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[1990 - 1994年期间耐甲氧西林金黄色葡萄球菌(MRSA)分离株的耐药模式、凝固酶类型及MRSA噬菌体类型的流行病学研究]

[Epidemiological studies on drug-resistance patterns, coagulase types, and MRSA-phage types of MRSA isolates during 1990-1994].

作者信息

Nakae M, Sugahara Y, Sasaki H, Yasui H, Imai C, Hasegawa Y, Osaka K, Sibasaki K, Nashimoto M

机构信息

Department of Clinical Laboratory, Nippon Dental University School of Dentistry at Niigata.

出版信息

Jpn J Antibiot. 1999 Apr;52(4):313-21.

Abstract

We examined drug-resistance patterns, coagulase types, and MRSA-phage types of 125 MRSA strains isolated from clinical specimens during the period of January 1990 and December 1994. No vancomycin-resistant strain was isolated. Twenty one antibiotics were divided into three classes, low-intermediate- and high-isolation-frequency class, based on isolation frequencies of resistant strains. Minocycline, chloramphenicol, streptomycin, and imipenem were found to be included in low-isolation-frequency class (16.8-40%). In intermediate-isolation-frequency class (45.6-62.9%), cefmetazole, amikacin, gentamicin, and tetracycline were included. Oxacillin, ampicillin, piperacillin, ceftizoxime, cefoperazone, cefazolin, erythromycin, oleandomycin, kitasamycin, clindamycin, kanamycin, tobramycin, and ofloxacin belonged to high-isolation-frequency class (97.6-100%). MIC90s of vancomycin and minocycline (1.56 and 25 micrograms/ml) were lower than that of other 13 drugs. Comparing medical ward with dental ward, imipenem-, gentamicin-, and minocycline-resistant strains at medical ward, chloramphenicol- and streptomycin-resistant strains at dental ward were isolated dominantly on each ward, MRSA isolates were classified to 39 types by drug-resistance patterns. The isolation frequencies of coagulase type II and type IV strains were 65.6% and 29.6%, respectively. At dental ward, the isolation frequency of coagulase type IV strains was higher than that of coagulase type II strains during 1990-1992. However, coagulase type II strains were isolated considerably more than type IV strains during 1993-1994. By MRSA-phage typing, MRSA isolates were grouped into 18 MRSA-phage types. One hundred and twenty five MRSA isolates were divided into 56 types by using drug-resistance patterns, coagulase typing, and MRSA-phage typing. It was considered that such classification in combination of three methods is useful to make decision of epidemic by the same MRSA strain.

摘要

我们检测了1990年1月至1994年12月期间从临床标本中分离出的125株耐甲氧西林金黄色葡萄球菌(MRSA)的耐药模式、凝固酶类型和MRSA噬菌体类型。未分离出耐万古霉素菌株。根据耐药菌株的分离频率,将21种抗生素分为三类,即低、中、高分离频率类。发现米诺环素、氯霉素、链霉素和亚胺培南属于低分离频率类(16.8 - 40%)。在中分离频率类(45.6 - 62.9%)中,包括头孢美唑、阿米卡星、庆大霉素和四环素。苯唑西林、氨苄西林、哌拉西林、头孢唑肟、头孢哌酮、头孢唑林、红霉素、竹桃霉素、吉他霉素、克林霉素、卡那霉素、妥布霉素和氧氟沙星属于高分离频率类(97.6 - 100%)。万古霉素和米诺环素的MIC90(1.56和25微克/毫升)低于其他13种药物。比较内科病房和牙科病房,内科病房以亚胺培南、庆大霉素和米诺环素耐药菌株为主,牙科病房以氯霉素和链霉素耐药菌株为主,MRSA分离株按耐药模式分为39种类型。凝固酶II型和IV型菌株的分离频率分别为65.6%和29.6%。在牙科病房,1990 - 1992年期间凝固酶IV型菌株的分离频率高于凝固酶II型菌株。然而,1993 - 1994年期间凝固酶II型菌株的分离数量远多于IV型菌株。通过MRSA噬菌体分型,MRSA分离株被分为18种MRSA噬菌体类型。利用耐药模式、凝固酶分型和MRSA噬菌体分型,125株MRSA分离株被分为56种类型。认为这三种方法联合进行这样的分类有助于判定同一MRSA菌株引起的流行情况。

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