CAJ | 학술논문

目的研究分离于糖尿病足感染(DFI)溃疡创面的耐甲氧西林表皮葡萄球菌(MRSE)的SCCmec分型特点及不同型别的耐药特征.方法 2008年1月-2010年6月从天津某医院390例DFI溃疡中分离出70株表皮葡萄球菌,提取细菌的DNA,用聚合酶链反应(PCR)方法检测mecA基因,并对MRSE进行SCCmec分型;采用K-B纸片法进行药敏试验,分析不同SCCnec型别的耐药特点.结果 20株(28.6%,20/70)mecA均为阳性,SCCmec分型:Ⅱ型2例(10.0%)、Ⅲ型9例(45.0%)、Ⅳ型9例(45.0%),未发现Ⅰ型和Ⅴ型菌株.20株SCCmecⅡ、Ⅲ型或Ⅳ型菌株,均为多重耐药菌,除了对β-内酰胺类(包括青霉素类、头孢西丁、头孢类)耐药外,对大环内酯类、磺胺类、喹诺酮类等非β-内酰胺类抗菌药物耐药率也较高.所有菌株都对万古霉素和利福平敏感.结论 DFI溃疡中分离的MRSE以SCCmecⅢ型和Ⅳ型菌株为主,SCCmecⅣ型菌株已在DFI溃疡中传播并且对多种药物耐药.
목적 연구분리우당뇨병족감염(DFI)궤양창면적내갑양서림표피포도구균(MRSE)적SCCmec분형특점급불동형별적내약특정.방법 2008년1월-2010년6월종천진모의원390례DFI궤양중분리출70주표피포도구균,제취세균적DNA,용취합매련반응(PCR)방법검측mecA기인,병대MRSE진행SCCmec분형;채용K-B지편법진행약민시험,분석불동SCCnec형별적내약특점.결과 20주(28.6%,20/70)mecA균위양성,SCCmec분형:Ⅱ형2례(10.0%)、Ⅲ형9례(45.0%)、Ⅳ형9례(45.0%),미발현Ⅰ형화Ⅴ형균주.20주SCCmecⅡ、Ⅲ형혹Ⅳ형균주,균위다중내약균,제료대β-내선알류(포괄청매소류、두포서정、두포류)내약외,대대배내지류、광알류、규낙동류등비β-내선알류항균약물내약솔야교고.소유균주도대만고매소화리복평민감.결론 DFI궤양중분리적MRSE이SCCmecⅢ형화Ⅳ형균주위주,SCCmecⅣ형균주이재DFI궤양중전파병차대다충약물내약.
Objective To investigate SCCmec genotypes and drug-resistance profiles of the methieillin-resistant Staphylococcus epidermidis (MRSE) strains isolated from the patients suffered from diabetic foot infections (DFI) in the Tianjin Metabohc Diseases Hospital. Methods After dabridement, specimens of 390 infectious diabetic foot ulcers in the hospital from Jan 2008 to Jun 2010 were collected from the wound basal parts by cotton swab for culture. The disk-diffusion method was performed to examine antimicrobial susceptibility. DNAs of the MRSE strains were extracted, and their SCCmec genotypes were identified by PCR. Results Twenty of the seventy(28.6% ,20/70)Staphylococcus epidermidis strains were mecA posifive. Among the MRSE isolates, 2 ( 10.0% )were SCCmec Ⅱ ,9 (45.0%)were SCCmecⅢ and 9 (45.0%)were SCCmec Ⅳ. None of the isolates were genotyped as SCCmec Ⅰ or Ⅴ. No mater which genotypes they were, all the MRSE isolates were multi-drug resistant. They were resistant not only to β-lactams (including penicillins, cefoxitin and cephems), but also to non-β-lactams (including macrolides, fiuoroquinolones and sulfonamides ) . Resistance to voncomycin and rifampicin were not found in these strains . Conclusion SCCmec Ⅲ and SCCmecⅣ are major genotypes of the MRSE isolates from the infectious diabetic foot ulcers.The SCCmec Ⅳ genotype strains with multi-drug resistant profiles are prevalent in the diabetic foot infections.