CAJ | 학술논문

目的：研究医院感染耐药金黄色葡萄球菌的耐药表型及耐药基因，以期为临床防治医院感染提供参考。方法选取2011年1月－2013年1月医院感染患者送检标本中分离的120株金黄色葡萄球菌，根据美国临床实验室标准化研究所（CLSI）标准操作规程以及聚合酶链反应（PCR）分析金黄色葡萄球菌的耐药表型与耐药基因。结果金黄色葡萄球菌耐药率较高的抗菌药物为青霉素、红霉素、庆大霉素、克林霉素、四环素、环丙沙星，耐药率分别为100．00％、98．83％、80．00％、76．67％、76．67％、75．83％，对万古霉素、利奈唑胺较敏感；金黄色葡萄球菌各耐药表型中，以Ⅵ型97．50％的耐药率最高，其次分别为Ⅴ型（67．50％）、Ⅳ型（60．00％）；金黄色葡萄球菌各耐药基因中，以 mecA 98．83％的耐药率最高，且金黄色葡萄球菌耐药基因的耐药性与金黄色葡萄球菌对抗菌药物的耐药性一致。结论医院感染金黄色葡萄球菌对多数抗菌药物的耐药率较高，对万古霉素高度敏感；耐药表型以Ⅵ、Ⅴ、Ⅳ型为主，耐药基因以 tetK及mecA 为主。
목적：연구의원감염내약금황색포도구균적내약표형급내약기인，이기위림상방치의원감염제공삼고。방법선취2011년1월－2013년1월의원감염환자송검표본중분리적120주금황색포도구균，근거미국림상실험실표준화연구소（CLSI）표준조작규정이급취합매련반응（PCR）분석금황색포도구균적내약표형여내약기인。결과금황색포도구균내약솔교고적항균약물위청매소、홍매소、경대매소、극림매소、사배소、배병사성，내약솔분별위100．00％、98．83％、80．00％、76．67％、76．67％、75．83％，대만고매소、리내서알교민감；금황색포도구균각내약표형중，이Ⅵ형97．50％적내약솔최고，기차분별위Ⅴ형（67．50％）、Ⅳ형（60．00％）；금황색포도구균각내약기인중，이 mecA 98．83％적내약솔최고，차금황색포도구균내약기인적내약성여금황색포도구균대항균약물적내약성일치。결론의원감염금황색포도구균대다수항균약물적내약솔교고，대만고매소고도민감；내약표형이Ⅵ、Ⅴ、Ⅳ형위주，내약기인이 tetK급mecA 위주。
OBJECTIVE To study the drug resistance phenotypes and drug resistance genes in Staphylococcus au‐reus causing nosocomial infections so as to provide guidance for clinical prevention and treatment of the nosocomial infections .METHODS From Jan 2011 to Jan 2013 ,totally 120 strains of S .aureus were isolated from the submitted specimens that were obtained from the patients with nosocomial infections .According to the standard operation procedures of clinical laboratory standard institute ,the drug resistance phenotypes and drug resistance genes in the S .aureus strains were analyzed by using polymerase‐chain‐reaction (PCR) .RESULTS The drug resistance rates of the S .aureus strains to penicillin ,erythromycin ,gentamicin ,clindamycin ,tetracycline ,and ciprofloxacin were 100 .00% ,98 .83% ,80 .00% ,76 .67% ,76 .67% ,and 75 .83% ,respectively ;the strains were highly susceptible to vancomycin and linezolid .Among the different drug resistance phenotypes of S .aureus ,the drug resistance rate of the type Ⅵ S .aureus was the highest (97 .50% ) , followed by the type Ⅴ (67 .50% ) and the type Ⅳ(60 .00% ) .Among the S .aureus strains harboring different drug resistance genes ,the drug resistance rate of the S .aureus strains harboring mecA was the highest (98 .83% ) ,and the drug resistance of the drug resistance genes in the S .aureus strains was in accordance with the drug resistance of the S .aureus strains .CONCLUSION The S .aureus strains causing nosocomial infections are highly resistant to most of the antibiotics and highly susceptible to vancomycin .The type Ⅵ ,type Ⅴ ,and type Ⅳ are the major drug resistance phenotypes;the tetK and mecA are the predominant drug resistance genes .