某地区新生儿痰标本金黄色葡萄球菌分离株耐药情况及分子特征

Antibiotic resistance and molecular characteristics of Staphylococcus aureus isolated from sputum samples in neonatology

目的通过对某地区新生儿病区痰标本分离出的金黄色葡萄球菌(SA)耐药情况及分子特征进行回顾性研究分析,为防治新生儿SA感染提供理论依据。方法收集本院2014年1月至2017年12月新生儿病区呼吸道痰样本中分离出的SA株,进行菌株的抗菌药物敏感性试验、检测菌株的耐药基因、毒力因子检测。结果 52株SA中,对青霉素耐药率高达98.08%,对氨苄西林耐药率为73.08%,对环丙沙星、万古霉素、利奈唑胺无耐药,耐药基因及毒力基因检测检出12株mecA基因、11株SCCmecIVd基因、12株大环内酯类ermC耐药基因、10株四环素tetK耐药基因和5株携带PVL毒力因子基因,其他耐药基因未检出。结论新生儿病区痰标本分离的SA菌株呈现多重耐药性,因新生儿的特殊生理特点,抗SA治疗药物比较局限,应在药物敏感性试验前提下,借助SA耐药基因及毒力因子检测等手段,合理选择抗SA药物治疗。

Objective To retrospectively analyze the antibiotic resistance and molecular characteristics of Staphylococcus aureus isolated from sputum samples in neonatology,and provide theoretical basis for the prevention and treatment of neonatal Staphylococcus aureus infection.Methods We collected Staphylococcus aureus isolated from the sputum samples from January 2014 to December 2017 in our hospital,and antimicrobial susceptibility test,genotyping and virulence gene detection were conducted.Results Among the 52 strains,resistance rate for penicillin reached 98.08%,that for ampicillin reached 73.08%,while for ciprofloxacin,vancomycin and linezolid the resistance rate was zero.Virulence gene detection found that 12 strains carried mecA gene,11 strains carried SCCmecIVd gene,12 strains carried macrocyclic ester ermC gene,10 strains carried tetracycline tetK gene and 5 strains carried PVL virulence gene.Conclusion Staphylococcus aureus isolated from the sputum samples shows multiple drug resistance.Due to the physiological characteristics of newborns,antibiotic use for the infection is limited.It is important to reasonably select anti SA drugs with the help of drug sensitivity test and gene detection for drug resistance and virulence.