类 号：R378.1[医药卫生—病原生物学]