课件：苯唑西林耐药金黄色葡萄球分子流行病学调查及糖肽类抗生素对葡萄球菌体外活性研究.ppt

* The introduction of every new class of antimicrobial agents is followed by emergence of resistance. By 1962, penicillin-resistant S. aureus were a major threat in hospitals and nurseries. By the 1970s, methicillin-resistant S. aureus had emerged and spread, a phenomenon that encouraged widespread use of vancomycin. In the 1990s, vancomycin-resistant enterococci emerged and rapidly spread; most of these organisms are resistant to other traditional first-line antimicrobial drugs. In 1997, the first S. aureus strains with reduced susceptibility to vancomycin were documented, prompting concerns that S. aureus fully resistant to vancomycin may be on the horizon. In June 2002, the first case of vancomycin-resistant S. aureus was detected; the patient was receiving chronic hemodialysis. * * * * MRSA的脉冲场凝胶电泳（结果分型2） * 1 2 3 4 5 6 7 8 9 M 10 11 12 13 14 2002年ICU及RCU病房MRSA主要流行株(A1亚型) 1～14 lanes: A1亚型（共55株）; M: λ ladder marker PFGE MRSA的脉冲场凝胶电泳（结果判读） * PFGE ? CDC Tenover *等人推荐的方法判读： 突变位点数 酶切后DNA片断区别 亲缘关系 基因分型 0 无区别 同型 1 2-3条 亲缘关系密切 同型但不同亚型 2 4-6条 可能存在亲缘关系 同型但不同亚型 ≥ 3 ≥ 7条 无亲缘关系 不同型 1.???? * Tenover FC,JCM,1995,33:2233-2239. MRSA的脉冲场凝胶电泳（结果分型1） 5种：A（A1、A2）、B（B1、B2、B3）C、D、E型 * ICU及RCU病房65株MRSA 的PFGE图谱 M A1 A2 B1 B1 B2 B2 B3 D D C E M PFGE MRSA部分病例调查结果（三） A1亚型爆发流行株（55/65株）分离时