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目的探讨细胞壁锚定蛋白编码基因Sas X与金黄色葡萄球菌耐药性的相关性。方法 PCR扩增Sas X基因;运用琼脂稀释法检测抗菌药物的最小抑菌浓度;采用卡方检验和确切概率法分析数据。结果 Sas X基因的检出率为28.75%(92株),其中在MRSA和MSSA中的检出率分别是33.15%(61株)和22.79%(31株);Sas X基因在ICU和痰液中的检出率分别为42.05%(37株)和26.94%(45株)。ICU等的Sas X基因阳性株构成比均明显比阴性株高(P<0.05),但在MRSA中,神经外科和呼吸内科的Sas X基因阳性株构成比却明显比阴性株低(P<0.05);头孢西丁等在Sas X基因阳性株中的耐药率明显高于阴性株(P<0.05);在MRSA中,阿米卡星、复方新诺明等在Sas X基因阳性株中的耐药率明显高于阴性株,而在MSSA中,仅阿米卡星、红霉素在Sas X基因阳性株中的耐药率明显高于阴性株(P<0.05)。结论 Sas X基因阳性金黄色葡萄球菌更容易产生耐药性(对MRSA影响更大)。Sas X基因在各个临床科室和各种标本中的检出情况各异,应个体化处理。
Objective To investigate the relationship between the gene encoding cell wall anchored protein Sas X and drug resistance of Staphylococcus aureus. Methods Sas X gene was amplified by PCR. The minimum inhibitory concentration of antibacterials was determined by agar dilution method. The data were analyzed by chi-square test and exact probability method. Results The detection rate of Sas X gene was 28.75% (92 strains), of which 33.15% (61 strains) and 22.79% (31 strains) were detected in MRSA and MSSA respectively. The detection rate of Sas X gene in ICU and sputum The detection rates were 42.05% (37 strains) and 26.94% (45 strains), respectively. ICU and other Sas X gene positive strains were significantly higher than the negative strains (P <0.05), but in MRSA, neurosurgical and respiratory medicine Sas X gene positive ratio was significantly lower than the negative (P <0.05 ). The resistance rate of cefoxitin in Sas X gene-positive strains was significantly higher than that in negative strains (P <0.05). In MRSA, amikacin and cotrimoxazole in SasX gene-positive strains The resistance rates of amikacin and erythromycin in SasX gene positive strains were significantly higher than that of negative ones in MSSA (P <0.05). Conclusion Sas X gene-positive Staphylococcus aureus is more susceptible to drug resistance (a greater impact on MRSA). Sas X genes in various clinical departments and various specimens detected in different situations, should be individualized.