【摘要】 目的:了解并确定临床分离的耐甲氧西林金黄色葡萄球菌(MRSA)葡萄球菌染色体mec盒(SCCmec)型别的特点。方法:用常规方法将从天津医科大学第二医院等天津地区8家医院及武汉同济医院临床标本(痰、尿、血及分泌物)中分离细菌,金黄色葡萄球菌的鉴定采用凝固酶实验、常规生化鉴定、M43葡萄球菌乳胶凝集试剂盒及法国生物梅里埃公司的APIstaph条确定,MRSA的检测采用头孢西丁纸片扩散法及mecA基因的检测确定。应用10对引物的多重引物聚合酶链反应技术(M-PCR)扩增MRSA葡萄球菌染色体mec盒的基因片段,对其中不能分型的变异株进行mec基因复合体及ccr基因复合体分型,然后根据mec基因复合体及ccr基因复合体的组合情况对MRSA的型别情况作出判断。结果:本实验共分离出金黄色葡萄球菌127株,MRSA78株,其中天津地区51株,武汉地区27株。78株MRSA经过3组M-PCR方法最终得到SCCmec-Ⅰ型1株,SCCmec-Ⅱ型4株,SCCmec-Ⅲ型62株,SCCmec-Ⅴ型3株,未检测出SCCmec-Ⅳ型及SCCmec-Ⅵ型,并且有8株MRSA用本实验方法不能分型。结论:本实验分离的MRSA临床株的SCCmec以Ⅲ型(或SCCmecⅢ+dcs型)为主。更多还原

【Abstract】 Objective:To study the characteristic of staphylococcal cassette chromosome mec(SCCmec) type used in methicillin resistant staphylococcus aureus(MRSA).Methods:According to routine process,sputum,urine,blood,excreta and other samples which collected from Second Hospital of Tianjin Medical University,Tongji Hospital of Wuhan,and other six hospitals were cultured.Indentification of MRSA was conducted with coagulase test,routine biochemical identification,a rapid confirmatory latex agglutination test and Bio-Merieux products API staph test.The methods to determine MRSA are Cefoxitin disc diffusion test and the detection of mecA gene.Multiplex PCR was used for amplificating SCCmec element.Variants that could not be typed were undertakn mec and ccr gene complex typing,respectively.The genotypes of SCCmec were differentiated based on the combination of mec and ccr gene complex.Results:In this experiment,127 staphylococcus aureus were isolated,78 strains of them were MRSA(51 strains from Tianjin,and 27 strains from Wuhan).Among our MRSA isolates,SCCmec-Ⅰ 1,SCCmec-Ⅱ 4,SCCmec-Ⅲ 62,SCCmec-Ⅴ 3,no type Ⅳ and Ⅵ were detected according to SCCmec typing.There are 8 strains that could not be typed with these methods.Conclusion:MRSA isolated in this experimentation were mainly type Ⅲ according to SCCmec typing.更多还原