耐甲氧西林金黄色葡萄球菌多位点序列分型与耐药性研究

Molecular typing and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus

目的了解深圳地区耐甲氧西林金黄色葡萄球菌(MRSA)分子型别特征及其对常用抗生素的耐药情况,为治疗和防控MRSA感染提供科学依据。方法对2012-2014年深圳地区9家哨点医院临床分离的228株MRSA进行多位点序列分型,检测其对庆大霉素(GEN)、环丙沙星(CIP)、磺胺甲噁唑/甲氧苄啶(SXT)、红霉素(ERY)、万古霉素(VAN)、克林霉素(CLI)、四环素(TET)和利奈唑胺(LNZ)等8种非-β内酰胺类抗生素的敏感性。结果 228株MRSA可分为33种ST型,其中以ST59型为主,占41.7%(95/228);其次为ST338型,占15.4%(35/228);经e BURST软件分析它们属于15种克隆复合体和1个单一克隆,其中CC59为主要克隆,占61.0%(139/228),其次为CC239,占9.6%(22/228);ST59和ST338同属于CC59,耐药谱均为ERY/CLI/TET。结论深圳地区流行的MRSA以CC59为主,可选用环丙沙星或磺胺甲噁唑/甲氧苄啶治疗。

Objective To determine the prevalence of the molecular types and antibioticsusceptibilities of methicillinresistant Staphylococcus aureus（MRSA） in Shenzhen,China. Methods A total of 228 MRSA isolates were collected between January 2012 and December 2014 from nine sentinel hospitals in Shenzhen. The multilocus sequence typing（MLST） and the antibiotic susceptibilities to 8 kinds of non-β-lactam antibiotics of all MRSA strains were analyzed.Results Of the 228 MRSA isolates,33 sequence types（ST） were found. Among the 33 STs,15 clonal complexes（CCs） and one singleton were analyzed by the e BURST. The predominant ST was ST59（41.7%）,and followed by ST338（15.4%）; these two ST types were belonged to CC59（61.0%） and had the same drug resistant profile（ERY/CLI/TET）.Conclusion CC59 was the most predominant MRSA clone in Shenzhen,and would be effectively treated by Ciprofloxacin and sulfamethoxazole/trimethoprim.