耐甲氧西林溶血葡萄球菌耐药性及耐药基因研究

目的了解安徽省宿州地区临床分离的耐甲氧西林溶血葡萄球菌（MRSH）耐药性、耐药基因携带状况及诱导型克林霉素耐药的发生率。方法采用ATB STAPH5药敏试验板微量肉汤法对42株MRSH进行16种抗菌药物敏感性测定；聚合酶链反应（PCR）法检测MRSH中mecA、qacA/B/C、qacA、ermA/B/C、ermB、TetM耐药基因；D 试验检测诱导型克林霉素耐药表型。结果42株MRSH对万古霉素、呋喃妥因100%敏感，对利福平、米诺环素、奎奴普丁/达福普汀、替考拉宁的敏感率＞90%；而对庆大霉素、诺氟沙星、左氧氟沙星的耐药率＞70%，对青霉素、苯唑西林、红霉素耐药率为100.00%。mecA、qacA/B/C、qacA、ermA/B/C、ermB、TetM基因阳性率分别为100.00%（42株）、64.29%（27株）、59.52%（25株）、40.48%（17株）、28.57%（12株）、9.52%（4株）。D 试验阳性13株，诱导性耐药占30.95%。结论安徽宿州地区分离的MRSH呈多重耐药性，临床治疗应根据药敏试验结果合理选用抗菌药物。

Drug resistance and drug resistant genes of methicillin resistant Staphylococcus haemolyticus

Objective To investigate the drug-resistance,drug-resistant genes and prevalence of reducible clindamycin resistance of methicillin-resistant Staphylococcus haemolyticus（MRSH） in Suzhou district of Anhui province.Methods Susceptibility of 42 MRSH isolates to 16 kinds of antimicrobial agents were performed with ATB STAPH5 strip microdilute testing;drug-resistant genes mecA,qacA/B/C,qacA,ermA/B/C,ermB and TetM in MRSH were detected with polymerase chain reaction;inducible clindamycin resistance was detected with D-test.Results Sensitive rates of 42 MRSH isolates to vancomycin and nitrofurantoin were both 100.00%,sensitive rates to rifampicin,minocycline,quinupristin/dalfopristin and teicoplanin were all 90%;resistant rates to gentamicin,norfloxacin and levofloxacin were all 70%,resistant rates to penicillin,oxacillin and erythromycin were all 100.00%.The positive rate of mecA,qacA/B/C,qacA,ermA/B/C,ermB and TetM gene was 100.00%（42 isolates）,64.29%（27）,59.52%（25）,40.48%（17）,28.57%（12） and 9.52%（4） respectively.13 MRSH isolates were D-test positive,30.95% of which was inducible drug-resistance.Conclusion MRSH isolated from Suzhou district of Anhui province showed multi-drug resistance,antimicrobial agents should be chosen rationally according to antimicrobial susceptibility testing results.