【摘要】 目的研究两种临床标本来源中耐甲氧西林的金黄色葡萄球菌(MRSA)生物膜形成能力和抗菌药物耐药率,并探讨二者的关系,为临床检测和治疗提供依据。方法收集温州医学院附属第二医院2009年1月至2010年12月的分离鉴定的MRSA共128株,其中脓液59株,痰液69株;采用刚果红平板检测多糖粘附素(PIA),半定量粘附试验检测生物膜表型,PCR检测icaA基因结果用χ2分割法进行统计分析。结果 128株MRSA中生物膜阳性菌株为61株,其中脓液36株、痰液25株,脓液中检出生物膜的阳性率明显高于痰液中检出生物膜的阳性率(χ2=7.382,P=0.005)。MRSA对所有β-内酰胺类抗生素全耐药,对万古霉素和利奈唑胺全敏感,痰液中MRSA对利福平、庆大霉素、环丙沙星的耐药率显著高于脓液中MRSA的耐药率(P<0.05),但是痰液中MRSA对克林霉素的耐药率要显著低于脓液中MRSA的耐药率(P<0.05)。脓液中生物膜阳性菌株和生物膜阴性菌株对抗菌药物的耐药率差异无统计学意义(P>0.05),但是痰液中生物膜阳性菌株对克林霉素的耐药率高于生物膜阴性菌株的耐药率(P<0.05),对利福平的耐药率显著低于生物膜阴性菌株的耐药率(P<0.05)。结论脓液中MRSA的生物膜检出率比痰液高,但是脓液中MRSA的耐药率比痰液中的耐药率要低,MRSA对抗菌药物的耐药谱和生物膜的形成并无直接的关系。更多还原

【Abstract】 Objective To investigate the antimicrobial-resistance and biofilm forming ability of methicillin-resistant Staphylococcus aureus(MRSA) from two origins and discuss the relationship between them,and provide evidence for clinical detection and therapy.Method 128 strains MRSA were collected in the Second Affiliated Hospital of Wenzhou Medical Collage from January 2009 to December 2010,including 59 strains from abscess and 69 strains from sputum.Congo red agar plate was used to examine polysaccharide intercellular adhesion(PIA) synthesis;Semi-quatitative test was performed to examine biofilm phenotype.icaA gene was detected by PCR.χ2 test was performed to identify the significance of difference.Result Among the 128 collected MRSA strains,biofilm formation was positive in 61 strains(36 strains from abscess,25 strains from sputum).The positive rates of biofilm formation in abscess were significantly higher than those in sputum(χ2=7.382,P=0.005).MRSA were completely resistant to all β-lactam antibiotics,and completely sensitive to vancomycin and linezold.The resistance rates of MRSA from sputum to rifampin,gentamicin,ciprofloxacin and levofloxacin were significantly higher than those from abscess(P<0.05),but the resistance rates of MRSA from sputum to clindamycin were significantly lower than those from abscess(P<0.05).The resistance rates of biofilm positive strains were not significantly different from those of biofilm negative strains in abscess,but the resistance rates of biofilm formation positive strains to clindamycin were significantly higher than those of the negative strains,while their resistance rates to rifampin significantly lower than those of biofilm formation negative strains in sputum(P<0.05).Conclusion The positive rates of biofilm formation of MRSA from abscess are higher than those from sputum,but the resistance rates of MRSA from abscess are lower than those from sputum.There is no direct relationship between biofilm formation and resistance spectrum.更多还原