扬州地区克林霉素耐药金黄色葡萄球菌遗传进化特征  

Genetic and evolutionary characteristics of clindamycin-resistant Staphylococcus aureus in Yangzhou

作　　者：徐娅雯 黄瑶 王艳 周乐 XU Yawen;HUANG Yao;WANG Yan;ZHOU Le(Yangzhou Center for Disease Control and Prevention,Jiangsu,Yangzhou 225011)

机构地区：[1]江苏省扬州市疾病预防控制中心,江苏扬州225000

出　　处：《公共卫生与预防医学》2023年第3期56-60,共5页Journal of Public Health and Preventive Medicine

基　　金：新冠疫情下重症流感流行特征及生物标志物的研究(YZ2020122);扬州地区COVID-19等呼吸道疾病监测预警系统(R2002);新型冠状病毒3D数字PCR检测方法的建立及抗体消长规律的研究(YZ2020121)。

摘　　要：目的揭示扬州地区2016—2020年克林霉素耐药金黄色葡萄球菌临床分离株的耐药表型、耐药基因及分子特征。方法设立哨点医院,收集5年内临床分离经鉴定包括克林霉素固有耐药和诱导耐药的金黄色葡萄球菌,检测对临床常用抗生素的耐药情况。通过SNP分析及MLST分型的方法对菌株进行分子分型,同时检测mecA、erm等耐药基因的携带率。结果研究共收集到71株克林霉素耐药的金黄色葡萄球菌,其中42株(59.15%)为固有耐药,29株(40.85%)为诱导性耐药;其中44株(61.97%)为耐甲氧西林金黄色葡萄球菌(MRSA)。71株中发现了18个ST型,其中ST59菌株的mecA和ermB检出率均高于其他ST型;成簇菌株中,CC59均为固有耐药。结论扬州地区临床分离的金黄色葡萄球菌耐药情况严峻,克林霉素耐药的CC59克隆群携带有较多耐药基因,并且均为耐甲氧西林金黄色葡萄球菌。研究为临床选择合适的药物与开展克林霉素耐药株流行趋势研究提供可靠数据。Objective To investigate the drug resistance phenotype,drug resistance genes and molecular characteristics of clinical isolates of Staphylococcus aureus in Yangzhou from 2016 to 2020.Methods A total of 71 strains of clindamycin resistant Staphylococcus aureus were collected.Molecular typing of the strains was performed using multilocus sequence typing(MLST)and SNP.Antimicrobial minimal inhibitory concentrations were detected by the method of microdilution broth.Different resistance genes were detected.Results A total of 71 strains of clindamycin resistant Staphylococcus aureus were collected in this study,of which 42 strains(59.15%)were inherently resistant and 29 strains(40.85%)were induced resistant;44 strains(61.97%)were found to be methicillin resistant Staphylococcus aureus(MRSA).Among the 71 strains,18 ST types were found,and the detection rates of mecA and ermB in ST59 strain were higher than those in other ST types.Among the clustered strains,CC59 was inherently resistant.Conclusion The clinically isolated Staphylococcus aureus in Yangzhou has severe drug resistance,especially the resistance to clindamycin.CC59 clone group carries many drug resistance genes,and all of them are MRSA.This study provides reliable data for clinical selection of appropriate drugs and further investigation of the prevalence of clindamycin-resistant strains.

关 键 词：金黄色葡萄球菌 克林霉素耐药 分子分型 

分 类 号：R181[医药卫生—流行病学]