瑞安地区社区获得性耐甲氧西林金黄色葡萄球菌spa分型和耐药特征

Study on spa typing and resistance characteristics of community-acquired methicillin-resistant Staphylococcus aureus in Rui'an

目的研究瑞安地区社区获得性MRSA的PVL毒力基因、spa分型和耐药特征。方法收集2011年1月-2013年12月,瑞安人民医院分离的社区获得性金黄色葡萄球菌132株,头孢西丁纸片法筛选MRSA;对CA-MRSA患者收集病史资料,PCR法检测PVL基因,PCR测序进行spa分型,采用whonet 5.6进行耐药谱分析。结果 132株社区获得性金黄色葡萄球菌有36株为CA-MRSA,其中17株PVL基因阳性;36株spa分型有18种,其中t437有12株占33.3%;36株CA-MRSA耐药谱主要为POEC(青霉素、苯唑西林、红霉素、克林霉素)占36.1%。结论瑞安地区CAMRSA PVL基因阳性比例不高,不能使用PVL基因来确认是否CA-MRSA感染,PVL基因患者主要见于皮肤软组织感染,瑞安地区CA-MRSA spa分型主要为t437,主要耐药谱为POEC的耐药模式。

Objective To investigate the community- acquired staphylococcus aureus（ CA- MRSA） virulent PVL gene,spa typing and the resistance characteristics in Rui＇an. Methods 132 strains of CA- MRSA isolated from our hospital from January 2011 to December 2013 were collected and screened by cefoxitin K- B test; To collect the patientsv medical information,detect the PVL gene by polymerase chain reaction（ PCR）,conduct spa gene typing by PCR sequencing and analyze the resistance patterns by whonet 5. 6. Results Total 36 MRSA strains were identified,and 17 strains＇ s PVL gene were positive（ 7strains were skin and soft tissue infections）,18 spa gene types were detected in the 36 strains,t437 was detected in 12 strains（ 33. 3%）,the main resistance patterns,which accounted for 36. 1%,were mainly POEC（ penicillin,oxacillin,erythromycin and clindamycin）. Conclusion The PVL gene positive proportion in Rui＇an was not high,so PVL gene can not be used to confirm CA- MRSA infection; PVL genes were mainly in patients with skin and soft tissue infections,the main spa genetype was t437,POEC was the major drug resistance.