耐甲氧西林葡萄球菌检测及耐药性研究.docVIP

精品论文 参考文献 耐甲氧西林葡萄球菌检测及耐药性研究 郭续胜（山东省临沂市中医医院检验科 276002） 【中图分类号】R378.1+1【文献标识码】A【文章编号】1672-5085（2012）16-0080-03 【摘要】目的 调查金黄色葡萄球菌、凝固酶阴性葡萄球的耐药性现状。方法 对195株金黄色葡萄球菌和286株凝固酶阴性葡萄球，用VITEK-32和GPS-107药敏卡，GPI鉴定卡，API-Spath手工条鉴定细菌并测定其对药物的敏感性。应用胶乳凝集试验检测青霉素结合蛋白2a(PBP2a)，同时用NCCLS推荐的纸片扩散法检测耐甲氧西林的葡萄球菌。耐万古霉素的葡萄球菌(VRSA)和异质性耐万古霉素的葡萄球菌(hetro-VRSA)。结果 耐甲氧西林的金黄色葡萄球菌仪器法、PBP2a、纸片扩散法阳性率分别为72%、76%、68%，凝固酶阴性的葡萄球菌耐甲氧西林仪器法、纸片扩散法(CNS)分别是78%、72%，PBP2a全部阴性。未检出VRSA和hetro-VRSA。结论 万古霉素、复方新诺明和四环素对耐甲氧西林的葡萄球菌有较好的抗菌活性，胶乳凝集试验检测PBP2a简便、快速、准确。 【关键词】耐甲氧西林金黄色葡萄球菌 凝固酶阴性葡萄球菌 耐药性 DETECIION AND DRUG-RESISTANCE RESEARCH ON METHICILLIN-RESTSTANT STAPHYLOCOCCUS 【Abstract】 Objective To determine the drug-resistance of staphylococcus aureus and coagulase-negative staphylococcus. Methods VITER-32 drug-sensitive cards, GPI cards and API-spath strips were used to determine the drug-resistance of 195 staphylococci aureus and 286 coagulase-negative staphylococci. Latex fixation test was used to detect PBP2a, and meanwhile, paper strip method recommended by NCCLS was used to detect methicillin resistant staphylococcus, vancomycin-resistant staphylococcus and heteo-VRSA. Results The positive rates confirmed by methicillin-resistant staphylococci instrumental method, PBP2a method and paper strip diffusion method were 72%, 76% and 68% respectively. The positive rates detected by methicillin-reseitant coagulase-negative staphylococci instrumental method and paper strip diffusion method were 78% and 72% respectively. All the PBP2a showed negative in the detections. No VRSA and heteo-VRSA were detected. Conclusion Vancomycin, compound sulfamethoxazole and tetracycline have good antibacterial effects against methicillin-resistant staphylococci. Latex fixation test can be used to detect PBP2a accurately and conveniently. 【Key words】Methicillin-resistant staphylococcus aureus Coagulase-negative staphylococcus Drug-resistance 抗生素在临床抗感染过程中发挥着重要作用，但由于其广泛应用，细菌对其产生的耐药性也逐年增加。特别是耐甲氧西林金黄色葡萄球菌（MRSA）耐药菌株的相继出现，给临床治疗带来非常大的困难。因此，本文对4