目的 探讨引发医院感染的耐甲氧西林金黄色葡萄球菌(mrsa)的抗药性、来源和分子流行病学特征.方法 采集北京同仁医院2007-2008年分离的明确致病mrsa 57株,结合k-b法、mic法、多重pcr、自动化重复序列pcr(rep-pcr)分型平台及dl mrsa libr...目的 探讨引发医院感染的耐甲氧西林金黄色葡萄球菌(mrsa)的抗药性、来源和分子流行病学特征.方法 采集北京同仁医院2007-2008年分离的明确致病mrsa 57株,结合k-b法、mic法、多重pcr、自动化重复序列pcr(rep-pcr)分型平台及dl mrsa library数据库信息比对来分别描述mrsa的抗生素耐药表型、潘顿-瓦伦丁杀白细胞素基因(pvl)携带、stapblococcal cassette chromosome mec(sccmec)分型及rep-pcr分型情况.结果 根据对利福平、克林霉素、左氧氟沙星、复方磺胺甲恶唑的耐药差异,57株mrsa被分为(a～f型)6种抗生素耐药表型.sccmecⅢ和sccmecⅡ型mrsa分别为52株和3株,占研究菌株的91.23%和5.26%,仅1株mrsa pvl阳性.通过自动化rep-pcr分型平台,研究菌株被分为rep-a～f共6型和3株"单克隆株".rep-c型菌株数量最多(52.63%,30/57).6株rep-d型mrsa菌株中,3株分离自喉科病房.本院rep-c-sccmecⅢ型与dl mrsa library中的brazilian clone-sccmecⅢ型遗传学最接近.结论 社区相关性耐甲氧西林金黄色葡萄球菌(ca-mrsa)引起的医院感染在北京同仁医院还较罕见.rep-c-sccmecⅢ-a型mrsa为该院医疗相关性耐甲氧西林金黄色葡萄球菌(ha-mrsa)的主要流行株,rep-d-sccmecⅢ-d型菌株是喉癌术后医院感染的相对特有菌株.自动化rep-pcr检测平台结合dl mrsa library数据库的方法是研究医院感染的快速、有效工具.
abstract：
objective to investigate the drug resistance,source and molecular epidemiology of methicillin-resistant staphyloccus aureus(mrsa)causing nosocomial infection. methods fifty-seven pathogenic mrsa strains were isolated from beijing tongren hospital during 2007 and 2008.k-b method,mic assay,multiple pcr,automatic repetitive element sequence-based pcr(rep-pcr)typing platform and dl mrsa library were used to identify the resistant phenotypes,panton-valentine leukocidin gene (pvl)and rep-pcr types of the mrsa.results all strains were classified as 6 antibiotic resistant phenotypes(a-f)based on the resistance to rifampin,clindamycin,levofloxacin and cotrimoxazole.the mrsas with staphylococcal cassette chromosome mec(sccmec)Ⅲ and sccmec Ⅱ accounted for 91.23% (52/57)and 5.26%(3/57)of all strains,respectively.only one strain was pvl positive.all strains were typed as rep-a-f(6 types)and three single clones by automatic rep-pcr typing platform,in which rep-c was predominant(30/57,52.63%).three out of 6 rep-d strains were from laryngology wards.the rep-c-sccmec Ⅲ were genetically most close to the brazilian clone-sccmec Ⅲ in dl mrsa library.conclusion s rep-c-sccmec Ⅲ-a type are the major epidemic hospital-associated mrsa and the rep-d-sccmec Ⅲ-d is usually isolated from patients received laryngeal surgery. automatic rep-pcr typingplatform combined with dl mrsa library database is an effective approach to study the nosocomial infection.展开更多
文摘目的 探讨引发医院感染的耐甲氧西林金黄色葡萄球菌(mrsa)的抗药性、来源和分子流行病学特征.方法 采集北京同仁医院2007-2008年分离的明确致病mrsa 57株,结合k-b法、mic法、多重pcr、自动化重复序列pcr(rep-pcr)分型平台及dl mrsa library数据库信息比对来分别描述mrsa的抗生素耐药表型、潘顿-瓦伦丁杀白细胞素基因(pvl)携带、stapblococcal cassette chromosome mec(sccmec)分型及rep-pcr分型情况.结果 根据对利福平、克林霉素、左氧氟沙星、复方磺胺甲恶唑的耐药差异,57株mrsa被分为(a～f型)6种抗生素耐药表型.sccmecⅢ和sccmecⅡ型mrsa分别为52株和3株,占研究菌株的91.23%和5.26%,仅1株mrsa pvl阳性.通过自动化rep-pcr分型平台,研究菌株被分为rep-a～f共6型和3株"单克隆株".rep-c型菌株数量最多(52.63%,30/57).6株rep-d型mrsa菌株中,3株分离自喉科病房.本院rep-c-sccmecⅢ型与dl mrsa library中的brazilian clone-sccmecⅢ型遗传学最接近.结论 社区相关性耐甲氧西林金黄色葡萄球菌(ca-mrsa)引起的医院感染在北京同仁医院还较罕见.rep-c-sccmecⅢ-a型mrsa为该院医疗相关性耐甲氧西林金黄色葡萄球菌(ha-mrsa)的主要流行株,rep-d-sccmecⅢ-d型菌株是喉癌术后医院感染的相对特有菌株.自动化rep-pcr检测平台结合dl mrsa library数据库的方法是研究医院感染的快速、有效工具.
abstract：
objective to investigate the drug resistance,source and molecular epidemiology of methicillin-resistant staphyloccus aureus(mrsa)causing nosocomial infection. methods fifty-seven pathogenic mrsa strains were isolated from beijing tongren hospital during 2007 and 2008.k-b method,mic assay,multiple pcr,automatic repetitive element sequence-based pcr(rep-pcr)typing platform and dl mrsa library were used to identify the resistant phenotypes,panton-valentine leukocidin gene (pvl)and rep-pcr types of the mrsa.results all strains were classified as 6 antibiotic resistant phenotypes(a-f)based on the resistance to rifampin,clindamycin,levofloxacin and cotrimoxazole.the mrsas with staphylococcal cassette chromosome mec(sccmec)Ⅲ and sccmec Ⅱ accounted for 91.23% (52/57)and 5.26%(3/57)of all strains,respectively.only one strain was pvl positive.all strains were typed as rep-a-f(6 types)and three single clones by automatic rep-pcr typing platform,in which rep-c was predominant(30/57,52.63%).three out of 6 rep-d strains were from laryngology wards.the rep-c-sccmec Ⅲ were genetically most close to the brazilian clone-sccmec Ⅲ in dl mrsa library.conclusion s rep-c-sccmec Ⅲ-a type are the major epidemic hospital-associated mrsa and the rep-d-sccmec Ⅲ-d is usually isolated from patients received laryngeal surgery. automatic rep-pcr typingplatform combined with dl mrsa library database is an effective approach to study the nosocomial infection.
