天津医药

• 论著 •    

79株临床分离MRSA的SCCmec基因分型及耐药性分析

马艳红1,吕星2,祁伟3,田彬4,王哲4,郭文学5,王俊6   

  1. 1. 天津医科大学第二医院
    2. 天津医科大学总医院
    3. 天津医大二院感染性疾病研究所
    4.
    5. 天津医科大学第二医院 天津市感染性疾病研究所
    6. 天津医科大学第二医院感染性疾病研究所
  • 收稿日期:2009-12-10 修回日期:2010-02-26 出版日期:2010-06-15 发布日期:2010-06-15
  • 通讯作者: 马艳红

Study on antimicrobial resistance and Staphylococcal cassette chromosome mec genotype of 79 methicilin-resistant Staphylococcus aureus

  • Received:2009-12-10 Revised:2010-02-26 Published:2010-06-15 Online:2010-06-15

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摘要： 摘要 目的：了解天津某医院临床分离耐甲氧西林金黄色葡萄球菌（MRSA）耐药状况及葡萄球菌盒染色体mec(SCCmec）类型。方法：应用聚合酶链式反应（PCR）技术检测mecA基因，多重PCR方法对MRSA进行SCCmec基因分型。应用微量肉汤法及K-B纸片扩散法测试MRSA对青霉素、苯唑西林、氨苄西林、环丙沙星、莫西沙星、头孢唑林、氯霉素、林可霉素、庆大霉素、头孢曲松、红霉素、利福平、四环素、万古霉素、替考拉宁、复方磺胺甲恶唑、利奈唑胺、替加环素18种抗生素药物敏感性。大环内酯、林可霉素、链阳霉素B类抗生素诱导耐药的检测采用克林霉素-红霉素双纸片诱导试验（D试验）。结果:SCCmec分型显示79株受试MRSA均为SCCmecⅢ型菌株。79株MRSA临床株对包括苯唑西林在内的多种抗生素耐药，对氯霉素、复方磺胺甲恶唑耐药率相对较低，分别为3.80%、10.13%，对糖肽类抗生素和利奈唑胺、替加环素均敏感。7株红霉素耐药、林克霉素敏感MRSA D试验阳性。结论：天津某医院临床分离MRSA SCCmec基因型均为Ⅲ型，且具有多重耐药的特征，红霉素耐药、林可霉素敏感株存在诱导耐药现象。

关键词: 金黄色葡萄球菌, 甲氧西林, 耐药性, 葡萄球菌盒染色体mec, 聚合酶链反应

Abstract: Abstract Objective: To investigate antimicrobial resistance and Staphylococcal cassette chromosome mec(SCCmec) genotype characteristics of methicillin-resistant Staphylococcus aureus(MRSA) isolated from one teaching hospital, TianJin. Methods: mecA gene was detected by PCR, SCCmec genotype by multiplex PCR. Antimicrobial susceptibility of penicillin, oxacillin, ampicillin, ciprofloxacin, moxifloxacin, cefazolin, chloramphenicol, lincomycin, gentamycin, ceftriaxone, erythromycin, Rifampicin, tetracycline, vancomycin, teicoplanin, sulfamethoxazole complex, linezolid, tigecycline was detected by microdilution broth method or Kirby-Bauer method. Inducible macrolide-lincosamide- streptogramin B(MLSB) resistance was identified as a D-shaped inhibition zone by the clindamycin-erythromycin double-disk test. Results: All of the 79 MRSA harboured SCCmec type Ⅲ. They had high resistant rate to vary kind of antibiotics, but the resistant rate to chloramphenicol and sulfamethoxazole-trimethoprim were relatively lower (3.80%、10.13%). All of the testing strains were susceptible to glycopeptide antibiotics, linezolid, Tige- cycline.7 strains are D-zone test positive. Conclusion: MRSA isolated from clinic source had multiple resistance to commonly used antibiotics. All of the isolates contained SCCmec type Ⅲ. Inducible MLSB resistance was found in erythromycin-resistant, lincomycin-sensitive strains.

Key words: staphylococcus aureus, methicillin, drug resistance, Staphylococcal cassette chromosome mec, polymerase chain reaction