临床患者标本金黄色葡萄球菌肠毒素基因及耐药性的检测分析

Enterotoxin genes of Staphylococcus aureus of clinical specimens and drug resistance

目的了解临床标本分离的金黄色葡萄球菌的产肠毒素携带情况及耐药现状。方法应用mini-VIDAS仪器检测金黄色葡萄球菌肠毒素、PCR扩增肠毒素基因sea～see(sea、seb、sec、sed、see)、seg～sej(seg、she、sei、sej)和tsst基因,电泳检测扩增产物,耐甲氧西林金黄色葡萄球菌(MRSA)检测用检测头孢西丁方法,药敏试验采用琼脂稀释法进行。结果 55株金黄色葡萄球菌中40株携带肠毒素基因,占72.73%,主要为sea型14.55%(8/55)、sec型12.73%(7/55)、seb型9.10%(5/55),同时携带≥2种肠毒素的占9.09%(5/55);另外,19株耐甲氧西林金黄色葡萄球菌(MRSA)有17株(89.47%)携带肠毒素基因,以sea为主,占26.32%(5/19);甲氧西林敏感金黄色葡萄球菌(MSSA)36株,肠毒素基因携带率63.89%(23/36),毒素基因以sec为主,占16.67%(6/36)。金黄色葡萄球菌除对呋喃妥因敏感外,对青霉素、苯唑西林等11种抗菌素均有耐药性,且MRSA的耐药性MSSA的强。结论应重视对金黄色葡萄球菌肠毒素和MRSA的检测,合理使用抗菌素,以利于医院MRSA感染的控制。

Objective To understand the enterotoxin carrying situation and drug resistance of Staphylococcus aureus （S. aureus ） isolated from clinical specimens. Methods Mini-VIDAS and PCR amplification were used to detect S. aureus enterotoxin and its genes, S. aureus enterotoxin and enterotoxin genes sea - see （ sea. seb, see, sed, see ）, seg - sej （ seg, seh, sei, sej ） and tsst. Amplification products were tested by agarose gel electrophoresis. Cefoxitin was used to detect Methieillin- resistant Staphylococcus aureus （MRSA）. The strain susceptibility was tested by agar dilution. Results 40 （72. 73 % ） out of 55 S. aureus strains were enterotoxin positive, mainly, sea 14.55% （ 8/55 ） , sec 12. 73% （7/55） and seb 9. 10% （5/55） ,9.09 （5/55） strains carrying two or more enterotoxins; In addition, 17 out of 19 MRSA strains carried enterotoxin （89.47%）, sea is the main enterotoxin gene, accounting for 26.32% （5/19） ; 23 out of 36 MSSA strains carried enterotoxin （63.89%） ,sec was the main enterotoxin gene,aecounting for 16. 67% （6/36）. S. aureus was susceptible to furadantin, but resistant to 11 kinds of antibiotics, including penicillin, oxacillin, et al. MRSA had stronger resistance to MSSA. Conclusions More attention should be paid to the detection of S. aureus enterotoxin and MRSA, and rational use of antibiotics was important for the control of MRSA infection in hospital.