金黄色葡萄球菌临床监测与葡萄球菌A蛋白快速检验研究

目的分析临床金黄色葡萄球菌(SA)分布特征及耐药性,并建立可用于检测葡萄糖球菌A蛋白(SPA)的新方法。方法分析132株SA菌株的分布特征与耐药性。构建金属螯合免疫磁性微球,对其表面形态、大小、表面基团吸收峰进行测定,用该磁性微球分离SPA,并用于SA检测。结果 132株SA分离自痰液74株(占56.06%)、分泌物43株(占32.58%)、血液10株(占7.57%)、胆汁3株(占2.23%)、器械导管2株(占1.52%)。检出甲氧西林敏感SA(MSSA)61株(占46.21%),对青霉素G、左氧氟沙星、庆大霉素、克林霉素、红霉素的耐药率分别为93.12%、13.23%、23.12%、56.87%、54.23%;甲氧西林耐药SA(MRSA)71株(占53.79%),对青霉素G、复方磺胺甲噁唑、左氧氟沙星、庆大霉素、克林霉素的耐药率分别为92.12%、21.21%、61.21%、29.21%、76.23%。磁性微球分散性良好,对SA样品的检测灵敏度可达100CFU,在一定条件下可维持高活性3周。结论 SA菌株耐药性较强;免疫磁性微球技术可用于SA的快速检测,值得推广应用。

Staphylococcus aureus clinical monitoring and SPA rapid test research

Objective To analyze the distribution character and drug resistance of Staphylococcus aureus（SA） and construct a new method for the detection of Staphylococcus protein A（SPA）.Methods Distribution character and drug resistance of 132 strains of SA were analyzed.Metal chelate immune magnetic microsphere was constructed and detected for morphology,size,surface group absorption peak,and used for the isolation of SPA and detection of SA.Results Among 132 strains of SA,74 strains（56.06%） were isolated from sputum,43 strains（32.58%） from secretions,10 strains（7.57%） from blood,3 strains（2.23%） from bile duct,2 strains（1.52%） from instrument.61 strains（46.21%） of methicillin sensitive SA（MSSA） were isolated,with resistant rates to penicillin G,levofloxacin,gentamicin,clindamycin and erythromycin 93.12%,13.23%,23.12%,56.87% and 54.23%.71 strain（53.79%） of methicillin resistant SA（MRSA） were isolated,with resistant rates to penicillin G,cotrimoxazole,levofloxacin,gentamicin and clindamycinw were 92.12%,21.21%,61.21%,29.21% and 76.23%.Magnetic microspheres were with good dispersion,could detect SA samples with concentration of 100 CFU and could maintain high performance for 3 weeks under certain conditions.Conclusion Drug resistance of SA might be serious.Immune magnetic microsphere could be used for the rapid detection of SA,worthy for clinical application.