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目的 了解甲氧西林耐药的金黄色葡萄球菌 (MRSA)的耐药性及分子流行病学特点。方法 采用纸片扩散法及琼脂稀释法检测 2 0 0 2年从北京协和医院住院患者分离的 1 6 5株MRSA的耐药性 ;采用脉冲场凝胶电泳 (PFGE)技术对其中重症监护病房 (ICU)和呼吸重症监护病房 (RCU)分离的6 5株MRSA作同源性分析。结果 1 6 5株MRSA对万古霉素和替考拉宁的敏感率为 1 0 0 %,对庆大霉素的耐药率为 1 0 0 %;对左氧氟沙星、四环素、红霉素耐药率分别为 98.2 %、96 .3%、93.9%。对甲氧苄啶 磺胺甲唑和氯霉素敏感率分别为 95 .8%及 98.8%;ICU和RCU病房分离MRSA的PFGE图谱有 5种类型 (A～E型 ) ,以A型为主 (5 6株 ) ,A型又包括A1亚型 (5 5株 )和A2亚型 (1株 )。结论 医院获得性MRSA是多重耐药菌 ,在ICU和RCU病房发生了基因型为A1亚型的MRSA菌株暴发流行。
Objective To understand the drug resistance and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA). Methods The drug resistance of 165 strains of MRSA isolated from hospitalized patients in Peking Union Medical College Hospital in 2002 by disk diffusion method and agar dilution method was tested. Pulsed-field gel electrophoresis (PFGE) ICU) and respiratory intensive care unit (RCU) isolated 6 5 MRSA homology analysis. Results The sensitivity of MRSA to vancomycin and teicoplanin was 100% and the resistance rate to gentamicin was 100%. The resistance rate to levofloxacin, tetracycline and erythromycin Respectively 98.2%, 96.3%, 93.9%. The susceptibilities to trimethoprim sulfadiazole and chloramphenicol were 95.8% and 98.8%, respectively. There were five types of PFGE profiles (MR type A / E) (56 strains), A type and subtype A1 (55 strains) and A2 subtype (1 strain). Conclusions Hospital-acquired MRSA is a multi-drug resistant bacterium. MRSA strains with genotype A1 subtype have been reported to have developed outbreaks in ICU and RCU wards.