CAJ | 학술논문

目的：调查了解我院临床分离的124株金黄色葡萄球菌的耐药谱特征及PVL基因携带状况,为临床合理使用抗菌药物提供科学依据。方法采用Vitek2 Compact全自动微生物鉴定仪进行菌株鉴定及药物敏感试验，PCR法检测mecA基因、mecC基因和PVL基因。结果耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为56.45%(70/124)，MRSA主要分离自烧伤病区，其次是神经外科ICU。 MRSA菌株对青霉素G均耐药；对左氧氟沙星、庆大霉素、红霉素、四环素、复方新诺明和利福平的耐药率分别为57.1%、67.1%、85.7%、80.07%、28.6%、37.1%；MRSA对多种常用抗菌药物的耐药率普遍高于甲氧西林敏感金黄色葡萄球菌(MSSA)，差异有统计学意义(P<0.05)；MRSA和MSSA对呋喃妥因、喹奴普汀／达福普汀、利奈唑胺的耐药率分别为2.9%、11.4%、2.9%；0.0%、5.6%、5.6%，差异无统计学意义(P>0.05)。检出6株PVL阳性，其中MRSA和MSSA各占3株。结论我院分离的金黄色葡萄球菌对抗菌药物呈多重耐药性,MRSA菌株耐药率明显高于MSSA,应加强对MRSA的监测,指导临床合理使用抗菌药物，加强对呋喃妥因、喹奴普汀／达福普汀、利奈唑胺耐药菌株的检测及PVL基因的检测，防止此类菌株的播散。
목적：조사료해아원림상분리적124주금황색포도구균적내약보특정급PVL기인휴대상황,위림상합리사용항균약물제공과학의거。방법채용Vitek2 Compact전자동미생물감정의진행균주감정급약물민감시험，PCR법검측mecA기인、mecC기인화PVL기인。결과내갑양서림금황색포도구균(MRSA)적검출솔위56.45%(70/124)，MRSA주요분리자소상병구，기차시신경외과ICU。 MRSA균주대청매소G균내약；대좌양불사성、경대매소、홍매소、사배소、복방신낙명화리복평적내약솔분별위57.1%、67.1%、85.7%、80.07%、28.6%、37.1%；MRSA대다충상용항균약물적내약솔보편고우갑양서림민감금황색포도구균(MSSA)，차이유통계학의의(P<0.05)；MRSA화MSSA대부남타인、규노보정／체복보정、리내서알적내약솔분별위2.9%、11.4%、2.9%；0.0%、5.6%、5.6%，차이무통계학의의(P>0.05)。검출6주PVL양성，기중MRSA화MSSA각점3주。결론아원분리적금황색포도구균대항균약물정다중내약성,MRSA균주내약솔명현고우MSSA,응가강대MRSA적감측,지도림상합리사용항균약물，가강대부남타인、규노보정／체복보정、리내서알내약균주적검측급PVL기인적검측，방지차류균주적파산。
Objective To investigate the drug-resistance and carriage of Panton-Valentine leukocidin (PVL) gene of 124 Staphylococcus aureus isolated from the hospitalized patients to guide the clinical treatment. Methods 124 Staphylococcus aureus isolates were tested by Vitek 2 Compact automatic microorganism identifying, and the drug sensitivity tests were also performed by it. MecA gene、mecC gene and PVL gene were detected by PCR. Results Methicillin-resistant Staphylococcus aureus (MRSA) ac-counted for 56.45%(70/124), which mainly came from Burns ward and secondly came from Neurosurgery Intensive Care Unit (NICU). All MRSA strains were resistant to penicillin G, and the resistance rates of levofloxacin, gentamicin, erythromycin, tetracy-cline, SMZ-TMP and rifampicin were 57.1%, 67.1%, 85.7%, 80.07%, 28.6% and 37.1%, repectively. For many drug resistances, there was statistical difference between MRSA and methicillin susceptible Staphylococcus aureus (MSSA)(P<0.05). The drug resis-tance rates of MRSA were 2.9%, 11.4%, 2.9%in Nitrofurantoin, Quinupristin-Dalfoprisdn and Linezolid, 0.0%, 5.6%, 5.6%refer-ring to MSSA. 6 of 124 Staphylococcus aureus carried PVL genes. Conclusions The Staphylococcus aureus strains from our hos-pital were multi-drug resistant for antibiotics, and the drug resistance rate of the MRSA strains was higher than the MSSA strains. The surveillance of MRSA should be strengthened to guide clinical medicine, the same with the surveillance of Nitrofurantoin, Quinupristin-Dalfoprisdn and Linezolid resistant Staphylococcus aureus and PVL genes.