新疆乌鲁木齐地区皮肤软组织感染社区获得性金黄色葡萄球菌分子分型与耐药性分析

Antibiotic resistance and molecular typing of community-acquired Staphylococcus aureus infections in skin and soft tissue in Urumqi, Xinjiang province

目的:研究新疆乌鲁木齐成年人皮肤软组织感染(skin and soft tissue infections, SSTIs)社区获得性金黄色葡萄球菌(community-acquired staphylococcus aureus,CA-SA,简称金葡菌)的分子流行特征。方法:收集2012年12月—2016年5月分离自成人SSTIs的非重复CA-SA 126株。聚合酶链反应(PCR)鉴定耐甲氧西林金葡菌(methicillin-resistant Staphylococcus aureus, MRSA)。多位点序列分型(MLST)、金葡菌A蛋白(SPA)和葡萄球菌mec基因盒(SCCmec)分型等方法对菌株进行分型,VITEK-2全自动微生物分析仪进行药敏试验,对其耐药谱情况及临床特点进行分析。结果:126株CA-SA中检出6株MRSA,120株甲氧西林敏感型金葡菌(methicillin-susceptible Staphylococcus aureus, MSSA)。主要流行的CA-MRSA为ST59-SCCmecⅣ克隆。主要流行的CA-MSSA有ST22、ST398、ST121、ST5、ST188及ST7共6种克隆,尤其是ST22具有较高的检出率(40%)。药敏试验显示6株MRSA均为多重耐药(multidrug-resistant, MDR)菌株,120株MSSA中有52株为MDR菌株。结论:引起乌鲁木齐地区成人SSTIs的CA-SA主要为MSSA,流行的MRSA以ST59-SCCmecⅣ克隆为主。而MSSA以ST22和ST398等6种克隆为主,MSSA菌株呈现多重耐药趋势。

Objective： This study aimed to characterize community-associated Staphylococcus aureus（CA-SA） infections in skin and soft tissue（SST） of adult patients in Urumqi, Xinjiang province. Methods： 126 non-repetitive isolates of CA-SA were obtained from December 2012 to May 2016. Methicillin-resistant Staphylococcus aureus（MRSA） and the genotypes of SCCmec were determined by PCR. All isolates were characterized using SPA typing and multilocus sequence typing （MIST）. Drug susceptibilities of S. aureus were deternined by VITEK-2 system. Results： Among 126 cases of CA-SA SSTIs, 6（4.8%） cases were MRSA infections, and 120（95.2%） were MSSA infections. Majority of CA-MRSA clones were ST59-SCCmec IV. CA-MSSA included ST22, ST398, ST121, STS, ST188 and ST7, among which largest portion was ST22（48 clones, 40%）. The results of drug susceptibility showed that all 6 MRSA strains were multidrug resistant（MDR） and 52（43.3%） MSSA strains were MDR. Conclusions： In Urumqi, the prevalence of CA-MRSA was low in adults with SSTIs. ST59-SCCmec IV was the most predominant MRSA in SSTIs patients. ST22, ST398 and other four ST clones of MSSA were the major causes of SSTIs. CA-MSSA from SSTIs show high resistance to multiple antibiotic drugs.