伊朗一项多中心研究中耐甲氧西林凝固酶阴性葡萄球菌的检测及抗菌药物耐药性监测
Detection of Methicillin-Resistant Coagulase-Negative Staphylococci and Surveillance of Antibacterial Resistance in a Multi-Center Study from Iran.
作者信息
Nahaei Mohammad Reza, Shahmohammadi Mohammad Reza, Ebrahimi Shiva, Milani Morteza
机构信息
Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran ; Department of Microbiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
Shabestar Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran ; Aalinasab Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran ; Department of Microbiology, Ahar Branch, Islamic Azad University, Ahar, IR Iran.
出版信息
Jundishapur J Microbiol. 2015 Aug 25;8(8):e19945. doi: 10.5812/jjm.19945v2. eCollection 2015 Aug.
BACKGROUND
Coagulase-negative staphylococci (CNS) are a common cause of nosocomial infections. In recent years, an increase in the incidence of methicillin-resistant coagulase-negative staphylococci (MRCNS) has led to the severity of the disease.
OBJECTIVES
The aim of this study was to isolate and identify MRCNS strains by oxacillin disk agar diffusion, oxacillin agar screening, and polymerase chain reaction (PCR) and to evaluate their antibacterial resistance patterns.
PATIENTS AND METHODS
Totally, 122 CNS isolates were collected from the clinical specimens of four hospitals in Iran. Susceptibility testing was performed by disk agar diffusion against 15 antimicrobial agents. Then, disk agar diffusion, agar screening, and PCR were applied to determine susceptibility to oxacillin.
RESULTS
Out of the 122 isolates, 92 isolates were found to be MRCNS by PCR. The sensitivities and specificities of disk agar diffusion and agar screening were 89.2% and 69% and 93.8% and 96.3%, respectively. Also, 93 CNS isolates were resistant to Methicillin according to disk agar diffusion.
DISCUSSION
Our results indicated that agar screening was superior to oxacillin disk agar diffusion. A comparison between the antibiotic sensitivity patterns of the MRCNS and the Methicillin-Susceptible Coagulase-Negative Staphylococci (MSCNS) showed that the MRCNS were predominantly multiple-drug resistant isolates as the simultaneous resistance rate to 4 or more antibiotics in the MRCNS and MSCNS was 93% and 56%, respectively.
背景
凝固酶阴性葡萄球菌（CNS）是医院感染的常见原因。近年来，耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）发病率的增加导致了疾病的严重性。
目的
本研究的目的是通过苯唑西林纸片琼脂扩散法、苯唑西林琼脂筛选法和聚合酶链反应（PCR）分离和鉴定MRCNS菌株，并评估其抗菌耐药模式。
患者和方法
共从伊朗四家医院的临床标本中收集了122株CNS分离株。采用纸片琼脂扩散法对15种抗菌药物进行药敏试验。然后，应用纸片琼脂扩散法、琼脂筛选法和PCR法测定对苯唑西林的敏感性。
结果
在122株分离株中，通过PCR检测发现92株为MRCNS。纸片琼脂扩散法和琼脂筛选法的敏感性和特异性分别为89.2%和69%以及93.8%和96.3%。此外，根据纸片琼脂扩散法，93株CNS分离株对甲氧西林耐药。
讨论
我们的结果表明琼脂筛选法优于苯唑西林纸片琼脂扩散法。MRCNS与甲氧西林敏感凝固酶阴性葡萄球菌（MSCNS）的抗生素敏感性模式比较显示，MRCNS主要是多重耐药菌株，因为MRCNS和MSCNS对4种或更多抗生素的同时耐药率分别为93%和56%。
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