摘要
目的调查了解我院临床分离的124株金黄色葡萄球菌的耐药谱特征及PVL基因携带状况,为临床合理使用抗菌药物提供科学依据。方法采用Vitek2 Compact全自动微生物鉴定仪进行菌株鉴定及药物敏感试验,PCR法检测mec A基因、mec C基因和PVL基因。结果耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为56.45%(70/124),MRSA主要分离自烧伤病区,其次是神经外科ICU。MRSA菌株对青霉素G均耐药;对左氧氟沙星、庆大霉素、红霉素、四环素、复方新诺明和利福平的耐药率分别为57.1%、67.1%、85.7%、80.07%、28.6%、37.1%;MRSA对多种常用抗菌药物的耐药率普遍高于甲氧西林敏感金黄色葡萄球菌(MSSA),差异有统计学意义(P<0.05);MRSA和MSSA对呋喃妥因、喹奴普汀/达福普汀、利奈唑胺的耐药率分别为2.9%、11.4%、2.9%;0.0%、5.6%、5.6%,差异无统计学意义(P>0.05)。检出6株PVL阳性,其中MRSA和MSSA各占3株。结论我院分离的金黄色葡萄球菌对抗菌药物呈多重耐药性,MRSA菌株耐药率明显高于MSSA,应加强对MRSA的监测,指导临床合理使用抗菌药物,加强对呋喃妥因、喹奴普汀/达福普汀、利奈唑胺耐药菌株的检测及PVL基因的检测,防止此类菌株的播散。
Objective To investigate the drug-resistance and carriage of Panton-Valentine leukocidin （PVL） gene of 124 Staphylococcus aureus isolated from the hospitalized patients to guide the clinical treatment. Methods 124 Staphylococcus aureus isolates were tested by Vitek 2 Compact automatic microorganism identifying, and the drug sensitivity tests were also performed by it. MecA gene、mecC gene and PVL gene were detected by PCR. Results Methicillin-resistant Staphylococcus aureus （MRSA） ac-counted for 56.45%（70/124）, which mainly came from Burns ward and secondly came from Neurosurgery Intensive Care Unit （NICU）. All MRSA strains were resistant to penicillin G, and the resistance rates of levofloxacin, gentamicin, erythromycin, tetracy-cline, SMZ-TMP and rifampicin were 57.1%, 67.1%, 85.7%, 80.07%, 28.6% and 37.1%, repectively. For many drug resistances, there was statistical difference between MRSA and methicillin susceptible Staphylococcus aureus （MSSA）（P〈0.05）. The drug resis-tance rates of MRSA were 2.9%, 11.4%, 2.9%in Nitrofurantoin, Quinupristin-Dalfoprisdn and Linezolid, 0.0%, 5.6%, 5.6%refer-ring to MSSA. 6 of 124 Staphylococcus aureus carried PVL genes. Conclusions The Staphylococcus aureus strains from our hos-pital were multi-drug resistant for antibiotics, and the drug resistance rate of the MRSA strains was higher than the MSSA strains. The surveillance of MRSA should be strengthened to guide clinical medicine, the same with the surveillance of Nitrofurantoin, Quinupristin-Dalfoprisdn and Linezolid resistant Staphylococcus aureus and PVL genes.
出处
《实验与检验医学》
CAS
2014年第6期677-679,682,共4页
Experimental and Laboratory Medicine
基金
江西省教育厅青年科学基金项目编号:GJJ14178
