【作者】 姚岚；

【导师】 惠艳；

【作者基本信息】 新疆医科大学 ， 皮肤病与性病学， 2011， 硕士

【摘要】 目的：(1)了解皮肤感染耐甲氧西林金黄色葡萄球菌(Methicillin-resistant Staphylococcus aureus, MRSA)的感染及耐药情况；(2)检测表型耐药鉴定出的MRSA中mecA、PVL基因的表达情况；(3)检测耐甲氧西林金黄色葡萄球菌的SCCmec基因型及耐药基因。方法：收集2010年1月-8月新疆医科大学第一附属医院皮肤科门诊就诊的242例皮肤和软组织感染患者,(1)应用K-B纸片扩散法分离MRSA,并检测MRSA对9种抗菌药物的耐药性；(2)应用聚合酶链反应方法(Polymerase- Chain Reaction, PCR)对表型耐药检测出的MRSA进行necA基因检测,(3)应用PCR法进行SCCmec基因型和耐药基因的检测。结果：(1)MRSA的检出率为8.7%(21/242),；(2)应用K-B纸片法对9种抗生素的药敏试验结果为：青霉素100%、头孢唑林47.62%、红霉素42.86%、四环素38.09%、克林霉素33.33%、庆大霉素28.57%、氯霉素23.81%,环丙沙星19.05%、万古霉素0%；(3)应用PCR方法检测耐甲氧西林金黄色葡萄球菌mecA阳性21株,检出率为100%,PVL阳性12株,检出率为57.1%,本次实验中SCCmec型以Ⅳ型为主,占57.1%(12/21),Ⅰ、Ⅱ、Ⅲ型检出率分别为4.8%(1/21)、9.5%(2/21),28.6%(6/21)。最常见的耐药基因是erm,检出率为49.8%(9/21),ant(4,,4”)未检出；aac(6,)/aph(2”)、aph(3,)-Ⅲ、tetM检出率分别为28.6%(6/21)、23.8%(5/21)、38.1%(8/21)。结论：(1)我院皮肤科门诊MRSA的检出率低于国内外其它地区的报道；(2)MRSA呈现多重耐药,尚未发现万古霉素耐药株；(3)我院皮肤科门诊患者皮肤感染MRSA中耐药基因的携带率较低。更多还原

【Abstract】 Objective:(1)To investigate the resistance of Methicillin-resistant Staphylococcus aureus(MRSA); (2)To detect the mecA, pvl gene in polymerase chain reaction(PCR);(3)To detect the antibiotic-resistant genes gene and SCCmec genetype in polymerase chain reaction (PCR). Methods:(1)Antibiotic resistance of 242 pationts which isolated from clinical specimen in Xinjiang Medical University, First Affiliated Hospital dermatological department from Jan.2010 to Aug.2010 was studied by K-B disc diffusion method; (2)The mec and pvl genes were detected with PCR; (3). SCCmec genetype and antibiotic-resistant were detected with PCR. Results:(1) The detection ratio of MRSA is 8.7% (21/242), We detected 9 antimicrobial agents by K-B Disc Diffusion Method.of 100% strains were resistant to penicillin and 47.62% to Cephazolin,42.86% to erythromycin,38.09% to tetracycline,33.33% to clindamycin, 28.57% to gentamicin,23.81% to chloramphenicol,19.05% to Ciprofloxacin,0 to vancomycin; (2) The results of PCR showed that all MRSA strains were mecA positive, The ratio of mecA is 100%, and pvl is 57.1%; (3) SCCmecIV genetype is 57.1%,Ⅰ、Ⅱ、Ⅲgenetype is 4.8%,9.5%,28.6%;and aac(6’)/aph(2")、aph(3’)Ⅲ、tetM、erm is respectively 28.6%、23.8%、38.1%、49.8%.Conclusion:(1) The detection ratio of MRSA is low; (2) Isolates of MRSA posed a serious situation of multidrug-resistance; (3) There are low positive percentages of antibiotic resistant genes in the isolates.更多还原