医院耐甲氧西林金黄色葡萄球菌的SCCmec基因分型及耐药性分析

Analysis on SCCmec genotypes and drug-resistance of methicillin-resistant Staphylococcus aureus in hospital

  • 摘要: 目的 分析医院耐甲氧西林金黄色葡萄球菌(Methicillin-resistant Staphylococcus aureus,MRSA)的检出率、SCCmec基因分型及耐药性情况,为临床的防控及治疗提供一定的参考。方法 收集2014-2016年医院检验科微生物室培养和分离的金黄色葡萄球菌(Staphylococcus aureus,SAU),根据对苯唑西林的耐药性筛选出MRSA,并进行SCCmec基因分型及药敏试验。结果 2014-2016年共检出SAU 397株,其中检出MRSA 148株,检出率为37.28%;经SCCmec基因分型,共检出SCCmecⅠ型、Ⅱ型、Ⅲ型和Ⅳ型4个型别,其中检出SCCmecⅢ型最多,107株,占MRSA总株数的72.30%;所有的MRSA均对青霉素、苯唑西林耐药,对万古霉素、利奈唑胺、替加环素、奎奴普丁/达福普汀、替考拉宁、呋喃妥因敏感;SCCmecⅠ型对其余抗菌药物表现较好的敏感性;SCCmecⅢ型耐药谱最广。结论 医院MRSA检出率略低于全国水平,SCCmecⅢ型为医院主要的流行株。需对MRSA检出率情况进行持续监测,掌握其型别分布、耐药菌谱的变化等情况。

     

    Abstract: OBJECTIVE To analyze the detection rate, SCCmec genotypes and drug resistance profiles of methicillin-resistant Staphylococcus aureus (MRSA) in our hospital, in order to provide reference for clinical prevention and treatment. METHODS Staphylococcus aureus (SAU) strains cultured and isolated in the microbiology laboratory of our hospital from 2014 to 2016 were collected, and MRSA isolates were identified according to their sensitivity to methicillin, and then SCCmec genotyping and drug susceptibility test were performed. RESULTS From 2014 to 2016, a total of 148 MRSA isolates was detected, and the average detection rate was 37.28%. SCCmec genotypes Ⅰ, Ⅱ Ⅲ and Ⅳ were found, with SCCmec Ⅲ type as the top common type, accounting for 72.30%. All MRSA isolates were resistant to penicillin and oxacillin, and sensitive to vancomycin, linezolid,tigecycline,quinupristin/dalfopristin, and nitrofurantoin. All of the isolates of SCCmec genotype Ⅰ were sensitive to the rest of the antibiotics. SCCmec genotype Ⅲ showed the widest antimicrobial resistance profiles. CONCLUSION The MRSA detection rate in our hospital is slightly lower than the national average level. The main epidemic genotype of the isolates is SCCmec Ⅲ. The detection rate of MRSA should be continuously monitored, so as to master the distribution of genotypes and the changes of antimicrobial resistance profiles.

     

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