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目的:获得本地区苯唑西林和头孢西丁敏感金黄色葡萄球菌(SA)MecA基因携带率并分析其分子流行病学特征,为临床耐甲氧西林金黄色葡萄球菌(MRSA)感染的诊治提供循证学依据。方法:回顾性分析深圳大学附属南山医院微生物室2010年1月至2016年12月分离出的435株甲氧西林敏感金黄色葡萄球菌(MSSA)的临床药敏特点,总结其对苯唑西林和头孢西丁的耐药情况。应用聚合酶链式反应(PCR)方法扩增MecA基因,红霉素耐药基因ermA、ermB和ermC,扩增SA7对管家基因(arcc、aroe、glpf、gmk、pta、tpi、yqiL)。结果:在435株MSSA中发现2株对苯唑西林和头孢西丁敏感但MecA基因阳性的MRSA菌株,其多基因座顺序分型(MLST)分别为ST239和ST2631,标本均来源于痰液。ermA,ermB和ermC基因除ermA在菌株CHS172中检测阳性,其余均为阴性。结论:临床药敏实验提示苯唑西林和头孢西丁敏感的MSSA有必要进一步检测MecA基因,以验证耐药表型和指导临床治疗方案确定。
OBJECTIVE: To obtain the prevalence of MecA gene in oxacillin and cefoxitin-sensitive Staphylococcus aureus (SA) in our area and analyze its molecular epidemiological characteristics for the diagnosis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection Evidence based. Methods: The clinical susceptivity characteristics of 435 methicillin-sensitive Staphylococcus aureus (MSSA) isolated from the Microbiology Department of Nanshan Hospital Affiliated to Shenzhen University from January 2010 to December 2016 were retrospectively analyzed. The clinical susceptibility to oxacillin and Cefoxitin resistance. The MecA gene, erythromycin resistance genes ermA, ermB and ermC were amplified by polymerase chain reaction (PCR) and the SA7 housekeeping genes (arcc, aroe, glpf, gmk, pta, tpi and yqiL) were amplified. Results: Two strains of MRSA susceptible to oxacillin and cefoxitin but positive to MecA gene were found in 435 strains of MSSA. Their MLST were ST239 and ST2631, respectively. All specimens were derived from sputum. ErmA, ermB and ermC genes except for ermA were detected positive in strain CHS172, the rest were negative. Conclusion: Clinical susceptibility testing suggests that it is necessary to further test the MecA gene by oxacillin and cefoxitin sensitive MSSA in order to verify the drug resistance phenotype and to guide the clinical treatment plan determination.