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目的了解乌鲁木齐地区金黄色葡萄球菌临床分离株的分子特征及其对临床常用抗生素的耐药情况。方法收集2010年6月至2012年12月期间乌鲁木齐地区一所大型综合医院临床分离的86株金黄色葡萄球菌,在鉴定区分耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)和甲氧西林敏感金黄色葡萄球菌(methicillin-susceptible Staphylococcus aureus,MSSA)的基础上,应用SCCmec分型、spa分型、多位点序列分型(multilocus sequence typing,MLST)、脉冲场凝胶电泳分型(pulsed-field gel electrophoresis,PFGE)、agr分型等葡萄球菌分子分型方法进行分析,检测pvl毒力基因的携带率,检测菌株对苯唑西林、红霉素、四环素等13种临床常用抗生素的耐药性,分析菌株的耐药情况及耐药基因。结果 86株金葡菌中31株为MRSA,55株为MSSA。31株MRSA分为8种spa型和7种ST型,优势流行克隆为ST239-MRSA-Ⅲ-t030(71%,22/31)。55株MSSA分为23种spa型、16种ST型和8个PFGE聚类组,agrⅠ型占56.4%(31/55)。MSSA菌株的pvl毒力基因检出率为49.1%(27/55),MRSA为38.7%(12/31)。药敏结果显示31株MRSA均为多重耐药(multidrugresistant,MDR)菌株,55株MSSA中有31株为MDR菌株。结论乌鲁木齐地区流行的MRSA以ST239-MRSA-Ⅲ-t030为主,而MSSA表现出较高遗传多样性,发现有t11413,ST121等新的型别流行。
Objective To understand the molecular characteristics of Staphylococcus aureus clinical isolates in Urumqi and their resistance to commonly used antibiotics in clinical practice. Methods A total of 86 strains of Staphylococcus aureus isolated from a large general hospital in Urumqi from June 2010 to December 2012 were collected for identification of methicillin-resistant Staphylococcus aureus (MRSA) and On the basis of methicillin-susceptible Staphylococcus aureus (MSSA), SCCmec typing, spa typing, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (Pulsed-field gel electrophoresis, PFGE), agr typing and other staphylococcal molecular typing methods to detect pvl virulence gene carrier rate of the test strains of oxacillin, erythromycin, tetracycline and other 13 kinds of commonly used Antibiotic resistance, analysis of bacterial resistance and drug resistance genes. Results Among the 86 Staphylococcus aureus strains, 31 strains were MRSA and 55 strains were MSSA. Thirty-one MRSA strains were divided into eight spa types and seven ST types. The dominant epidemic clone was ST239-MRSA-Ⅲ-t030 (71%, 22/31). 55 MSSA were divided into 23 kinds of spa, 16 kinds of ST and 8 PFGE clustering group, agr Ⅰ type accounted for 56.4% (31/55). The detection rate of pvl virulence genes in MSSA strains was 49.1% (27/55) and MRSA was 38.7% (12/31). The susceptibility results showed that all 31 MRSA strains were multidrug resistant (MDR) strains, and 31 of 55 MSSA strains were MDR strains. Conclusion The prevalence of MRSA in Urumqi is mainly based on ST239-MRSA-Ⅲ-t030, while MSSA shows high genetic diversity. There are some new epidemics such as t11413 and ST121.