合肥地区耐甲氧西林金黄色葡萄球菌SCCmec分型及耐药性分析  

SCCmec typing and drug resistance of methicillin-resistant Staphylococcus aureus in Hefei

作　　者：周银娣[1] 黄颖[2] 李婷婷[2] 张昌峰[3] 成组群 沈继录 李霞[5] 胡付品 ZHOU Yindi;HUANG Ying;LI Tingting;ZHANG Changfeng;CHENG Zuqun;SHEN Jilu;LI Xia;HU Fupin(Department of Laboratory Medicine,Hefei First People’s Hospital,Hefei 230001,Anhui,China;Department of Laboratory Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei 230002,Anhui,China;Department of Laboratory Medicine,The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230006,Anhui,China;Department of Laboratory Medicine,The Fourth Affiliated Hospital of Anhui Medical University,Hefei 230036,Anhui,China;Department of Laboratory Medicine,The Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230033,Anhui,China;Institute of Antibiotics,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]合肥市第一人民医院检验科,合肥230001 [2]安徽医科大学第一附属医院检验科,合肥230002 [3]安徽中医药大学第一附属医院检验科,合肥230006 [4]安徽医科大学第四附属医院检验科,合肥230036 [5]安徽中医药大学第二附属医院检验科,合肥230033 [6]复旦大学附属华山医院抗生素研究所,上海200040

出　　处：《海军军医大学学报》2023年第8期984-988,共5页Academic Journal of Naval Medical University

摘　　要：目的 研究合肥地区临床分离的耐甲氧西林金黄色葡萄球菌(MRSA)携带mec基因簇的葡萄球菌盒式染色体(SCCmec)分型及药物敏感性,了解合肥地区MRSA流行株的耐药表型和分型特征。方法 从5所教学医院随机选取2016年1月至2021年12月的264株非重复MRSA菌株,利用头孢西丁纸片扩散法筛选MRSA,采用PCR扩增mec A基因,采用多重PCR进行MRSA的SCCmec分型分析。采用WHONET 5.6软件分析不同SCCmec型别MRSA菌株对抗菌药物的敏感性。结果 264株MRSA菌株中,SCCmecⅡ型156株(59.1%),Ⅳa型92株(34.8%),Ⅲ型4株(1.5%),12株(4.5%)未分型。SCCmecⅡ型和Ⅳa型MRSA对达托霉素、替加环素、利奈唑胺和万古霉素的敏感率均为100.0%。SCCmecⅡ型MRSA对环丙沙星、左氧氟沙星、莫西沙星和庆大霉素的耐药率高于SCCmecⅣa型,差异均有统计学意义(P均<0.05)。不同分型的MRSA菌株对红霉素、克林霉素、四环素、复方磺胺甲唑和利福平的耐药率差异无统计学意义(P均>0.05)。结论 合肥地区MRSA菌株SCCmec分型以Ⅱ型和Ⅳa型为主,不同分型MRSA对某些抗菌药物的耐药性存在差异,动态监测这类细菌的分型和药物敏感性有一定临床意义。Objective To investigate the staphylococcal chromosome cassette mec(SCCmec)typing and drug susceptibility of methicillin-resistant Staphylococcus aureus(MRSA)clinically isolated in Hefei,so as to understand the drug resistance phenotypic and genotypic characteristics of MRSA epidemic strains in this region.Methods Totally 264 non-replicated MRSA strains were randomly selected from 5 teaching hospitals from Jan.2016 to Dec.2021.MRSA was screened by cefoxitin disk diffusion method,mecA gene was amplified by polymerase chain reaction(PCR),and SCCmec typing of MRSA was performed by multiplex PCR.Software WHONET 5.6 was used to analyze the antimicrobial susceptibility of MRSA strains of different SCCmec types.Results Among the 264 MRSA strains,156 strains(59.1%)were SCCmec typeⅡ,92 strains(34.8%)were typeⅣa,4 strains(1.5%)were typeⅢ,and 12 strains(4.5%)were untyped.The sensitivities of SCCmec typeⅡand typeⅣa MRSA to daptomycin,tigecycline,linezolid and vancomycin were all 100.0%.The resistance of SCCmec typeⅡMRSA to ciprofloxacin,levofloxacin,moxifloxacin and gentamicin was significantly higher than that of SCCmec typeⅣa MRSA(all P<0.05).There was no significant difference in the resistance of different types of MRSA strains to erythromycin,clindamycin,tetracycline,sulfamethoxazole,or rifampicin(all P>0.05).Conclusion The SCCmec typing of MRSA strains in Hefei is dominated by typesⅡandⅣa.There is some variation in the resistance of MRSA to certain antimicrobial drugs by genotype,and dynamic monitoring of the typing and drug susceptibility of this group of bacteria is of clinical interest.

关 键 词：耐甲氧西林金黄色葡萄球菌 SCCmec分型 药物敏感性 MECA 葡萄球菌盒式染色体 

分 类 号：R446.5[医药卫生—诊断学]