社区糖尿病人群携带金黄色葡萄球菌的分型与耐药谱关系研究

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目的了解社区糖尿病人群携带金黄色葡萄球菌的分型情况并分析其耐药谱。方法随机抽取佛山市里水镇11个社区糖尿病人438名并收集其鼻拭子样本,根据传统实验室方法分离鉴定金黄色葡萄球菌,采用头孢西丁纸片扩散法和mec A基因扩增法进行耐甲氧西林金黄色葡萄球菌(Methicillin-Resistant Staphylococcus Aureus,MRSA)的鉴定,利用多重聚合酶链式反应(Polymerase Chain Reaction,PCR)的方法对MRSA菌株进行葡萄球菌染色体盒(Staphyloccoccal Cassette Chromosome mec,SCCmec)的分子分型,应用K-B纸片扩散法分析金黄色葡萄球菌的耐药谱。结果 438份样本中分离出43株金黄色葡萄球菌,检出率为9.82%,其中22株(5.02%)为MRSA。22株MRSA中,医院获得性耐甲氧西林金黄色葡萄球菌(Hospital-Acquired MRSA,HA-MRSA)7株,社区获得性耐甲氧西林金黄色葡萄球菌(Community-Acquired MRSA,CA-MRSA)10株,SCCmec未分型5株。金黄色葡萄球菌除对替考拉宁无耐药外,对其他抗生素均有不同程度的耐药,MRSA的耐药率普遍高于甲氧西林敏感金黄色葡萄球菌(Methicillin Sensitive Staphylococcus Aureus,MSSA)的耐药率,两者对红霉素和克林霉素耐药率差异有统计学意义,36.36%(8/22)的MRSA具有多重耐药性,MSSA中未发现多重耐药菌株。结论该地区糖尿病人群携带的金黄色葡萄球菌中MRSA比例高,所携带的MRSA中以CA-MRSA为主,MRSA对抗生素的多重耐药问题值得重视。 Objective To understand the typing of Staphylococcus aureus in community diabetic population and analyze its drug resistance spectrum. Methods A total of 438 diabetics from 11 communities in Lishui Town, Foshan City were collected and their nasal swab samples were collected. Staphylococcus aureus was isolated and identified according to the traditional laboratory methods. The cefoxitin disk diffusion and mec A gene amplification Methicillin-resistant Staphylococcus Aureus (MRSA) was identified. The MRSA strains were stained with Staphyloccoccal Cassette Chromosome mec by Polymerase Chain Reaction (PCR) , SCCmec) molecular typing, the application of KB disk diffusion method for the analysis of drug resistance spectrum of Staphylococcus aureus. Results 43 strains of Staphylococcus aureus were isolated from 438 samples, the detection rate was 9.82%. Among them, 22 strains (5.02%) were MRSA. Among 22 MRSA strains, 7 were hospital-acquired hospital-acquired MRSA (HA-MRSA), 7 were community-acquired MRSA (CA-MRSA) 10 strains, SCCmec not type 5 strains. Staphylococcus aureus in addition to no resistance to teicoplanin, the other antibiotics have different levels of resistance, MRSA resistance rates were generally higher than methicillin-sensitive Staphylococcus aureus (Methicillin Sensitive Staphylococcus Aureus, MSSA) The resistance rates of erythromycin and clindamycin were statistically different between the two groups. 36.36% (8/22) MRSA was multi-drug resistant and no multi-drug resistant strains were found in MSSA. Conclusion The proportion of MRSA in Staphylococcus aureus carried by diabetic population in this area is high, and the MRSA carried by them is mainly CA-MRSA. The MRSA should pay more attention to the multi-drug resistance of antibiotics.
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