严平, 陆元胜, 李珺, 赵锋, 阮陟, 张钧. 浙江省富阳区临床分离甲氧西林耐药金黄色葡萄球菌的流行现状及耐药性分析[J]. 疾病监测, 2015, 30(12): 1056-1061. DOI: 10.3784/j.issn.1003-9961.2015.12.016
引用本文: 严平, 陆元胜, 李珺, 赵锋, 阮陟, 张钧. 浙江省富阳区临床分离甲氧西林耐药金黄色葡萄球菌的流行现状及耐药性分析[J]. 疾病监测, 2015, 30(12): 1056-1061. DOI: 10.3784/j.issn.1003-9961.2015.12.016
YAN Ping, LU Yuan-sheng, LI Jun, ZHAO Feng, RUAN Zhi, ZHANG Jun. Drug susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus isolated from clinical specimens in Fuyang, Zhejiang[J]. Disease Surveillance, 2015, 30(12): 1056-1061. DOI: 10.3784/j.issn.1003-9961.2015.12.016
Citation: YAN Ping, LU Yuan-sheng, LI Jun, ZHAO Feng, RUAN Zhi, ZHANG Jun. Drug susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus isolated from clinical specimens in Fuyang, Zhejiang[J]. Disease Surveillance, 2015, 30(12): 1056-1061. DOI: 10.3784/j.issn.1003-9961.2015.12.016

浙江省富阳区临床分离甲氧西林耐药金黄色葡萄球菌的流行现状及耐药性分析

Drug susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus isolated from clinical specimens in Fuyang, Zhejiang

  • 摘要: 目的 分析浙江省富阳区临床分离的甲氧西林耐药金黄色葡萄球菌(MRSA)的检出率、基因分型及药敏特征等流行现状。方法 收集2013年11月至2014年10月两家医院临床标本中分离的金黄色葡萄球菌,对其中经头孢西丁纸片表型筛选确认的44株MRSA进行应用多位点序列分型(multilocus sequence typing,MLST)、spa、SCCmec基因分型,筛查pvl基因,应用脉冲场凝胶电泳的分型图谱进行菌株间的同源性分析。同时应用16种抗菌药物进行药敏实验。结果 44株MRSA,占金黄色葡萄球菌的16.4%(44/268)。两家医院流行的主要克隆不同,富阳中医骨伤医院以ST59-t437-SCCmecⅣ型为主,菌株间同源程度低;人民医院以ST5-t311-SCCmecⅡ型为主,部分菌株间同源程度高。检出3株pvl阳性菌株,占6.8%。药敏结果表示MRSA对内酰胺类普遍耐药,红霉素、克林霉素的耐药率高(85.0%),未发现万古霉素、利奈唑胺、替加环素的耐药株。结论 富阳地区MRSA的检出率相对较低,流行以ST5-t311-SCCmecⅡ型为主,两家医院MRSA流行的主要克隆有较大差异。MRSA的耐药情况不容乐观,多重耐药现象严重,不同基因型别的菌株其药敏结果有差异。

     

    Abstract: Objective To investigate the genotype, epidemic characteristics and susceptibility of methicillin-resistant Staphylococcus aureus(MRSA) in Fuyang district of Hangzhou, Zhejiang province. Methods Staphylococcus aureus strains were collected from the clinical specimens in two hospitals in Fuyang from November 2013 to October 2014. Multiple locus sequence typing(MLST), pvl screening and spa, SCCmec subtyping were conducted. Pulsed field gel electrophoresis(PFGE) were conducted for homology analysis. The drug susceptibility test was conducted with vitek2 compact automatic system. Results A total of 44 MRSA strains were analyzed in our study, accounting for 16.4% of the S. aureus strains isolated. The predominant clones detected in two hospital were different:ST59-t437-SCCmecIV was predominant in orthopedics and traumatology hospital, and ST5- t311-SCCmecⅡwas predominant in people's hospital. The homology of the strains from the people's hospital was high. Three pvl positive strains were detected(6.8%). All the MRSA isolates were resistant to -lactam antibiotics, more than 85.0% of the strains were resistant to erythromycin and clindamycin and no vancomycin, linezolid and tigecycline resistant strains were detected. Conclusion The detection rate of MRSA in Fuyang was low, ST5-t311-SCCmecⅡwas the major circulating clone. The drug resistance of MRSA was serious, and multi drug resistance was very common. The results of the drug susceptibility varied with the genotype of the isolates.

     

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