CAJ | 학술논문

目的了解金黄色葡萄球菌(SAU)对莫匹罗星的耐药性,并探讨其耐药菌株对临床常用抗菌药物的耐药特性.方法用含量为5 μg莫匹罗星纸片筛选2005年1月至2007年5月温州医学院附属第一医院临床分离的SAU 490株,对耐药菌株进行莫匹罗星最小抑菌浓度(MIC)检测及mupA基因扩增,以确定其耐药水平;纸片扩散法检测莫匹罗星耐药菌株对头孢西丁、庆大霉素、左氧氟沙星、复方磺胺甲恶唑、利福平、红霉素、克林霉素、四环素及万古霉索的耐药性,对头孢西丁耐药的菌株再行mecA基因扩增,以确定其对甲氧西林的耐药性.结果共获得27株莫匹罗星耐药的SAU,其中22株(81.5%)为对莫匹罗星高水平耐药(MuH),其余5株为低水平耐药(MuL).头孢西丁药物敏感性试验和mecA基因检测发现,27株莫匹罗星耐药SAU中,有24株为甲氧西林耐药金黄色葡萄球菌(MRSA),其中21株为MuH,3株为MuL.药物敏感性试验显示,MuH和MuL菌株对庆大霉素、左氧氟沙星、复方磺胺甲恶唑、利福平、红霉素、克林霉素、四环素的耐药率都较高,且呈多药耐药,但对万古霉素全部敏感.结论对莫匹罗星耐药的SAU已在临床分离株中出现,且以高水平耐药为主,临床上应加强对该类菌株的鉴定及药物敏感性监测,以防其传播流行.
목적 료해금황색포도구균(SAU)대막필라성적내약성,병탐토기내약균주대림상상용항균약물적내약특성.방법 용함량위5 μg막필라성지편사선2005년1월지2007년5월온주의학원부속제일의원림상분리적SAU 490주,대내약균주진행막필라성최소억균농도(MIC)검측급mupA기인확증,이학정기내약수평;지편확산법검측막필라성내약균주대두포서정、경대매소、좌양불사성、복방광알갑악서、리복평、홍매소、극림매소、사배소급만고매색적내약성,대두포서정내약적균주재행mecA기인확증,이학정기대갑양서림적내약성.결과 공획득27주막필라성내약적SAU,기중22주(81.5%)위대막필라성고수평내약(MuH),기여5주위저수평내약(MuL).두포서정약물민감성시험화mecA기인검측발현,27주막필라성내약SAU중,유24주위갑양서림내약금황색포도구균(MRSA),기중21주위MuH,3주위MuL.약물민감성시험현시,MuH화MuL균주대경대매소、좌양불사성、복방광알갑악서、리복평、홍매소、극림매소、사배소적내약솔도교고,차정다약내약,단대만고매소전부민감.결론 대막필라성내약적SAU이재림상분리주중출현,차이고수평내약위주,림상상응가강대해류균주적감정급약물민감성감측,이방기전파류행.
Objective To investigate mupiroein resistance in Staphylococcus aureus (SAU) and the resistance to commonly used antibiotics in mupirocin-resistant strains. Methods Four hundred and ninety clinically isolated SAU strains froin January 2005 to May 2007 in the First Affiliated Hospital,Wenzhou Medical College were screened by mupirocin(5μg)disc diffusion method.Minimum inhibition concentration(MIC)and the amplification of mupA gene were performed to determine the resistance to mupirocin.Resistance to cefoxitin,gentamycin, levofloxacin, trimethoprim/sulfamethoxazole, rifampin, erythromycin, clindamycin, tetracycline and vancomycin in mupirocin-resistant strains was detected by disc diffusion method, and the amplification of mecA gene was performed to confirm the methieillin resistance among mupiroein-resistant strains.Results Twenty-seven mupirocin-resistant strains were obtained,in which 22(81.5%)were hish-level mupirocin resistant(MuH)and the rest were low-level mupirocin resistant(MuL).Among 27 mupirocin-resistant strains,24 were methicillin-resistant Staphylococcus aureus (MRSA)in which 21 were MuH and 3 were MuL strains.Drug sensitivity tests showed that the resistance to gentamycin,levofloxacin,trimethoprim/sulfamethoxazole,rifampin,erythromycin,elindamycin and tetracycline were hish among MuH and MuL strains,and most of these strains were multi-drug resistant.All strains were susceptible to vaneomycin.Conclusions Most of the clinical emerged mupirocin-resistant SAU strains are MuH and show hish resistance to commonly used antibiotics.Therefore,detection and drug sensitivity test of mupirocin-resistant strains should be strengthened in clinic practice in order to prevent it from dissemination.