纹带棒状杆菌耐药性及院内传播特征分析  

Analysis of drug resistance and nosocomial transmission characteristics of Corynebacterium striatum

作　　者：徐帅[1] 王雪冰 周海健[1] 崔尧 马小涵 娄静[1] 李丹 李振军[1] 陈东科[2] XU Shuai;WANG Xuebing;ZHOU Haijian;CUI Yao;MA Xiaohan;LOU Jing;LI Dan;LI Zhenjun;CHEN Dongke(State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206;Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China)

机构地区：[1]中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室,北京102206 [2]北京医院检验科国家老年医学中心中国医学科学院老年医学研究院,北京100730

出　　处：《临床检验杂志》2021年第11期817-821,共5页Chinese Journal of Clinical Laboratory Science

基　　金：生物安全重点专项课题(2019YFC1200601,2019YFC1200700);国家自然科学基金(82073624)。

摘　　要：目的揭示纹带棒状杆菌临床分离株耐药性及分子分型特征,为制定纹带棒状杆菌感染防治措施提供依据。方法收集从临床标本中分离的124株纹带棒状杆菌,经基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)和16S rRNA鉴定后,采用微量肉汤稀释法进行体外药敏试验,并分析交叉耐药情况;采用脉冲场凝胶电泳进行分子分型,并进行聚类分析。结果所有菌株均对环丙沙星耐药,96.0%的菌株为多重耐药菌株。124株纹带棒状杆菌可分为28个耐药谱,其中,美罗培南-克林霉素-四环素-头孢噻肟-环丙沙星-红霉素-青霉素为主要的耐药表型(37.9%,47/124)。克林霉素与红霉素、头孢噻肟与青霉素、美罗培南与青霉素之间存在交叉耐药。124株纹带棒状杆菌共分为44个型别,其中优势型别为CSS01.CN0058、CSS01.CN0022、CSS01.CN0055、CSS01.CN0015,具有相同或相似的耐药谱。结论纹带棒状杆菌已逐渐发展为院内感染常见病原菌,在院内传播过程中具有4个优势型别,耐药严重,传播能力强,应加强纹带棒状杆菌的系统监测。Objective To investigate the characteristics of drug resistance and molecular typing for clinical isolates of Corynebacterium striatum,and provide a basis for formulating the prevention and treatment measures of Corynebacterium striatum infection.Methods A total of 124 strains of Corynebacterium striatum isolated from clinical specimens were collected.All isolates were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry(MALDI-TOF MS)and 16S rRNA gene sequencing.The microdilution broth method was used for detecting the drug susceptibility of Corynebacterium striatum in vitro,and cross resistance was analyzed.The molecular typing of Corynebacterium striatum was carried out by pulsed field gel electrophoresis(PFGE),and clustering analysis was performed.Results All the strains were resistant to ciprofloxacin,and 96.0%of them were multidrug-resistant strains.The 124 strains of Corynebacterium striatum could be divided into 28 resistance spectra.Among them,meropenem-clindamycin-tetracycline-cefotaxime-ciprofloxacin-erythromycin-penicillin was the main drug resistance phenotype(37.9%,47/124).There were cross resistances between clindamycin and erythromycin,cefotaxime and penicillin,and between meropenem and penicillin.The 124 strains of Corynebacterium striatum were divided into 44 types.Among them,dominant types included CSS01.CN0058,CSS01.CN0022,CSS01.CN0055 and CSS01.CN0015,which had same or similar resistance spectrum.Conclusion Corynebacterium striatum has gradually developed into a common pathogen of nosocomial infection,with serious drug resistance and strong transmission ability.It has four dominant types in the process of nosocomial transmission.Therefore,systematic monitoring of Corynebacterium striatum should be strengthened.

关 键 词：纹带棒状杆菌 药物敏感性 交叉耐药 分子分型 院内感染 

分 类 号：R446.5[医药卫生—诊断学] R978.1[医药卫生—临床医学]