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目的了解慢性鼻窦炎患者分离的金黄色葡萄球菌耐药情况。方法收集慢性鼻窦炎患者标本,进行金黄色葡萄球菌培养及分离纯化,表征患者病灶部位及菌株,K-B法分析其耐药性,PCR检测耐药基因。结果金黄色葡萄球菌是引发慢性鼻窦炎患者发生感染的原因及主要病原菌。药敏试验显示金黄色葡萄球菌对阿米卡星、苯唑西林、四环素、红霉素、万古霉素、环丙沙星、替考拉宁、克林霉素、利福平、庆大霉素的耐药率、中介率及敏感率分别为14.94%、39.08%、37.93%、59.20%、0.00%、31.03%、0.00%、47.70%、17.82%、45.98%,10.92%、0.00%、5.17%、1.72%、0.00%、2.87%、0.00%、9.20%、0.00%、6.90%和74.14%、60.92%、56.90%、39.08%、100.00%、66.09%、100.00%、43.10%、82.18%、47.13%。PCR扩增ermA、ermC、qacA、ermB、aac(6’)/aph(2’)、mecA基因大小分别为421、572、629、359、220和162bp,且其基因检出率分别为21.26%、10.92%、16.09%、35.06%、29.89%、43.10%。结论金黄色葡萄球菌是引发慢性鼻窦炎患者感染的主要病原菌,药敏试验显示其对万古霉素和替考拉宁敏感。
Objective To understand the drug resistance of Staphylococcus aureus isolated from patients with chronic sinusitis. The method of collecting specimens from patients with chronic sinusitis, a Staphylococcus aureus culture and purification, characterization of the lesion site of a patient and strain, K-B method which analyze drug resistance, the PCR detection of resistance genes. Results Staphylococcus aureus was the main cause of infection in patients with chronic sinusitis. Susceptibility test showed Staphylococcus aureus amikacin, oxacillin, tetracycline, erythromycin, vancomycin, ciprofloxacin, teicoplanin, clindamycin, rifampin, gentamicin The drug resistance rate, mediation rate and sensitivity rate were 14.94%, 39.08%, 37.93%, 59.20%, 0.00%, 31.03%, 0.00%, 47.70%, 17.82%, 45.98%, 10.92%, 0.00%, 5.17 %, 1.72%, 0.00%, 2.87%, 0.00%, 9.20%, 0.00%, 6.90% and 74.14%, 60.92%, 56.90%, 39.08%, 100.00%, 66.09%, 100.00%, 43.10%, 82.18% 47.13%. The gene sizes of mecA gene were 421, 572, 629, 359, 220 and 162 bp, respectively, and the gene detection rates were 21.26% , 10.92%, 16.09%, 35.06%, 29.89%, 43.10%. Conclusion Staphylococcus aureus is the main pathogen causing the infection of patients with chronic sinusitis. Susceptibility tests have shown that it is sensitive to vancomycin and teicoplanin.