【摘要】 目的研究北京电力医院2009年10月至2010年3月连续分离的金葡菌的分子流行病学特征及药物敏感性状况。方法收集在此期间临床连续分离的金葡菌,采用多位点序列分型(MLST)和葡萄球菌蛋白A基因(spa)分型技术进行分子生物学分型,同时进行Panton-Valentine(PVL)毒素基因检测,并对其中的33株甲氧西林耐药金葡菌(MRSA)进行SCCmec分型;采用琼脂稀释法作MRSA对14种抗菌药物的药敏试验。结果 50株金葡菌中,检出MRSA33株,占66.0%,其中1株为社区获得性(CA)-MRSA。MRSA有6种克隆型,其中ST239-t030-Ⅲ型占绝对优势,并且发现了国内罕见的新克隆型(ST239-t2270-Ⅲ)的传播;相比较,MSSA分子分型则呈散在分布。药敏试验结果显示,糖肽类抗生素及替加环素对MRSA的抗菌作用最强。CA-MRSA携带PVL毒素基因,其耐药谱与医院获得性(HA)-MRSA有较大差异。结论相比于MSSA,MRSA的克隆型别相对集中,提示MRSA更容易引起医院内的传播。MRSA以ST239-t030-Ⅲ为最常见型别,与我国总体趋势一致。更多还原

【Abstract】 Objective To investigate the molecular epidemiology and antimicrobial susceptibility of Staphylococcus aureus strains isolated from Beijing Electric Power Hospital during the period from October 2009 to March 2010.Methods A total of 50 S.aureus isolates were collected and analyzed by multilocus sequence typing(MLST),Staphylococcus protein A gene(spa) typing and detection of the lukS gene encoding PVL.In addition,SCCmec typing was performed for methicillin-resistant S.aureus(MRSA) isolates.The antimicrobial activities of 14 agents including ceftaroline and tigecycline against MRSA isolates were further determined by agar dilution method.Results Thirty-three strains were identified as MRSA among the 50 S.aureus isolates,including one CA-MRSA.Six clone types were recognized from these MRSA strains.ST239-t030-Ⅲ was the predominant type.Prevalence of an unusual molecular type,ST239-t2270-Ⅲ,was observed.In comparison,no significant clonal spread was detected in methicillin-susceptible S.aureus(MSSA).Glycopeptides and tigecycline showed potent activity against MRSA.The lukS gene was only identified in the CA-MRSA isolate,which showed the drug resistant pattern different from HA-MRSA.Conclusions Unlike MSSA,MRSA showed clustered clonal types,suggesting a nosocomial spread in hospital.The most common molecular clone identified in this hospital was ST239-t030-Ⅲ,which is consistent with the overall situation in China.更多还原