上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (12): 1754-.doi: 10.3969/j.issn.1674-8115.2011.12.021

• 论著（临床研究） • 上一篇    下一篇

金黄色葡萄球菌耐药性监测分析

吴 晶, 应春妹, 汪雅萍, 郑 冰, 张灏旻   

  1. 上海交通大学 医学院附属仁济医院检验科, 上海 200127
  • 出版日期:2011-12-28 发布日期:2012-01-04
  • 通讯作者: 应春妹, 电子信箱: ycmzh@yahoo.com.cn。
  • 作者简介:吴 晶（1981—）, 女, 检验师；电子信箱: jing_jing_wu@hotmail.com。

Surveillance of drug resistance of Staphylococcus aureus

WU Jing, YING Chun-mei, WANG Ya-ping, ZHENG Bing, ZHANG Hao-min   

  1. Department of Clinical Laboratory, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2011-12-28 Published:2012-01-04

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摘要：

目的 分析临床分离金黄色葡萄球菌的科室分布情况及耐甲氧西林金黄色葡萄球菌（MRSA）检出率，比较MRSA和甲氧西林敏感的金黄色葡萄球菌（MSSA）的抗生素耐药情况。方法 收集2010年7—2010年9月临床分离的80株金黄色葡萄球菌菌株，分别通过头孢西丁纸片法及聚合酶链反应（PCR）扩增macA基因筛选MRSA，用琼脂稀释法检测MRSA和MSSA对11种抗生素的最低抑菌浓度（MIC），比较两者耐药性的差异。结果 80株金黄色葡萄球菌经头孢西丁纸片法检测，筛选出46株MRSA，检出率为57.50%；经PCR检测mecA基因，筛选出45株MRSA，检出率为56.25%。MRSA检出率前3位科室是神经外科（17/45，37.78%）、普外科（7/45，15.56%）和留院观察室（5/45，11.11%）。80株金黄色葡萄球菌对替考拉宁、万古霉素和利奈唑胺的敏感率均为100%，MRSA与MSSA对其余8种抗生素的耐药性差异有统计学意义（P<0.05）。结论 MRSA检出率及耐药率均较高，应引起临床各科室和微生物实验室的高度重视，以避免由其引发的大规模院内感染和流行。

关键词: 耐甲氧西林金黄色葡萄球菌, 最低抑菌浓度, mecA基因, 耐药性监测

Abstract:

Objective To analyse the clinical distribution of Staphylococcus aureus and detection rate of methicillin resistant Staphylococcus aureus (MRSA), and compare the resistance of MRSA and methicillin sensitive Staphylococcus aureus(MSSA) to antibiotics. Methods Eighty isolates of Staphylococcus aureus were collected from clinical specimens from July to September in 2010. Cefoxitin disk diffusion method and polymerase chain reaction (PCR) were carried out to screen isolates of MRSA. Agar dilution was conducted to determine the minimum inhibitory concentrations (MICs) of 11 antibiotics for MRSA and MSSA, and the differences in drug resistance were compared. Results Forty-six (57.50%) isolates of MRSA were detected from 80 isolates of Staphylococcus aureus. Forty-five (56.25%) isolates of MRSA were screened after detection of mecA gene by PCR. Department of Neurosurgery (17/45, 37.78%), Department of General Surgery (7/45, 15.56%) and Emergency Observation Unit (5/45, 11.11%) were the sections with highest detection rates of MRSA. All the 80 isolates of Staphylococcus aureus were sensitive to linezolid, vancomycin and teicoplanin. However, there were significant differences in drug resistance to the other 8 antibiotics between MRSA and MSSA (P<0.05). Conclusion The detection rate and drug resistance rate of MRSA are high, which should arouse more attention from clinical departments and microbiology laboratory, so as to avoid largescale epidemics caused by nosocomial infection.

Key words: methicillin-resistant Staphylococcus aureus, minimum inhibitory concentration, mecA gene, resistance monitoring