马鞍山市临床来源金黄色葡萄球菌的耐药性和肠毒素基因特征分析  

Analysis of drug resistance and enterotoxin gene characteristics of Staphylococcus aureus from clinic in Ma′anshan city

作　　者：王芳 刘晓 任小东 汪永禄 晏世园 胡金桓 武倩 郑娟 王多春[2] WANG Fang;LIU Xiao;REN Xiaodong;WANG Yonglu;YAN Shiyuan;HU Jinhuan;WU Qian;ZHENG Juan;WANG Duochun(Ma′anshan Clinical Laboratory Center,Ma′anshan,Anhui 243000,China;National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China;Ma′anshan Center for Disease Control and Prevention,Ma′anshan,Anhui 243000,China)

机构地区：[1]安徽省马鞍山市临床检验中心,安徽马鞍山243000 [2]中国疾病预防控制中心传染病预防控制所,北京102206 [3]兰州大学公共卫生学院,甘肃兰州730000 [4]安徽省马鞍山市疾病预防控制中心,安徽马鞍山243000

出　　处：《检验医学与临床》2024年第24期3631-3636,共6页Laboratory Medicine and Clinic

基　　金：国家科技基础资源调查专项(2021FY100900)。

摘　　要：目的分析马鞍山市临床检验中心临床培养分离的金黄色葡萄球菌的标本来源、耐药性及毒力基因的特征。方法以马鞍山市临床检验中心2022年收集的98株金黄色葡萄球菌作为研究对象,使用VITEK 2 Compact全自动微生物鉴定药敏分析仪检测耐药表型;使用聚合酶链反应扩增法检测肠毒素基因,对13株多药耐药菌株进行全基因组测序并分析耐药相关基因。结果98株金黄色葡萄球菌主要来源于分泌物标本(40.82%),其次是痰液(36.73%)、脓液(6株,6.12%)和血液(6株,6.12%)。药敏试验结果表明,金黄色葡萄球菌对青霉素的耐药率最高(98.97%),其次是红霉素(53.06%)和克林霉素(46.94%),而对庆大霉素、复方磺胺甲噁唑、环丙沙星、左氧氟沙星和莫西沙星的耐药率相对较低,对喹努普汀/达福普汀、利福平、利奈唑胺、万古霉素表现出完全敏感。29株金黄色葡萄球菌为耐甲氧西林金黄色葡萄球菌(MRSA),占总分离株数的29.59%。肠毒素基因分布显示,SEA基因最为常见(95.92%),其次是SEC(71.43%)和SEF(31.63%),SEE(5.10%)检出率较低。13株多药耐药金黄色葡萄球菌基因组的耐药基因预测,共发现了26个耐药基因,可以分为11个大类。所有菌株均含有氟喹诺酮类、氨基嘧啶类、消毒剂和防腐剂类、四环素类抗菌药物耐药基因及多药耐药基因。结论该中心分离的98株金黄色葡萄球菌表现出明显的耐药性,以SEA、SEC和SEF肠毒素基因为主。全基因组测序分析进一步揭示了其耐药和致病力背后的复杂机制,为制订有效的预防和治疗策略提供了依据。Objective To analyze the sample sources,drug resistance and virulence gene characteristics of strains of Staphylococcus aureus isolated from clinical culture of Ma′anshan Clinical Laboratory Center.Methods A total of 98 strains of Staphylococcus aureus samples collected in Ma′anshan Clinical Laboratory Center in 2022 were used as the research subjects,and the antibiotic resistance phenotype was detected using VITEK 2 Compact fully automated microbial identification drug sensitivity analyzer.Polymerase chain reaction amplification method was used to detect enterotoxin genes,genome sequencing was performed on 13 multidrug-resistant strains,and resistance related genes were analyzed.Results A total of 98 strains of Staphylococcus aureus were mainly derived from secretion specimens(40.82%),followed by sputum(36.73%),pus(6 strains,6.12%)and blood(6 strains,6.12%).The drug sensitivity test results showed that the Staphylococcus aureus had the highest resistance rate to penicillin(98.97%),followed by erythromycin(53.06%)and clindamycin(46.94%),while the resistance rates to gentamicin,compound sulfamethoxazole,ciprofloxacin,levofloxacin and moxifloxacin were relatively low,showing complete sensitivity to quinoputin/dapoxetine,linezolid,vancomycin and rifampicin.A total of 29 strains Staphylococcus aureus belong to methicillin-resistant Staphylococcus aureus(MRSA),accounting for 29.59%.The distribution of enterotoxin genes showed that SEA gene was the most common(95.92%),followed by SEC(71.43%)and SEF(31.63%),while SEE(5.10%)had a lower detection rate.Prediction of resistance genes in the genomes of 13 multidrug-resistant Staphylococcus aureus strains revealed a total of 26 resistance genes,which could be classified into 11 major categories.All strains contain resistance genes for fluoroquinolones,aminopyrimidines,disinfectants and preservatives,tetracycline antibiotics,multidrug resistance gene.Conclusion The 98 strains Staphylococcus aureus isolated from the center demonstrated significant resistance,primarily chara

关 键 词：金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 肠毒素基因 耐药性 全基因组测序 耐药基因 临床分布 

分 类 号：R446.5[医药卫生—诊断学]