本文選題：耐甲氧西林金黃色葡萄球菌　切入點：耐藥性　出處：《臨床和實驗醫(yī)學(xué)雜志》2017年01期

【摘要】：目的檢測臨床分離耐甲氧西林金黃色葡萄球菌(MRSA)mec A基因和殺白細(xì)胞素(PVL)基因攜帶情況,并分析其對常用抗菌藥物的耐藥性,指導(dǎo)臨床上合理規(guī)范用藥。方法應(yīng)用96孔肉湯微量稀釋法對菌株進行10種常用抗菌藥物敏感性試驗,全部藥物敏感試驗采用MIC法鑒定,采用聚合酶鏈反應(yīng)(PCR)法檢測mec A基因和PVL基因攜帶情況,并對PVL基因陽性菌株感染患者的臨床資料進行分析。結(jié)果 60株MRSA對克林霉素、慶大霉素、利福平耐藥率均80%,環(huán)丙沙星、莫西沙星、左氧氟沙星耐藥率均90%,對呋喃妥因,復(fù)方新諾明較敏感,耐藥率10%,60株MRSA對萬古霉素,利奈唑胺均敏感。60株MRSA的mec A基因均為陽性,其中檢出3株菌株攜帶PVL基因,占5.0%,另外57株MRSA為PVL基因陰性,占95.0%。結(jié)論本地區(qū)臨床分離出的MRSA耐藥性較高,以攜帶mec A耐藥基因為主,因此治療應(yīng)以糖肽類抗生素為主,合理規(guī)范用藥。MRSA-PVL基因陽性率相對較低,但其與一些嚴(yán)重的金黃色葡萄球菌感染有關(guān),臨床應(yīng)予以關(guān)注并加強對PVL基因的監(jiān)測,有效控制及防止此類菌株播散流行。
[Abstract]:Objective to detect the prevalence of MRSA-mec A gene and PVL gene in clinical isolates of methicillin-resistant Staphylococcus aureus, and to analyze their resistance to common antimicrobial agents. Methods 10 common antimicrobial susceptibility tests were carried out with 96 well broth microdilution method, and all drug sensitivity tests were identified by MIC method. Mec A gene and PVL gene were detected by polymerase chain reaction (PCR), and the clinical data of patients infected with PVL gene positive strains were analyzed. Results 60 strains of MRSA were treated with clindamycin and gentamicin. The resistant rates of rifampicin, ciprofloxacin, moxifloxacin and levofloxacin were 90 and 90 respectively. The drug resistance rates of 100.60 strains of MRSA were positive for vancomycin, and 60 strains of MRSA were positive for MRSA. Among them, 3 strains were found to carry PVL gene, accounting for 5.0%, and 57 strains of MRSA were negative for PVL gene, accounting for 95.0.Conclusion the drug resistance of MRSA isolated from our region is higher, and the drug resistance gene of mec A is the main one. Therefore, glycopeptide antibiotics should be used as the main therapy. The positive rate of MRSA-PVL gene is relatively low, but it is related to some serious Staphylococcus aureus infection. We should pay close attention to it in clinic and strengthen the monitoring of PVL gene to effectively control and prevent the spread of these strains.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院檢驗科;
【分類號】：R446.5

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