摘要
目的分析2011~2013年北京友谊医院耐甲氧西林金黄色葡萄球菌（MRSA）耐药谱变迁;了解其葡萄球菌盒式染体色mec（SCCmec）基因型分布特点。方法使用WHONET 5.6软件对2011至2013年间MRSA药物敏感结果进行数据分析。收集2013年3月至2013年10月首都医科大学附属北京友谊医院临床检验中心细菌室分离的非重复MRSA 30株,采用多重聚合酶链反应（PCR）对其进行SCCmec基因型分型。结果 2011~2013年3年的调查显示,临床标本中共分离出1 133株金黄色葡萄球菌检出MRSA 662株,检出率58.4%,3年检出率成逐渐上升趋势。MRSA检出标本来源于痰液及咽拭子最多,其次为血液、脓分泌物和尿液标本。MRSA主要分布在ICU、医保中心和急诊。662株MRSA对青霉素均为100%耐药,红霉素、克林霉素、庆大霉素、四环素耐药率均〉80%,环丙沙星、莫西沙星、左氧氟沙星耐药率97.2%~95%和96.7%~88.8%和97.2%~95.4%,对呋喃妥因、复方新诺明较敏感,耐药率〈10%,3年中未发现对万古霉素、替加环素,喹努普汀/达福普汀、利奈唑胺耐药菌。检出SCCmec III型有27株,检出率为90.0%;其余3株为未分型菌株,占10.0%。结论本次MRSA耐药监测中,其对万古霉素、利奈唑胺、替加环素均保持着高度敏感性,对呋喃妥因、复方新诺明较敏感,耐药率〈10%。其SCCmec基因分型以SCCmecⅢ型为主,与国内多数地区、医院报道的以SCCmecⅢ型为主相符。
Objectives To analyze the drug-resistant spectrum change 2011 ~ 2013 from methicillin-resistant staphylococcus aureus（ MRSA）. To understand the staphylococcus cassette chromosome mec（ SCCmec） genotype characteristics. Methods The WHONET 5. 6 software was used to analyze methicillin-resistant staphylococcus aureus drug sensitivity results between 2011 and 2013. The isolates of methicillin-resistant staphylococcus aureus from different patients in March 2013 to October 2013 were collected. The specimens were isolated in Clinical Laboratory Center of Beijing Friendship Hospital,Capital Medical University. Multiple polymerase chain reaction（ PCR） on the SCCmec genotype was used in this study. Results According to the survey of Clinical specimens,1133 strains of staphylococcus aureus were isolated,662 strains of MRSA detection were isolated in our hospital from 2011 ~ 2013. The detection rate was 58. 4%. The 3 years detection rate showed a rising trend.MRSA detection from sputum specimens and pharyngeal swab up,followed by pus discharge blood and urine samples. MRSA are mainly distributed in the ICU,health center,emergency. All 662 strains of MRSA are resistant to penicillin. For erythromycin,clindamycin gentamicin,tetracycline. the resistant rate is more than 80%. For tociprofloxacin,moxifloxacin,levofloxacin,the resistant rate 97. 2% ~ 95% and 96. 7% ~ 88. 8%and 97. 2% ~ 5. 4%. For nitrofurantoin,trimethoprim / sulfamethoxazole is sensitive,the resistance rate is less than 10%. In the pastthree years,we did not find vancomycin,tigecycline,quinupristin / dalfopristin,linezolid resistant bacteria. After checking out the type SCCmec III 27 strains,the detection rate is 90. 0%. The rest 3 strains did not have parting strains,accounting for 10. 0%. Conclusion Our methicillin-resistant staphylococcus aureus resistance monitoring,remain highly sensitive to vancomycin and linezolid and tigecycline. The nitrofurantoin and trimethoprim /sulfamethoxazole is sensitive,resistance to less than 10%. The SCCmec genotypi
出处
《临床和实验医学杂志》
2015年第6期462-466,共5页
Journal of Clinical and Experimental Medicine
