婴幼儿耐甲氧西林金黄色葡萄球菌感染状况和耐药基因的研究

目的了解感染婴幼儿的耐甲氧西林金黄色葡萄球菌(MRSA)耐药性和耐药基因,明确检测青霉素结合蛋白2a(PBP2a)和甲氧西林耐药基因(mecA)的临床价值。方法用金黄色葡萄球菌乳胶凝集试验和梅里埃鉴定金黄色葡萄球菌,同时用纸片扩散法完成12种常用抗生素的药敏试验。对头孢西丁的结果,按当年CLSI标准执行,用于判断菌株甲氧西林的耐药性。采用PBP2检测试剂盒检测PBP2a蛋白,PCR检测mecA基因。结果 2007-2009年婴幼儿共检出245株金黄色葡萄球菌,其中MRSA检出率为17.6%(43/245)。MRSA对庆大霉素、复方新诺明、克林霉素、红霉素、氯霉素的耐药性均显著高于甲氧西林敏感金黄色葡萄球菌(P<0.05),其余抗生素的差异无统计学意义(P>0.05),43株MRSA的PBP2a蛋白和mecA基因的检测结果全为阳性,阳性率为100%。结论用头孢西丁(30μg)能有效地筛查MRSA,检测PBP2a蛋白和mecA基因均能正确地确认MRSA。且检测PBP2a蛋白方便快捷,特异性好,值得临床推广。

The suitation of methicillin-resistant Staphylococcus aureus infection in children

Objective To investigate the development of drug-resistance and the clinical values of using the drug resistant genes and PBP2a protein.Methods Staphylococcus aureus were screened by using latex agglutination test and the isolates were identified with GPI card of Biomerieux system.Antimicrobial susceptibility test against 12 antimicrobial agents was performed using the Kurby-Bauer method.CLSI standard was used in the identification of methicillin-resistant Staphylococcus aureus(MRSA).PBP2a protein was deter...