Imafuku Y, Nozawa A, Okamura H, Yoshida H, Saito M, Tanabe F, Ogata M
Department of Clinical Laboratory Medicine, Fukushima Medical College.
Rinsho Byori. 1994 Jul;42(7):669-75.
Recently, it has become more important to establish rapid and reliable methods for identifying bacterial species and their drug resistances because of the high incidence of nosocomial infection caused by multi-drug resistant bacteria. At first, several enzymes were tested to evaluate the efficacy of DNA extraction. N-acetylmuramidase, lysozyme and achromopeptidase were most effective to extract DNA from E. faecalis, E. faecium and S. aureus, respectively. After achromopeptidase extraction, the mecA gene was amplified by polymerase chain reaction (PCR) in clinically isolated MRSA (95 strains), MSSA (66), MRSE (methicillin-resistant S. epidermidis, 37), MSSE (methicillin-sensitive S. epidermidis, 1), S haemolyticus(5), S.hominis(1) and others (Enterococcus, Pseudomonas, and Streptococcus, total 45). PCR products were analyzed by agarose gel electrophoresis. The positive rates were 95% (MRSA), 1.5% (MSSA), and 97% (MRSE). The mecA gene was also positive in 2/2 of methicillin-resistant S.haemolyticus and 2/3 of methicillin-sensitive S.haemolyticus and 1/1 of methicillin-resistant S.hominis. The mecA gene was not detected in 45 non-Staphylococcal strains. MecA and femA gene by PCR and PBP 2' by IRMA were further detected in newly isolated MRSA (20 strains), MSSA(20), MRSE(14), MSSE(1) and S.simulans(2). Complete correlation between MPIPC susceptibility and mecA were found. The femA gene was positive in 39/40 of S. aureus, and 0/14 of S.epidermidis, 2/3 of S.simulans. PBP2' were positive in 20/20 of MRSA, 0/20 of MSSA, 14/14 of MRSE, 0/1 of MSSE, 1/1 of methicillin-resistant S.simulans, and 0/2 of methicillin-sensitive S.simulans. In conclusion, diagnoses of MRSA by simultaneous detection of mecA and femA gene as well as PBP2' are similarly useful because of their specificity and rapidity.
近年来,由于多重耐药菌引起的医院感染发生率较高,建立快速可靠的细菌种类及其耐药性鉴定方法变得更加重要。首先,测试了几种酶以评估DNA提取的效果。N-乙酰胞壁酸酶、溶菌酶和无色肽酶分别对从粪肠球菌、屎肠球菌和金黄色葡萄球菌中提取DNA最有效。用无色肽酶提取后,通过聚合酶链反应(PCR)对临床分离的耐甲氧西林金黄色葡萄球菌(95株)、甲氧西林敏感金黄色葡萄球菌(66株)、耐甲氧西林表皮葡萄球菌(37株)、甲氧西林敏感表皮葡萄球菌(1株)、溶血葡萄球菌(5株)、人葡萄球菌(1株)及其他(肠球菌、假单胞菌和链球菌,共45株)中的mecA基因进行扩增。PCR产物通过琼脂糖凝胶电泳进行分析。阳性率分别为95%(耐甲氧西林金黄色葡萄球菌)、1.5%(甲氧西林敏感金黄色葡萄球菌)和97%(耐甲氧西林表皮葡萄球菌)。2/2的耐甲氧西林溶血葡萄球菌、2/3的甲氧西林敏感溶血葡萄球菌和1/1的耐甲氧西林人葡萄球菌中mecA基因也呈阳性。在45株非葡萄球菌菌株中未检测到mecA基因。对新分离的耐甲氧西林金黄色葡萄球菌(20株)、甲氧西林敏感金黄色葡萄球菌(20株)、耐甲氧西林表皮葡萄球菌(14株)、甲氧西林敏感表皮葡萄球菌(1株)和模仿葡萄球菌(2株)进一步检测了PCR法检测的mecA和femA基因以及免疫放射测定法检测的PBP 2'。发现MPIPC敏感性与mecA之间完全相关。femA基因在39/40的金黄色葡萄球菌中呈阳性,在14/0的表皮葡萄球菌中呈阳性,在2/3的模仿葡萄球菌中呈阳性。PBP2'在20/20的耐甲氧西林金黄色葡萄球菌中呈阳性,在20/0的甲氧西林敏感金黄色葡萄球菌中呈阳性,在14/14的耐甲氧西林表皮葡萄球菌中呈阳性,在1/0的甲氧西林敏感表皮葡萄球菌中呈阳性,在1/1的耐甲氧西林模仿葡萄球菌中呈阳性,在2/0的甲氧西林敏感模仿葡萄球菌中呈阳性。总之,同时检测mecA和femA基因以及PBP2'来诊断耐甲氧西林金黄色葡萄球菌,因其特异性和快速性同样有用。