作　　者： (曾海玲）; (李文婷）; (王冬梅）; (龚夏莲）; (唐萍）; (沈叙庄）; (文德年）; (姚开虎）;

机构地区： 中江县人民医院检验科,四川中江618100

出　　处： 《中华实用儿科临床杂志》 2017年第16期1235-1238,共4页

摘　　要： 目的明确中江县人民医院住院呼吸道感染患儿鼻咽部金黄色葡萄球菌（金葡菌）的葡萄球菌染色体盒（SCCmec）基因型分布和耐药情况。方法收集2015年1至12月中江县人民医院住院呼吸道感染患儿鼻咽拭子分离出的77株金葡菌，采用头孢西丁纸片法和mecA检测鉴定耐甲氧西林金葡菌（MRSA）或甲氧西林敏感金葡萄（MSSA），E—test法检测菌株对常用抗菌药物的最小抑菌浓度（MIC），多重PCR对MRSA菌株进行SCCmec基因分型。结果77株菌中，MRSA42株（54．5％），MRSA均对青霉素耐药，对头孢呋辛、头孢曲松和红霉素耐药率分别为78．6％、95．2％、97．6％。MSSA35株，对青霉素、红霉素耐药率分别为97．1％、62．9％，对其余药物均敏感。42株MRSA可明确SCCmec基因分型，其中SCCmecIVa27株（64．3％），SCCmecIVg和V型各5株（11．9％），IVc和IVh型各1株（2．4％）。SCCmecIV型的头孢呋辛不敏感率显著高于其他型（P〈0．05）。结论中江县住院呼吸道感染患儿鼻咽部定植的金葡菌常对青霉素、红霉素耐药，MRSA检出率较高，SCCmec基因型以IVa为主。 Objective To investigate the antimicrobial resistance and genotype distribution of staphylococcal cassette chromosome mec（SCCmec） of staphylococcus anreus（ S. aureus） isolated from children hospitalized at Pediatric People＇s Hospital of Zhongjiang County. Methods Seventy - seven strains of S. aureus were collected by nasopharyngeal swabs at the Pediatric Department of People＇s Hospital of Zhongjiang County from January to December 2015. Methicillinresistant staphylococcus aureus （MRSA） and methicillin- susceptible staphylococcus aureus （MSSA） were identified by cefoxitin disc diffusion and detection of mecA method. The minimum inhibitory concentrations（MIC） of antibiotics were determined by E - test method. SCCmec typing on MRSA strains was performed by using multiplex PCR. Results MRSA accounted for 54.5% （42 strains） strains of 77 strains. All MRSA strains were resistant to Penicillin,and the rates of antibiotic resistance to Cefuroxime, Ceftriaxone, Erythromycin were 78.6% ,95.2% and 97.6% ,respectively. The rates of antibiotic resistance of 35 MSSA to Penicillin and Erythromycin were 97. 1% and 62.9%, and they were also sensitive to other antibiotics. In 42 strains of MRSA,SCCmec type Ⅳa was the predominant type（27 strains,64.3% ）, which was followed by type Ⅳg and Ⅴ （ each 5 strains, 11.9% ）, type Ⅳc and Ⅳh （ each 1 strain,2.4% ）. Non - susceptibility rate of SCCmec Ⅳ to cefuroxime was significantly higher than that of other SCCmec types（P 〈 0.05）. Conclusions All strains from children hospitalized in People＇s Hospital of Zhongjiang County are often resistant to Penicillin and Erythromycin. The proportion of MRSA isolated from hospitalized children was high. SCCmec type Ⅳa is the main genotype of MRSA.

关 键 词： 金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 葡萄球菌染色体盒 耐药