临床分离表皮葡萄球菌的耐药性分析及与icaD基因表达关系的研究

目的了解我院ICU表皮葡萄球菌对抗生素的耐药性,为制定合理的预防控制措施,指导临床用药提供依据。方法采用K-B纸片扩散法和分子生物学方法对临床标本和健康人皮肤分离的共125株表皮葡萄球菌的耐药性及其mecA和icaD基因进行检测分析。结果①两组在icaD基因的表达与mecA基因表达均存在相关性(r=0.528,P=0.000;r=0.309,P=0.016);②mecA基因表达在临床患者体液组中较健康自愿者非体液组明显增高,差异有统计学意义(P<0.01),而与icaD基因表达的菌株之间差异无统计学意义;③两组表皮葡萄球菌对利福平、呋喃妥因、利奈唑胺、万古霉素等均具有较高的敏感性;④两组mecA基因表达菌株对抗菌药物的敏感性差异无统计学意义,而基因表达菌株对青霉素、头孢西丁、复方新诺明、红霉素、氯霉素的敏感性差异有统计学意义(P<0.05)。结论 ICU表皮葡萄球菌对常用抗菌药物有较高的耐药性,须加强耐药监测,根据药敏结果合理用药,控制院内感染。

Analysis of drug resistance and relationship with icaD genetypes of clinically isolated staphylococcus epidermidis

Objective To detect the drug resistance of our ICU staphylococcus epidermidis to antibiotics,and to provide evidence for reasonable prevention and control measures to guide clinical medication.Methods mecA gene and icaD gene of the 125 strains staphylococcus epidermidis from clinical specimens and healthy skin were inspected and analyzed the drug resistance by K-B disk diffusion method and molecular biology method.Results In two groups,icaD gene expression was correlated with mecA’s(r=0.528,P=0.000;r=0.309,P=0.016).MecA gene expression in humor of clinical patients group was significantly higher than that in non-humor of normal people,and there was significant difference(P<0.01),while there was no significant difference in bacterial strain of icaD gene expression.Staphylococcus epidermidis in two groups were sensitive to rifampicin,nitrofurantoin,linezolid and Vancomycin.The resistant rates of mecA gene expression bacterial strain to antibacterial agents had no significant difference in two groups,but the resistant rates of icaD gene expression had significant difference in ampicillin,cefoxitin,bactrim,erythromycin and chloramphenicol(P<0.05).Conclusion That ICU staphylococcus epidermidis to antibacterial agents have high drug resistance,we must strengthen resistance monitoring,and according to antimicrobial susceptibility test results to choose rational drug,control nosocomial infection.