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王恒伟, 杨琳, 郝民, 邵希凤, 宋衍燕. 早孕宫颈拭子166株表皮葡萄球菌耐药性与SCCmec分型[J]. 疾病监测, 2022, 37(5): 668-673. DOI: 10.3784/jbjc.202109010476
引用本文: 王恒伟, 杨琳, 郝民, 邵希凤, 宋衍燕. 早孕宫颈拭子166株表皮葡萄球菌耐药性与SCCmec分型[J]. 疾病监测, 2022, 37(5): 668-673. DOI: 10.3784/jbjc.202109010476
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Wang Hengwei, Yang Lin, Hao Min, Shao Xifeng, Song Yanyan. Analysis on antibiotic resistance and staphylococcal chromosome cassette mec of 166 strains of Staphylococcus epidermidis isolating from early pregnancy cervical swabs[J]. Disease Surveillance, 2022, 37(5): 668-673. DOI: 10.3784/jbjc.202109010476
Citation: Wang Hengwei, Yang Lin, Hao Min, Shao Xifeng, Song Yanyan. Analysis on antibiotic resistance and staphylococcal chromosome cassette mec of 166 strains of Staphylococcus epidermidis isolating from early pregnancy cervical swabs[J]. Disease Surveillance, 2022, 37(5): 668-673. DOI: 10.3784/jbjc.202109010476
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早孕宫颈拭子166株表皮葡萄球菌耐药性与SCCmec分型

Analysis on antibiotic resistance and staphylococcal chromosome cassette mec of 166 strains of Staphylococcus epidermidis isolating from early pregnancy cervical swabs

    摘要
  • 摘要:
      目的   了解2015－2017年从北京市朝阳区早孕宫颈拭子中分离的166株表皮葡萄球菌耐药性与耐药基因携带情况以及葡萄球菌染色体mec盒（SCCmec）型别，为合理用药及预防感染提供依据。
      方法  回顾性分析2015－2017年从北京市朝阳区早孕宫颈拭子中分离的166株表皮葡萄球菌耐药情况，分别采用K-B法对头孢西丁，微量肉汤稀释法对其他11种抗菌药物进行药敏试验，采用聚合酶链式反应（PCR）对红霉素类、喹诺酮类、磺胺类、氨基糖苷类、大环内酯类、四环素类耐药基因和SCCmec的基因型和亚型进行检测，使用SPSS 22.0软件，用χ2检验对表皮葡萄球菌耐药率和耐药基因携带情况进行统计分析。
      结果  166株表皮葡萄球菌药敏试验结果对万古霉素100.00% 敏感、对达托霉素93.37% 敏感，对青霉素、苯唑西林、红霉素的耐药率在90%以上，对其他抗菌药物均有不同程度的耐药；多重耐药比例为72.89%；mecA基因携带率45.78%；耐药基因携带率以norA1（100.00%）和norA2（95.78%）较高，其次为msrA（71.08%）；76株mecA阳性表皮葡萄球菌中，以SCCmecⅢ型（40.79%）为主，其次为SCCmecⅤ型（22.37%）。
      结论  健康人群早孕宫颈拭子表皮葡萄球菌的携带率超过50%，耐甲氧西林的表皮葡萄球菌菌株比例达24.70%，有必要回溯往期孕期妇女宫颈分泌物携带菌株分型及耐药情况，对多重耐药菌株需长期加大抗生素监管，以减少耐药菌株产生，降低新生儿败血症感染风险。

     

    Abstract:
      Objective  To analyze the antimicrobial resistance, distribution of resistance genes and staphylococcal chromosome cassette mec (SCCmec) typing in 166 strains of Staphylococcus epidermidis isolated from early pregnancy cervical swabs in Chaoyang district of Beijing during 2015–2017, and provide evidence for rational medication and infection prevention.
      Methods  A retrospective analysis on antibiotic resistance of 166 strains of S. epidermidis isolated from early pregnancy cervical swabs in Chaoyang during 2015–2017 was conducted. K-B disk diffusion method was used to detect the susceptibility to cefoxitin. Microbroth dilution method was used to detect the susceptibility to 11 antibiotics. PCR was performed to detect drug resistance genes to erythromycin, quinolone, sulfa, aminoglycoside, macrolide and tetracycline and the genotypes and subtypes of all currently described SCCme. SPSS 22.0 was used for data analysis.
      Results  The results showed that the sensitivity rate of 166 strains of S. epidermidis was 100% to vancomycin and 93.37% to daptomycin. The resistance rates to penicillin, oxacillin and erythromycin were above 90%, and the resistance rates to other antibiotics were different. For the 166 strains, the multi-drug resistance rate was 72.89%, the detection rate of mecA gene was 45.78%. The carriage rates of resistance genes norA1 (100%) and norA2 (95.78%) were highest, followed by msrA (71.08%). Among 76 strains of mecA gene-positive S. epidermidis, the major genotype was SCCmecⅢ (40.79%), followed by SCCmeⅤ (22.37%) .
      Conclusion  The carrying rate of S. epidermidis in cervical swabs of healthy population was more than 50%, the detection rate of methicillin resistant S. epidermidis (MRSE) was 24.70%. It is necessary to trace back the typing and drug resistance of strain from cervical secretion of pregnant women. Long-term enhanced antibiotic supervision for multi-drug resistant strains is needed to reduce drug-resistant strains and reduce the risk for neonatal sepsis infection.

     

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