摘要
目的探讨儿童社区获得性金黄色葡萄球菌肺炎临床分离株分子特征及耐药情况,为诊断和治疗提供依据。方法对2012-08/2016-05月分离自作者医院儿科病区100株金黄色葡萄球菌进行调查研究,聚合酶链式反应(polymerase chain reaction,PCR)方法鉴定耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)进行葡萄球菌染色体mec基因盒(staphyloccoccal cassette chromosome mec,SCCmec)分型,检测pvl毒力基因,检测菌株对苯唑西林等16种抗生素的耐药性。spa分型及多位点序列分型(multilocus sequence typing,MLST)方法对菌株进行分子分型。结果 100株金黄色葡萄球菌中18株为MRSA,82株为甲氧西林敏感金黄色葡萄球菌(methicillin sensitive Staphylococcus aureus,MSSA)。MRSA中鉴定出5种spa型,5种序列型(sequence type,ST)型和2种SCCmec型,优势克隆为ST59-SCCmecⅣ-t437。MSSA中鉴定出23种spa型、13种ST型。MSSA的pvl基因检出率为24.39%(20/82),MRSA的pvl基因检出率为38.89%(7/18)。药敏结果显示所有菌株对非β-内酰胺类抗生素保持较好的敏感性,但对克林霉素及红霉素耐药程度较高。结论ST59-SCCmecⅣ-t437是引起乌鲁木齐地区儿童社区获得性肺炎(community-acquired pneumonia,CAP)的主要克隆,而社区获得性耐甲氧西林金黄色葡萄球菌(community-acquired methicillin-resistant Staphylococcus aureus,CA-MRSA)主要克隆为ST398、ST5、ST59及ST7型。所有菌株对非β-内酰胺类抗生素保持较好的敏感性,但对红霉素及克林霉素均存在一定的耐药性。
Objective To investigate the molecular types and drug sensitivities of Staphylococcus aureus strains isolated from the children with community-acquired pneumonia(CAP),and provide basis for clinical diagnosis and treatment.Methods A total of 100 Staphylococcus aureus isolated from CAP children were investigated from Augest 2012 to May2016 in author's hospital.The methicillin-resistant Staphylococcus aureus(MRSA)were determined by polymerase chain reaction(PCR).All strains were analyzed by staphylococcal cassette chromosome mec(SCCmec)typing,and detected pvl virulence gene,drug resistance such as oxacillin and other 16 kinds of antibiotics.Meanwhile,all isolates were made typing of spagene and multilocus sequence typing(MLST).Results Of the 100 Staphylococcus aureus isolates,18 were MRSA and 82 were methicillin sensitive Staphylococcus aureus(MSSA).The MRSA strains were identified with 5 spatypes,5 sequence type(ST)types and 2 SCCmectypes.ST59-SCCmecⅣ-t437 was the prevalent clone.Of the 82 MSSA strains,23 were classified as spatypes,and 13 were ST types.The detective rate of pvl gene was 24.4%(20/82)in MSSA strains,and 38.9%(7/18)in MRSA strains.The drug sensitivity test showed all strains had high sensitivities to most non-β-lactam antibiotics except clindamycin and erythromycin.Conclusion ST59-SCCmecⅣ-t437 is the predominant clone that causes CAP children in Urumqi.The predominant clone of community-acquired methicillin-resistant Staphylococcus aureus(CA-MRSA)are ST398,ST5,ST59 and ST7 types.All strains had high sensitivities to most non-β-lactam antibiotics except clindamycin and erythromycin.
出处
《华南国防医学杂志》
CAS
2017年第11期719-722,共4页
Military Medical Journal of South China
基金
国家自然科学基金项目(81401703)
关键词
金黄色葡萄球菌
社区获得性肺炎
分子分型
药敏试验
Staphylococcus aureus
Community-acquired pneumonia
Molecular classification
Drug sensitivity test
