摘要
目的分析儿童急性中耳炎分泌物中分离的金黄色葡萄球菌(staphylococcus aureus,SA)菌株抗生素药物敏感性和分子特征。方法收集150例临床诊断为急性中耳炎儿童中耳腔脓液或耳分泌物进行细菌培养鉴定,进一步进行菌株的抗菌药物敏感性试验,检测菌株的耐药基因、毒力基因和多序列基因分型(MLST)分析。结果共有86份非重复的标本分离出SA菌株,其中55株SA菌株至少对三种抗生素呈耐药状态,多重耐药率为63.9%。根据mecA基因分为甲氧西林敏感性SA(MSSA)66株和甲氧西林耐药性SA(MRSA)20株,与MSSA相比,MRSA对头孢曲松、红霉素和克林霉素的耐药率更高(均P<0.05),而MSSA比MRSA更容易对环丙沙星和庆大霉素产生耐药(圴P<0.05)。MRSA菌株携带的耐红霉素基因ermC和耐四环素基因tetK的检出率均显著高于MSSA菌株(均P<0.05);同时,MRSA菌株携带的免疫逃逸簇基因(scn、chp和sak)、肠毒素基因(seb和sek)、溶血素基因hlb以及杀白细胞素基因(pvl)的检出率均显著高于MSSA菌株(均P<0.05);MSSA菌株携带的肠毒素基因sem和中毒性休克综合征毒素-1(tsst-1)的检出率均显著高于MRSA(分别为P=0.002和P<0.001)。对应分析结果显示金黄色葡萄球菌不同的克隆复合体耐药的表型不一样(χ^(2)=131.11,P<0.001)。不同克隆复合体携带毒力基因的数量不一致,其分布存在显著差异(χ^(2)=159.79,P<0.001)。结论致儿童急性中耳炎的金黄色葡萄球菌大多呈多重耐药状态,不同的SA菌株不同的克隆复合体耐药的表型与携带的毒力基因均不一致。
Objective To tuvesigate the antimicrobial susceptibility and genotype of staphylococcus aureus(S.aureus,SA)isolated in children with acute otitis media(AOM).Methods After clinical diagnosed as AOM,middle ear fluid specimens were collected and cultured for bacterial pathogens.The antibiotic susceptibility,resistant genes,virulence genes,and sequence types of S.aureus were identified.Results A total of 86 SA isolates were detected from clinical specimens,about 63.9%of isolates were resistant to at least 3 classes of antibiotic.Twenty isolates were classified into methicillin-resistant SA(MRSA)and 66 were classified into methicillin-sensitive SA(MSSA)by detecting mecA gene.Compared with MSSA,MRSA were more likely resistant to ceftriaxone,erythromycin and clindamycin(P<0.05).Compared with MRSA,MSSA were more likely resistant to ciprofloxacin and gentamicin(P<0.05).The detection rates of the erythromycin-resistant gene ermC and the tetracycline-resistant gene tetK carried by the MRSA isolates were significantly higher than those of the MSSA isolates(P<0.05).At the same time,the detection rates of immune escape cluster genes(scn,chp and sak),enterotoxin genes(seb and sek),hemolysin gene hlb and leukocidin gene(pvl)carried by MRSA isolates were significantly higher than those of MSSA isolates(P<0.05).The detection rates of the enterotoxin gene sem and toxic shock syndrome toxin-1(tsst-1)carried by the MSSA isolates were significantly higher than those of MRSA(P 0.002 and<0.001,respectively).A significant correlation existed between clonal complexs(CCs)and antibiotic resistance spectrum(χ^(2)=131.11,P<0.001),and between CCs and number of virulence genes(χ^(2)=159.79.11,P<0.001).Conclusion Most of the staphylococcus aureus isolates detected from children with AOM are multi-drug resistance,which highlights the importance of continued surveillance of antibiotic resistance in the future work.The antibiotic resistance spectrum and number of specific virulence genes of SA isolates are highly associated with clonal complexs.
作者
周龙平
唐向荣
傅锦坚
Zhou Longping;Tang Xiangrong;Fu Jinjian(Department of Laboratory and Otolaryngology of Liuzhou Maternity and Child Health Care Hospital,Liuzhou,545001,China;不详)
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2022年第1期17-21,共5页
Journal of Audiology and Speech Pathology
基金
柳州市科学技术局重点研发计划(2018BJ10504)
广西壮族自治区卫健委课题(Z20200782)
广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180014)。
