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目的调查2007年中国7所教学医院耐甲氧西林金葡菌(MRSA)的分子流行病学分布及耐药性特征。方法采用多位点序列分型(MLST)和葡萄球菌蛋白A基因(spa)分型技术对114株MRSA进行分子流行病学研究,并进行Panton-Valentine毒素(PVL)编码基因lukS检测,采用琼脂稀释法进行13种抗菌药物的药敏试验。结果 114株MRSA中共发现8种MLST-spa分子克隆型,ST239-t030、ST239-t037和ST5-t002是主要的型别,分别占总数的41.2%、28.8%和21.9%。仅有1株MRSA检测到lukS基因阳性。MRSA菌株最敏感的抗菌药物为万古霉素与替考拉宁(100%),甲氧苄啶-磺胺甲口恶唑次之(86.8%);主要的分子克隆型ST239-t030、ST239-t037和ST5-t002菌株具有相似的药敏谱,但所有甲氧苄啶-磺胺甲口恶唑耐药菌株均属于ST239-t037。结论在中国MRSA的流行株由数种主要的分子克隆型引起,与周边国家和地区的情况基本一致。
Objective To investigate the molecular epidemiological distribution and drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) in seven teaching hospitals in China in 2007. Methods The molecular epidemiology of 114 strains of MRSA was studied by MLST and staphylococcal protein A gene typing methods. The gene encoding luteolin-Valentine toxin (PVL) was detected by lukS assay. Dilution method for antimicrobial drug sensitivity test of 13 kinds. Results Eight MLST-spa molecular clones were found in 114 strains of MRSA. ST239-t030, ST239-t037 and ST5-t002 were the major types, accounting for 41.2%, 28.8% and 21.9% of the total, respectively. Only 1 MRSA detected lukS gene positive. The most sensitive antibacterials of MRSA were vancomycin and teicoplanin (100%), followed by trimethoprim-sulfamethoxazole (86.8%). The main molecular clones, ST239-t030 and ST239-t037 And ST5-t002 strains have similar susceptibility spectrum, but all trimethoprim - sulfamethoxazole resistant strains belong to ST239-t037. Conclusions The prevalence of MRSA in China is caused by several major molecular clonotypes, which are basically consistent with those in neighboring countries and regions.