临床标本金黄色葡萄球菌肠毒素基因分布及耐药性

目的 了解临床分离的金黄色葡萄球菌肠毒素基因分布及耐药情况。 方法 对金黄色葡萄球菌进行分离鉴定。采用聚合酶链反应检测肠毒素基因 (SEA~SEE),采用K-B法进行药敏试验。 结果 共收集到138株金黄色葡萄球菌,其中74株分离自痰液标本,占53.62%;从年龄≥50岁患者中分离得到102株菌株,占73.91%;金黄色葡萄球菌中肠毒素阳性为120株,检出率为86.96%,SEA、SEB、SEC和SEE阳性率分别为63.33%、46.67%、45.00%和37.50%,未检测出SED基因,分离自痰液标本菌株以携带SEA和SEC为主,而分离自创面分泌物菌株则以携带SEB和SEE为主;药敏 结果 显示金黄色葡萄球菌对青霉素（96.67%）、红霉素（81.67%）、氯霉素（74.17%）、四环素（71.67%）耐药较为严重,对呋喃妥因（6.67%）、复方磺胺甲恶唑（16.67%）、阿莫西林/克拉维酸钾（4.17%）则比较敏感,所有菌株对万古霉素、替考拉宁均敏感。 结论 临床分离的金黄色葡萄球菌肠毒素基因携带率较高;不同标本来源的金黄色葡萄球菌携带肠毒素基因型存在差异,对于临床金黄色葡萄球菌的感染治疗应根据药敏结果选择合理的抗生素。

Drug resistance and enterotoxin genetype of clinical Staphylococcus aureus

Objective To investigate drug resistance and enterotoxin genetypes of clinical Staphylococcus aureus. Methods Staphylococcus aureus were isolated and identified. The five enterotoxin genes (SEA-SEE) were tested by polymerase chain reaction, and drug resistance test was performed by K-B method. Results Among 138 strains of Staphylococcus aureus, 74 strains were isolated from sputum specimens, accounted for 53.62%, the positive rate of Staphylococcus aureus isolated from patients that were over 50 years of age accounted for 73.91%(102 strains). There were 120 strains were found to produce enterotoxin, with an overall positive rate of 86.96%. The detection rate of SEA,SEB,SEC and SEE were 63.33%,46.67%,45.00% and 37.50% respectively, and the SED was not detected. The enterotoxin genetypes of strains isolated from sputum specimens were mainly SEA and SEC, while the strains isolated from secretion accounting for SEB and SEE. The rate of drug resistance of Staphylococcus aureus to Penicillin, Tetracycline, Chloramphenicol and Erythromycin were 96.67%, 81.67%, 74.17%and 71.67% respectively, but these strains only 6.67% were resistance to Furantoin, 16.67% resistance to Compound sulfamethoxazole, 4.17% resistance to Amoxicillin and Clavulanate, All the Staphylococcus aureus strains were sensitive to Vancomycin and Teicoplanin. Conclusions The Staphylococcus aureus enterotoxin gene had high detection rate. The detection rate and distribution pattern of enterotoxin genes of Staphylococcus aureus isolated from different specimens were different, and antibiotics for the treatment of Staphylococcus aureus should be based on the results of susceptibility test.