中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2014年
4期
301-305
,共5页
朱佩琼%蒋琰%王燕飞%裘云庆
硃珮瓊%蔣琰%王燕飛%裘雲慶
주패경%장염%왕연비%구운경
抗甲氧西林金黄色葡萄球菌%分子分型%多位点序列分型%SCCmec分型%spa分型%微生物敏感性试验
抗甲氧西林金黃色葡萄毬菌%分子分型%多位點序列分型%SCCmec分型%spa分型%微生物敏感性試驗
항갑양서림금황색포도구균%분자분형%다위점서렬분형%SCCmec분형%spa분형%미생물민감성시험
Methicillin-resistant Staphylococcus aureus%Molecular typing%Multilocus sequence typing%SCCmec typing%spa typing%Microbial sensitivity tests
目的 探讨浙江省分离的耐甲氧西林金黄色葡萄球菌(MRSA)的分子分型及菌株的耐药性.方法 连续收集2009年1月至2010年12月浙江省11家三级甲等医院临床分离的MRSA147株.采用琼脂稀释法对13种抗菌药物进行最小抑菌浓度(MIC)测定.通过多位点序列分型(MLST)、SCCmec分型和spa分型进行菌株同源性分析,并比较不同分型菌株的耐药谱.利用辛普森指数计算三种分型方法的分辨率并进行比较.结果 147株MRSA菌株共分为14种ST型,其中ST239(75株)、ST5(24株)和ST59(23株)为主要流行克隆;SCCmec分型以Ⅲ型为主(76株),其次是Ⅳ型(32株)、Ⅱ型(24株)和Ⅴ型(9株),6株菌株无法分到已知型;spa基因分型被分为23种,其中以t030、t437、t002和t037菌株数最多,分别为57,17,15和12株.药敏结果显示,MRSA菌株除对利奈唑胺、替考拉宁、万古霉素和去甲万古霉素敏感外,对其他常用抗菌药物的耐药率均很高,尤其是主要流行克隆ST239以及SCCmec Ⅲ型菌株耐药情况严重.三种分型方法的分辨率分别为0.6885,0.6577和0.8165,其中spa分型方法对菌株的区分能力更强.结论 浙江省临床分离的MRSA菌株存在主要流行克隆ST239-SCCmecⅢ-t030-MRSA,耐药形势严峻,应加强院内耐药菌株的监测.
目的 探討浙江省分離的耐甲氧西林金黃色葡萄毬菌(MRSA)的分子分型及菌株的耐藥性.方法 連續收集2009年1月至2010年12月浙江省11傢三級甲等醫院臨床分離的MRSA147株.採用瓊脂稀釋法對13種抗菌藥物進行最小抑菌濃度(MIC)測定.通過多位點序列分型(MLST)、SCCmec分型和spa分型進行菌株同源性分析,併比較不同分型菌株的耐藥譜.利用辛普森指數計算三種分型方法的分辨率併進行比較.結果 147株MRSA菌株共分為14種ST型,其中ST239(75株)、ST5(24株)和ST59(23株)為主要流行剋隆;SCCmec分型以Ⅲ型為主(76株),其次是Ⅳ型(32株)、Ⅱ型(24株)和Ⅴ型(9株),6株菌株無法分到已知型;spa基因分型被分為23種,其中以t030、t437、t002和t037菌株數最多,分彆為57,17,15和12株.藥敏結果顯示,MRSA菌株除對利奈唑胺、替攷拉寧、萬古黴素和去甲萬古黴素敏感外,對其他常用抗菌藥物的耐藥率均很高,尤其是主要流行剋隆ST239以及SCCmec Ⅲ型菌株耐藥情況嚴重.三種分型方法的分辨率分彆為0.6885,0.6577和0.8165,其中spa分型方法對菌株的區分能力更彊.結論 浙江省臨床分離的MRSA菌株存在主要流行剋隆ST239-SCCmecⅢ-t030-MRSA,耐藥形勢嚴峻,應加彊院內耐藥菌株的鑑測.
목적 탐토절강성분리적내갑양서림금황색포도구균(MRSA)적분자분형급균주적내약성.방법 련속수집2009년1월지2010년12월절강성11가삼급갑등의원림상분리적MRSA147주.채용경지희석법대13충항균약물진행최소억균농도(MIC)측정.통과다위점서렬분형(MLST)、SCCmec분형화spa분형진행균주동원성분석,병비교불동분형균주적내약보.이용신보삼지수계산삼충분형방법적분변솔병진행비교.결과 147주MRSA균주공분위14충ST형,기중ST239(75주)、ST5(24주)화ST59(23주)위주요류행극륭;SCCmec분형이Ⅲ형위주(76주),기차시Ⅳ형(32주)、Ⅱ형(24주)화Ⅴ형(9주),6주균주무법분도이지형;spa기인분형피분위23충,기중이t030、t437、t002화t037균주수최다,분별위57,17,15화12주.약민결과현시,MRSA균주제대리내서알、체고랍저、만고매소화거갑만고매소민감외,대기타상용항균약물적내약솔균흔고,우기시주요류행극륭ST239이급SCCmec Ⅲ형균주내약정황엄중.삼충분형방법적분변솔분별위0.6885,0.6577화0.8165,기중spa분형방법대균주적구분능력경강.결론 절강성림상분리적MRSA균주존재주요류행극륭ST239-SCCmecⅢ-t030-MRSA,내약형세엄준,응가강원내내약균주적감측.
Objective To investigate molecular types and drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) in Zhejiang province.Methods One hundred and fourty-seven clinical MRSA isolates were collected from 11 grade A tertiary hospitals during January 2009 and December 2010 in Zhejiang province.Minimal inhibitory concentrations (MICs) of 13 antimicrobial agents were determined by agar dilution.Multilocus sequence typing (MLST),staphylococcal cassette chromosome mec (SCCmec) typing and spa typing were used to examine the homology of the strains,and drug resistance patterns were compared among different molecular types.Simpson index was used to determine the discriminatory power of three typing methods.Results Fourteen STs were identified in 147 MRSA isolates,of which ST239 (75 isolates),ST5 (24 isolates) and ST59 (23 isolates) were the most prevalent clones.Four SCCmec types (types Ⅱ to Ⅴ) were identified in 141 isolates,and 6 isolates were not typed.SCCmec type Ⅲ was the predominant type (76 isolates),which was followed by type Ⅳ (32 isolates),type Ⅱ (24 isolates) and type Ⅴ (9 isolates).All MRSA isolates yielded 23 spa types,in which t030 (57 strains),t437 (17 strains),t002 (15 strains) and t037 (12 strains) were the predominant spa types.MRSA strains were sensitive to linezolid,teicoplanin,vancomycin and norvancomycin,but were highly resistant to other antibacterial agents,especially in strains carrying clone ST239 or of SCCmec type Ⅲ.The discriminatory power of MLST,SCCmec and spa typing were 0.6885,0.6577 and 0.8165,respectively.Conclusion The predominant clone of MRSA strains in Zhejiang province was ST239-SCCmec Ⅲ-t030-MRSA,and these strains are highly resistant to most antibacterial agents,so that the surveillance of MRSA in hospital should be strengthened.
