MRSA的检测、耐药、流行及抗菌药物选择的研究进展

摘要：耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus，MRSA)一直以来是全世界引起感染性疾病的 重要致病菌之一。MRSA的耐药机制主要与由葡萄球菌染色体mec盒(SCCmec)上的mecA和mecC耐药基因有关。同时，在sarA系 统和agr系统等调控下细菌容易聚集形成生物膜，能有效的阻挡抗菌药物作用而产生极大的耐药性。耐药基因和生物膜的共同作 用使MRSA的耐药机制更为复杂，并在全球广泛传播，而及时准确地选择抗菌药物和检测方法显得尤为重要。本文就MRSA流 行状况、抗菌药物选择、SCCmec的基本结构与功能、MRSA耐药机制和检测方法等方面进行综述，旨在更好地为临床治疗和预 防MRSA引起的感染提供科学依据。

Advances in detection,drug resistance,prevalence, and antimicrobial agent selection of MRSA

Abstract Methicillin resistant Staphylococcus aureus (MRSA) has been one of the most important pathogens causing infectious diseases all over the world. The main mechanism of MRSA resistance is the presence of resistance genes of mecA and mecC on Staphylococcal cassette chromosome mec (SCCmec). At the same time, under the control of sarA system and agr system, bacteria are easy to gather and form biofilms, which can effectively block the effect of antibiotics and produce great resistance. The combination of drug-resistant genes and biofilms makes the drug resistance of MRSA more complex and widely spread in the world, and it is particularly important to timely and accurately select antibiotics and detection methods. In this paper, the prevalence, selection of antimicrobial agents, basic structure and function of SCCmec, resistance mechanism, and detection methods of MRSA were reviewed in order to provide scientific references for clinical treatment and prevention of MRSA infections.