苏州市154株金黄色葡萄球菌耐药监测及脉冲场凝胶电泳分型

目的 分析苏州市2014 - 2017年金黄色葡萄球菌（staphylococcus aureus, SAU）的耐药情况和耐甲氧西林金黄色葡萄球菌（methicillin - resistance staphylococcus aureus，MRSA）的脉冲场凝胶电泳（pulsed - field gel electrophoresis, PFGE）分型特征，为临床合理使用抗生素提供参考，为MRSA感染溯源提供技术支持。方法 主要采用MIC法对常见的19种抗生素进行药敏试验，对检测为MRSA的菌株进行PFGE分析。结果 SAU耐药率达到93.5%，未发现万古霉素、达托霉素、奎奴普汀/达福普丁和利奈唑胺的耐药菌株。MRSA多重耐药率达到96.2%。MRSA对多种抗生素的耐药率明显高于甲氧西林敏感金黄色葡萄球菌，且差异具有统计学意义（P＜0.05）。26株MRSA共有15个PFGE型别，有3株100%同源的菌株来自同一所医院3位不同病人。结论 苏州市SAU除对万古霉素、达托霉素、奎奴普汀/达福普丁和利奈唑胺敏感外，对其他抗生素均发现耐药现象，MRSA多重耐药率较高。因此，应用抗生素治疗时建议进行药敏试验。MRSA的PFGE基因型别呈现分布多样性，存在院内传播的可能性，应加强PFGE在溯源分析中的应用。

Study of antimicrobial resistance and PFGE genotyping of 154 Staphylococcus aureus isolates in Suzhou

Objective To analyze the drug resistance of Staphylococcus aureus(SAU) and PFGE profile of methicillin-resistance Staphylococcus aureus(MRSA) in Suzhou from 2014 to 2017, so as to provide a reference for clinical rational use of antibiotics and to provide us technical support for source-tracking of MRSA infection. Methods SAU strains were tested against 19 commonly used antibiotics by MIC method. PFGE was performed on the strains detected as MRSA and then taxonomy analysis was conducted. Results 93.5% of all the SAU strains were antibiotic resistant in different degree. All the strains of SAU were sensitive to vancomycin, daptomycin, quinupristin/dalfopristin and linezolid. The multiple-drug resistance rate of MRSA was 96.2%. The drug-resistance rate of MRSA was significantly higher than that of methicillin-sensitive Staphylococcus aureus (MSSA) to most of the antibiotics and all the differences were statistically significant (P<0.05). The 26 MRSA isolates were of 15 genotypes by PFGE molecule typing method. Three 100% homologous strains were from three different patients in the same hospital. Conclusion All the strains of SAU were sensitive to vancomycin, daptomycin, quinupristin/dalfopristin and linezolid but resistant to the remaining antibiotics in different degrees. MRSA has a high rate of multi-drug resistance. Therefore, susceptibility testing is recommended when antibiotics are used to treat infections. The PFGE genotypes of MRSA in Suzhou are divers. There is possibility of nosocomial infection. The application of PFGE in traceability analysis should be strengthened.