烧伤科患者分离金黄色葡萄球菌耐药性和耐药基因研究

Drug resistance and drug resistance genes distribution of Staphylococcus aureus isolated from burn ward

目的了解烧伤科住院患者分离的金黄色葡萄球菌的耐药表型和耐药基因分布,指导临床医生合理使用抗菌药物,提高患者治愈率。方法收集2015年1―8月该院烧伤科住院患者分离的金黄色葡萄球菌,菌种鉴定及药敏试验采用法国生物梅里埃公司VITEK-2Compact系统,通过聚合酶链反应(PCR)方法分析其耐药基因mecA、TEM、ermA、ermB、ermC、tetM、tetK、ant6及aac6′/aph2′′的表达。结果 106株金黄色葡萄球菌对万古霉素、利奈唑胺、替加环素和替考拉宁的敏感率均为100.0%,对青霉素G的耐药率为99.1%,对环丙沙星、红霉素、庆大霉素、苯唑西林和利福平的耐药率较高,均大于60.0%。耐药基因的阳性率分别为mecA61.3%、TEM 30.2%、ermA 60.4%、ermB 12.3%、ermC 56.6%、tetM 76.4%、tetK 20.7%、ant6 10.4%、aac6′/aph2′′77.0%。结论烧伤患者分离的金黄色葡萄球菌对多数抗菌药物的耐药率较高,对万古霉素、利奈唑胺和替考拉宁高度敏感;耐药基因以mecA、ermA、ermC、tetM和aac6′/aph2′′为主。

Objective To investigate the drug resistance phenotypes and antibiotic-resistant genes distribution of Staphylococcus aureus isolated from burn ward so as to guide reasonable use of antibiotics and improve the cure rate.Methods Staphylococcus aureus isolated from burn ward from Jan.to Aug.2015 were collected,and VITEK-2 Compact system was adopted to detect strains and drug resistance.Polymerase-chain-reaction was used to analyze the expression of the drug-resistant gene mecA,TEM,ermA,ermB,ermC,tetM,tetK,ant6,and aac6′/aph2′′.Results Totally 106 strains of Staphylococcus aureus were 100.0%susceptible to vancomycin,linezolid,tigecycline and teicoplanin;the drug resistance rate of the 106 strains of Staphylococcus aureus strains to penicillin G were 99.1%;the drug resistance rates of the 106 strains of Staphylococcus aureus strains to ciprofloxacin,erythromycin,gentamin,oxacillin and rifampicin were more tan 60.0%.The positive rates of the drug resistance genes were as following：mecA 61.3%,TEM 30.2%,ermA 60.4%,ermB 12.3%,ermC 56.6%,tetM 76.4%,tetK 20.7%,ant6 10.4%,aac6′/aph2′′77.0%.Conclusion The Staphylococcus aureus strains isolated from burn ward are highly resistant to most of the antibiotics and susceptible to vancomycin,linezolid and teicoplanin;the mecA,ermA,ermC,tetM and aac6′/aph2′′are the predominant drug resistance gene.