金黄色葡萄球菌耐药性的临床检测及耐药机制分析

Analysis of the Antimicrobial-Resistant mechanism and clinical test of Staphylococcus Aureus

目的了解本院临床分离的80株金黄色葡萄球菌的耐药情况和耐药基因的流行情况,分析其耐药机制。方法采用VITEK 2-compact全自动细菌鉴定仪及配套鉴定卡、药敏卡对细菌进行鉴定及药敏试验;头孢西丁纸片扩散法筛选耐甲氧西林金黄色葡萄球菌(MRSA);应用聚合酶链反应(PCR)检测其可能的耐药基因。结果 80株金黄色葡萄球菌对青霉素、红霉素、庆大霉素的耐药性较强,分别为91.25%、85%和71.25%,对利奈唑胺、万古霉素、替考拉宁、替加环素敏感率为100%,共筛查出MRSA菌株22株,占27.5%;D实验共筛查出13株诱导型耐药株;携带耐药基因者共有57株,占71.25%(57/80),共检测出6个耐药基因。其中21株(26.25%)同时携带ermB和aac(6′)/aph(2")2种耐药基因;9株(11.25%)同时携带ermA、mecA、qacA3种耐药基因,且该9株均为MRSA;13株(16.25%)仅携带ermC1种耐药基因。结论金黄色葡萄球菌对青霉素、红霉素、庆大霉素耐药率高,同时携带多种耐药基因,临床应加强耐药基因检测,合理选择抗菌药物。

Objective To investigate the antimicrobial-resistant profile and genes carried by 80 staphylococcus aureus and analysize its antimicrobial-resistant mechanism.Methods The bacteria identification and the antimicrobial susceptibility test were conducted by VITEK-2compact automatic system.Methicillin resistant taphylococcus aureus（MRSA）were screened by disk diffusion method with cefoxitin.The polymerase chain reaction（PCR）was used to detect the antimicrobial-resistant genes.Results The resistance rates of 80 staphylococcus aureus to penicillin,erythromycin and gentamicin were 91.25%,85.0%and 71.25%,respectively.All of the isolates were susceptible to linezolid,vancomycin,teicoplanin and tigecycline.Among the 80 isolates,there were 22 MRSA,accounting for 27.5%,and 13 were inducible antimicrobial-resistant.57（71.25%）carried antimicrobial-resistant genes,including 6genes.Of which,21（26.25%）carried ermB and aac（6′）/aph（2＂）simultaneously,9（11.25%）carried ermA,mecA,qacA simultaneously,and all of the 9were MRSA,13（16.25%）only carried ermC.Conclusion The resistance rates of staphylococcus aureus were high to penicillin,erythromycin and gentamicin.The various antimicrobial-resistant genes were positive in staphylococcus aureus.We should pay attention to the detection of the antimicrobial-resistant gene and choose antibacterial drug rationally.