Pedroso Silvia H S P, Sandes Savio H C, Filho Robledo A T, Nunes Alvaro C, Serufo Jose C, Farias Luiz M, Carvalho Maria A R, Bomfim Maria R Q, Santos Simone G
1 Departamento de Microbiologia, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
2 Departamento de Biologia Geral, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Microb Drug Resist. 2018 Jun;24(5):635-647. doi: 10.1089/mdr.2017.0309. Epub 2018 Apr 23.
Coagulase-negative staphylococci (CNS) are important pathogens causing nosocomial infections worldwide with increasing resistance to antimicrobials. The aim of this study was to characterize resistance aspects of CNS isolated from patients with bloodstream infections acquired in hospitals in Belo Horizonte, MG, Brazil. Staphylococcus strains were characterized using repetitive sequence-based polymerase chain reaction (rep-PCR) fingerprinting with (GTG) primer. Phenotypic resistance was analyzed using AST-P5085 card (bioMérieuxVitek). PCR was used to detect mecA, vanA, blaZ, ermA/B/C, aac-aphD, and SCC-mec. For statistical analyses, we used hierarchical cluster, chi-square test (χ), and correspondence. Several clusters were formed within the same species using (GTG) primer, and strains showed resistance to the following antimicrobials: benzylpenicillin (100%); oxacillin (93.1%); gentamicin (36.3%); ciprofloxacin (63.7%); moxifloxacin (32.7%); norfloxacin (81.0%); erythromycin (86.2%); clindamycin (75.8%); linezolid, teicoplanin and vancomycin (1.7%); tigecycline (0%); fusidic acid (10.35%); rifampicin (13.7%); and trimethoprim/sulfamethoxazole (46.5%). Regarding genotypic analyses, 40%, 0%, 78%, 42%, 100%, 24%, and 30% were positive for mecA, vanA, blaZ, ermA, ermB, ermC, and aac-aphD, respectively. Regarding staphylococcal cassette mec (SCCmec) type, 3.4% presented type I; 5.0% type II; 27.1% type III; 20.3% type IIIA; and 32.2% type IIIB. Six clusters were formed and frequency distributions of resistant strains to oxacillin, gentamicin, ciprofloxacin, moxifloxacin, norfloxacin, erythromycin, clindamycin, linezolid, teicoplanin, vancomycin, fusidic acid, rifampicin, and trimethoprim/sulfamethoxazole, and mecA, blaZ, ermC, aac-aphD, and SCCmec type differed (p < 0.001). In conclusion, the strains investigated in this study were multidrug resistant and carried multiple antibiotic resistance genes.
凝固酶阴性葡萄球菌（CNS）是引起全球医院感染的重要病原体，且对抗微生物药物的耐药性不断增加。本研究的目的是对从巴西米纳斯吉拉斯州贝洛奥里藏特市医院获得血流感染的患者中分离出的CNS的耐药性特征进行描述。使用基于重复序列的聚合酶链反应（rep-PCR）指纹图谱和（GTG）引物对葡萄球菌菌株进行鉴定。使用AST-P5085卡（bioMérieux Vitek）分析表型耐药性。采用聚合酶链反应检测mecA、vanA、blaZ、ermA/B/C、aac-aphD和葡萄球菌盒式染色体mec（SCC-mec）。为进行统计分析，我们使用了层次聚类、卡方检验（χ）和对应分析。使用（GTG）引物在同一物种内形成了几个聚类，菌株对以下抗菌药物表现出耐药性：苄青霉素（100%）；苯唑西林（93.1%）；庆大霉素（36.3%）；环丙沙星（63.7%）；莫西沙星（32.7%）；诺氟沙星（81.0%）；红霉素（86.2%）；克林霉素（75.8%）；利奈唑胺、替考拉宁和万古霉素（1.7%）；替加环素（0%）；夫西地酸（10.35%）；利福平（13.7%）；以及甲氧苄啶/磺胺甲恶唑（46.5%）。关于基因型分析，mecA、vanA、blaZ、ermA、ermB、ermC和aac-aphD的阳性率分别为40%、0%、78%、42%、100%、24%和30%。关于葡萄球菌盒式染色体mec（SCCmec）类型，3.4%为I型；5.0%为II型；27.1%为III型；20.3%为IIIA型；32.2%为IIIB型。形成了六个聚类，耐苯唑西林、庆大霉素、环丙沙星、莫西沙星、诺氟沙星、红霉素、克林霉素、利奈唑胺、替考拉宁、万古霉素、夫西地酸、利福平以及甲氧苄啶/磺胺甲恶唑的菌株以及mecA、blaZ、ermC、aac-aphD和SCCmec类型的频率分布存在差异（p < 0.001）。总之，本研究中调查的菌株具有多重耐药性且携带多个抗生素耐药基因。
