凝固酶阴性葡萄球菌耐药基因和粘附基因检测及耐药性分析

Analysis of the detections of resistant and adhesive genes and the resistance in coagulase-negative staphylococci

目的了解凝固酶阴性葡萄球菌(CoNS)耐药基因和粘附基因的分布及其耐药性情况。方法收集45株凝固酶阴性葡萄球菌临床分离株,采用PCR检测其耐药基因mecA和粘附基因clfA、fnbpB,并分析其耐药性。结果 (1)凝固酶阴性葡萄球菌中mecA、clfA、fnbpB的阳性率依次为86.7%(39/45)、11.1%(5/45)、71.1%(32/45)。(2)凝固酶阴性葡萄球菌中耐甲氧西林凝固酶阴性葡萄球菌(MRCoNS)的检出率为88.9%,对β-内酰胺类抗生素的耐药率都在80%以上,对利福平、左氧氟沙星、林可霉素的耐药率较低,未发现对万古霉素、利奈唑胺耐药菌株。结论 CoNS中MRCoNS检出率很高,对常用抗生素耐药率高,且有一定的粘附能力,临床上应该根据药敏试验结果慎重及合理的使用抗生素。

Objective To investigate the distributions of the resistant and adhesive genes and the resistance profiles. Methods Totally 45 strains of clinlical isolates of coagulase-negative staphylococci （CONS） were collected, the mecA, clfA and fnbpB were detected by PCR methods, and analyzed the drug resistance. Results （ 1 ） The positive rates of mecA, clfA andfnbpB were 86.7% （39/45）, 11. 1% （5/45） and 71.1% （32/45） in CoNs, respectively. （2） The rates of methicillin resistant coagulase negative staphylococci （MRCoNS） were 88.9% in CONS, the resistant rates of CoNS to β-1actames were all above the 80% , to Rifampicin, Levofloxacin and Clinda- mycin were low, there were no isolates resistance to Vancomycin, Linezolid. Conclusion The detected rates of MRCoNS are very high in CONS, the resistant rates of isolates to common antibiotics are very high, also have the ability of adhension, we should carefully and rationly use the antibiotics based on the results of drug sensitive tests.