金黄色葡萄球菌耐消毒剂基因qaca的研究.docVIP

金黄色葡萄球菌耐消毒剂基因qacA的研究 【摘要】 目的 检测我院近年来临床分离的金葡菌耐消毒剂的qacA基因水平，为动态监测细菌耐药性的变化趋势、有效控制细菌耐药性的传播提供对策。方法 收集我科临床分离的金葡菌共252株，并经本实验室重新鉴定确认。参照美国CLSI/NCCLS标准，用6μg/ml苯唑西林和4% NaCl平板，筛选出耐苯唑西林金葡菌和对苯唑西林敏感的金葡菌。应用PCR基因扩增试验检测金葡菌中耐消毒剂的qacA基因水平。随机抽取一株MRSA阳性株进行基因测序，作qacA基因验证。作qacA基因阳性株的MIC检测，了解阳性株是否有耐药性的表达。结果 共检测金葡菌252株，其中MRSA 84株(带有qacA基因4株)，MSSA 168株(带有qacA基因1株)。MRSA阳性菌株对消毒剂的MIC值明显高于MSSA菌株。结论 携带含有耐消毒剂基因qacA的金葡菌未在我院流行。 【关键词】 金黄色葡萄球菌 消毒剂 qacA基因 Study on the disinfectantresistant gene qacA in Staphylococcus aureus ABSTRACT Objective To investigate the disinfectantresistant gene qacA in Staphylococcus aureus isolates from the First Affiliated Hospital of Chongqing Medical University and control drugresistance transmission of bacteria. Method Two hundred and fiftytwo Staphylococcus aureu isolates were collected and reconfirmed by our laboratory. The agar plate containing oxacillin 6μg/ml and 4% NaCl was used to select methicillinsusceptible Staphylococcus aureus and methicillinresistant Staphylococcous aureus, according to the standard recommended by CLSI/NCCLS (2005) of USA. The qacA gene in the isolates were amplified by PCR. The PCR products were sequenced for verification with the object sequence of GenBank. The drugsusceptible test was performed in qacA carrying stains. Results Among 252 Staphylococcous aureus isolates, only 4 strains were found qacA gene in 84 MRSA and 1 strain in 168. The MICs of antiseptics were higher against MRSA than MSSA. Conclusion Disinfectantresistant gene qacA carrying Staphylococcus aureus hasn′t previled in the hospital. KEY WORDS Staphylococcus aureus; Disinfectants; qacA gene 金黄色葡萄球菌(Staphylococcus aureus)是临床上最常见的致病菌之一，其产生的毒素和酶最多，毒力在葡萄球菌中最强，尤其耐甲氧西林金葡菌(methicillinresistant Staphylococcus aureus，MRSA)是医院内感染的主要病原菌，MRSA具有多重耐药特征，是临床抗感染治疗的难题之一。20世纪80年代国外学者已在金葡菌中检测到耐消毒剂基因qacA，2005年我国也从多重耐药MRSA中发现耐消毒剂基因qacA的报道［1］。 金葡菌对消毒剂的耐药基因命名来源于其对季胺类化合物(quaternary ammonium compounds，qac)的耐药，主要由qacA、qacB和qacC的基因编码，依靠细菌细