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临床输血与检验

临床输血与检验 ›› 2018, Vol. 20 ›› Issue (3): 301-305.DOI: 10.3969/j.issn.1671-2587.2018.03.025

• 临床检验 • 上一篇    下一篇

小儿呼吸道感染金黄色葡萄球菌基因分型及多重耐药分子机制研究*

闵长艳,马丹冬   

  1. 441021 湖北省襄阳市中心医院，湖北文理学院附属医院
  • 收稿日期:2018-01-28 出版日期:2018-06-20 发布日期:2018-06-22
  • 通讯作者: 马丹冬，女，检验师，主要从事临床检验工作，（E-mail）：410783915@qq.com.
  • 作者简介:闵长艳（1980–），女，湖北襄阳人，主管技师，学士，主要从事临床检验工作，（Tel）13387522788（E-mail）Minchangyan123@163.com。
  • 基金资助:
    本课题受湖北省自然科学基金项目（No.2013CFB233）资助

Staphylococcus Aureus Genotyping and Multi-drug Resistance in Pediatric Respiratory Tract Infections

MIN Chang-yan，MA Dan-dong.   

  1. Department of Laboratory Medicine，the Central Hospital of Xiangyang，Hubei 441003
  • Received:2018-01-28 Online:2018-06-20 Published:2018-06-22

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摘要： 目的 探讨小儿呼吸道感染金黄色葡萄球菌基因分型及多重耐药分子机制。方法 从呼吸道感染患儿新鲜痰液或咽拭子标本中分离72株金黄色葡萄球菌，采用VITEK全自动微生物鉴定系统进行药敏试验，聚合酶链式反应（PCR）检测β-内酰胺类、氨基糖苷类、四环素类、大环内酯类耐药基因，并计算甲氧西林敏感金黄色葡萄球菌（MSSA）和耐甲氧西林金黄色葡萄球菌（MRSA）耐药基因携带率。结果 72株金黄色葡萄球菌中共筛选出34株MRSA，检出34株mecA基因，检出率为47.2%。MSSA对阿莫西林、红霉素、庆大霉素、米诺环素的耐药率显著低于MRSA（P＜0.05）；MRSA对非β-内酰胺抗菌药物敏感率和对1～2种非β-内酰胺抗菌药耐药率显著低于MSSA，MRSA多重耐药率显著高于MSSA（P＜0.05）。MRSA菌株tetM、aac（6′）/ ph（2′′）、ermA、tetK基因检出率显著高于MSSA，MSSA菌株ermC基因检出率显著高于MRSA（P＜0.05），MSSA与MRSA aph（3′）-Ⅲ基因检出率比较差异无统计学意义（P＞0.05）。MRSA未携带耐药基因比例、携带1～2种耐药基因比例显著低于MSSA，MRSA携带≥3种耐药基因比例显著高于MSSA（P＜0.05）。结论 小儿呼吸道感染金黄色葡萄球菌耐药基因型主要有mecA、tetM、aac（6′）/ ph（2′′）、ermA、tetK，携带多种耐药基因可能是多重耐药发生的主要机制。

关键词: 呼吸道感染, 金黄色葡萄球菌, 耐药基因, 多重耐药

Abstract: Objective To explore Staphylococcus aureus genetic diversity and the mechanisms of multi-drug resistance in respiratory tract infections of children. Methods A total of 72 strains of S. aureus were isolated from fresh sputa or throat swab specimens in children with respiratory tract infections. The drug sensitivity was detected by VITEK full automatic microbial identification system，the β-lactam，amino glycosides，tetracycline. Large ring lactone drug resistance gene of the isolates was detected by PCR，and the drug resistance gene frequency of MRSA was calculated. Results Thirty four MRSA positive strains were screened out from 72 strains of S. aureus，34 strains of mecA genes were detected in 72 strains of S. aureus，with a prevalence of 47.2%. The frequency of MSSA resistant to amoxicillin，erythromycin，gentamicin，minocycline was significantly lower than MRSA （P<0.05）. Bacterial sensitivity to non β-lactam and resistance to 1-2 type non β-lactam in MRSA were remarkably lower than MSSA，MRSA multi-drug resistant rate was significantly higher than MSSA （P<0.05）.The tetM，aac（6＇）/ ph（2＇＇），ermA，tetK detection rate in MRSA strains was significantly higher than that of MSSA. The ermC detection rate of MSSA strain was significantly higher than that of MRSA （P<0.05），and there was no significant difference in （3 '） - III gene detection rate between MSSA and MRSA （P＞0.05）. The frequencies of non-resistance gene or1-2 resistance genes in MRSA were lower than those of MSSA. Conclusion The main genotypes associated with resistance of S. aureus are mecA，tetM，aac（6＇）/ ph（2＇＇），ermA，and tetK in respiratory tract infections of children，which may constitute the main mechanism of multiple drug resistance.

Key words: Respiratory infection, Staphylococcus aureus, Drug res

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