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目的对医院获得性耐甲氧西林金黄色葡萄球菌(HA-MRSA)A蛋白(Spa)和葡萄球菌mec基因盒(SCCmec)分型同源性研究,为预防和控制医院感染提供依据。方法采用药敏纸片法(K-B法)、SCCmec分型及Spa分型技术,收集自2013年8月至2014年4月80株HA-MRSA,进行药敏试验和同源性分析,并检测毒力基因杀白细胞毒素(pvl)基因和毒性休克综合征(tsst)基因。结果药敏结果显示,80株HA-MRSA对青霉素、氨苄西林/舒巴坦、亚胺培南均耐药,对环丙沙星耐药率为90.0%,对克林霉素耐药率为58.8%,对复方磺胺类耐药率为13.8%,对万古霉素、利奈唑胺、替考拉宁均敏感。SCCmec分型结果显示,80株MRSA中SCCmecⅡ型占73.75%、SCCmecⅢ型(13.75%)、SCCmecⅤ型(12.5%)。Spa分型,28株为t2460型(35%)、9株为t002型(11%)、6株为t030型(8%)、7株为t632型(9%)、5株为t037型(6%),其他Spa型相对分散。pvl基因阳性率为7.5%(6株),tsst基因为阴性。结论 HA-MRSA SCCmec分型以Ⅱ为主,Spa分型以t2460型为主,有较高的同源性;HA-MRSA对多种药物具有较高的耐药性并且存在多重耐药。
Objective To study the typing homology of hospital acquired methicillin-resistant Staphylococcus aureus (HA) and staphylococcus mec gene cassette (SCCmec), and to provide a basis for prevention and control of nosocomial infections. Methods Eighty strains of HA-MRSA from August 2013 to April 2014 were collected by susceptibility disk method (KB method), SCCmec classification and spa typing technique. The drug susceptibility test and homology analysis were performed and detected The virulence genes kill leukotoxin (pvl) gene and the toxic shock syndrome (tsst) gene. Results The results of drug sensitivity test showed that 80 strains of HA-MRSA were resistant to penicillin, ampicillin / sulbactam and imipenem, the rate of resistance to ciprofloxacin was 90.0%, the rate of resistance to clindamycin was 58.8%. The resistance to sulfamethoxazole was 13.8%, which was sensitive to vancomycin, linezolid and teicoplanin. The results of SCCmec typing showed that SCCmec Ⅱ accounted for 73.75%, SCCmec Ⅲ (13.75%) and SCCmec Ⅴ (12.5%) in 80 strains of MRSA. Spa type, 28 strains were t2460 (35%), 9 strains were t002 (11%), 6 were t030 (8%), 7 were t632 (9%) and 5 were t037 6%), other Spa types are relatively scattered. The positive rate of pvl gene was 7.5% (6 strains), and the tsst gene was negative. Conclusion The SCCmec typing of HA-MRSA is mainly Ⅱ, and its genotyping is mainly t2460, which has high homology. HA-MRSA is highly resistant to many drugs and has multi-drug resistance.