摘要
目的了解杀白细胞素(PVL)基因阳性耐甲氧西林金黄色葡萄球菌(MRSA)的耐药情况,指导临床合理用药。方法对临床收集的47株PVL基因阳性MRSA采用PCR法检测PVL基因,采用纸片扩散法进行药敏试验,并对结果进行分析。结果 47株MRSA的PVL基因检出率为46.8%,PVL基因阳性、阴性MRSA对β-内酰胺类抗菌剂均100.0%耐药,PVL基因阳性MRSA对氨基糖苷类、利福平、四环素、红霉素、环丙沙星、亚胺硫霉素等抗菌剂全部耐药,对盐酸克林霉素的耐药率为95.5%;PVL基因阴性MRSA对上述抗菌剂的耐药性虽比PVL基因阳性MRSA轻,但耐药率也在88.0%以上,2组间耐药性比较,差异有统计学意义(P<0.05)。对复方新诺明敏感率在90.0%以上,未发现对万古霉素耐药株。结论 PVL基因阳性MRSA在临床检出率已较高,耐药性严重并呈多重耐药特征,增加了临床抗感染治疗的难度。
Objective To study the resistance of panton-valetine leukocidin（PVL） positive methicillin-resistant Staphylococcus aureus（MRSA） for improving clinical therapy.Methods 47 strains of MRSA were isolated from various clinical specimens.The susceptibility of the MRSA strains to 14 kinds of antibiotics was tested by agar diffusion method.PVL gene was detected by polymerase chain reaction.Results Among all 47 strains of MRSA,the positive rate of PVL gene was 46.8%.The resistant rate of all MRSA strains to β-lactamase antibiotics was up to 100.0%.The resistant rate to aminoglycosides,rifampicin,tetracycline,erythromycin,ciprofloxacin,imipenem of MRSA positive with PVL gene were all up to 100.0%,and to clindamycin was 95.5%.Although antibiotic resistance of MRSA negative with PVL gene was lighter than MRSA positive with PVL gene,the resistant rate also exceeded 88.0% and was not significantly different with MRSA positive with PVL gene.The resistant rate of MRSA to trimethoprim/sulfa exceeded 90.0%.No vancomycin resistant isolate was found.Conclusion The detection rate of PVL gene positive MRAS was relatively high and PVL gene positive MRSA strains might be seriously resistant to antibiotics with multidrug resistance,causing clinical treatment more difficult.
出处
《国际检验医学杂志》
CAS
2012年第1期23-24,26,共3页
International Journal of Laboratory Medicine
