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目的探讨儿童社区获得性金黄色葡萄球菌肺炎临床分离株分子特征及耐药情况,为诊断和治疗提供依据。方法对2012-08/2016-05月分离自作者医院儿科病区100株金黄色葡萄球菌进行调查研究,聚合酶链式反应(polymerase chain reaction,PCR)方法鉴定耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)进行葡萄球菌染色体mec基因盒(staphyloccoccal cassette chromosome mec,SCCmec)分型,检测pvl毒力基因,检测菌株对苯唑西林等16种抗生素的耐药性。spa分型及多位点序列分型(multilocus sequence typing,MLST)方法对菌株进行分子分型。结果 100株金黄色葡萄球菌中18株为MRSA,82株为甲氧西林敏感金黄色葡萄球菌(methicillin sensitive Staphylococcus aureus,MSSA)。MRSA中鉴定出5种spa型,5种序列型(sequence type,ST)型和2种SCCmec型,优势克隆为ST59-SCCmecⅣ-t437。MSSA中鉴定出23种spa型、13种ST型。MSSA的pvl基因检出率为24.39%(20/82),MRSA的pvl基因检出率为38.89%(7/18)。药敏结果显示所有菌株对非β-内酰胺类抗生素保持较好的敏感性,但对克林霉素及红霉素耐药程度较高。结论ST59-SCCmecⅣ-t437是引起乌鲁木齐地区儿童社区获得性肺炎(community-acquired pneumonia,CAP)的主要克隆,而社区获得性耐甲氧西林金黄色葡萄球菌(community-acquired methicillin-resistant Staphylococcus aureus,CA-MRSA)主要克隆为ST398、ST5、ST59及ST7型。所有菌株对非β-内酰胺类抗生素保持较好的敏感性,但对红霉素及克林霉素均存在一定的耐药性。
Objective To investigate the molecular characteristics and drug resistance of clinical isolates of children with community-acquired Staphylococcus aureus in children and provide evidence for diagnosis and treatment. Methods A total of 100 Staphylococcus aureus isolates from the pediatric hospital ward of the hospital from 2012 to 08 / 2016-5 were investigated. Polymerase chain reaction (PCR) was used to identify methicillin-resistant Staphylococcus aureus methicillin-resistant Staphylococcus aureus (MRSA) was used to detect the virulence genes of pvl in staphyloccoccal cassette chromosome mec (SCCmec). The resistance of the strains to oxacillin and other 16 antibiotics was tested. Spa typing and multilocus sequence typing (MLST) were used to genotype the strains. Results 18 out of 100 Staphylococcus aureus were MRSA and 82 were methicillin sensitive Staphylococcus aureus (MSSA). Five spa types, five sequence types (ST) and two SCCmec types were identified in MRSA. The dominant clone was ST59-SCCmecⅣ-t437. Twenty-three spa types and 13 ST types were identified in the MSSA. The detection rate of pvl gene in MSSA was 24.39% (20/82), and the detection rate of pvl gene in MRSA was 38.89% (7/18). Susceptibility results showed that all strains maintained good sensitivity to non-β-lactam antibiotics, but higher resistance to clindamycin and erythromycin. Conclusion ST59-SCCmecⅣ-t437 is the major clone causing community-acquired pneumonia (CAP) in Urumqi. Community-acquired methicillin-resistant Staphylococcus aureus (CA) -MRSA) were cloned as ST398, ST5, ST59 and ST7. All strains of non-β-lactam antibiotics to maintain good sensitivity, but erythromycin and clindamycin have some resistance.