社区获得性肺炎金黄色葡萄球菌表型及耐药性

Characteristics and drug resistance of staphylococcus aureus in community-acquired pneumonia

目的探讨社区获得性肺炎金黄色葡萄球菌的表型及耐药性。方法选取社区获得性金黄色葡萄球菌肺炎患者100例。对13种抗菌药进行耐药表型检测,同时检测菌株mec A和β-内酰胺酶基因;单因素和Logistic分析,筛选影响耐药性的危险因素。结果 100株菌株,37株耐甲氧西林,63株敏感,37株携带mec A基因,mec A与表型检测无明显差异(P>0.05)。37株MRSA中,28株β-内酰胺酶基因阳性,63株MSSA中,35株阳性,存在显著性差异(P<0.05)。Logistic分析筛选出影响细菌耐药性的危险因素。结论社区获得性肺炎金黄色葡萄球菌耐药性严重,耐药性发生与携带mec Aβ-内酰胺酶基因相关。年龄、感染前是否使用抗生素、糖尿病和免疫疾病史是影响耐药性的危险因素。

Objective To research the characteristics and drug resistance of staphylococcus aureus in com-munity-acquired pneumonia. Methods 100 patients with community-acquired pneumonia infected with staphylococ-cus were selected. Drug resistance of 13 kinds of antibiotics were detected and the mecA and beta lactamase genes were detected. Single factor and logistic regression analysis were selected to screen the risk factors of bacterial drug resistance. Results Among the 100 strains, 37 strains were resistant to methicillin, and 63 strains were sensitive to methicillin. 37 strains were carrying mecA gene, and there was no significant difference between mecA gene detection results and drug resistance detection results （ P〉0. 05 ） . Among 37 strains of MRSA, 28 strains of beta lactamasegene were positive. 35 out of 63 strains of MSSA were positive （ P〈0. 05 ） . Conclusion The drug resistance of staphylococcus aureus in community acquired pneumonia is serious. The occurrence of drug resistance is closely relat-ed with mecA gene and beta lactamase genes. Age, whether the use of antibiotics before infection, diabetes and other basic disease and immune disease history are the independent risk factors of community-acquired pneumonia.