济南地区异质性万古霉素中介金葡菌的分离率及方法研究

山东大学学报(医学版) ›› 2010, Vol. 48 ›› Issue (6): 41-.

济南地区异质性万古霉素中介金葡菌的分离率及方法研究

毕少杰1，于晶2，刘婷3，刘明涛4，盛美艳4，李玉4

1.山东大学第二医院心内科，济南 250033； 2.山东医学高等专科学校，济南 250002；
3.山东大学第二医院检验科，济南 250033； 4.山东大学齐鲁医院呼吸科，济南 250012

收稿日期:2010-02-11 出版日期:2010-06-16 发布日期:2010-06-16
通讯作者: 李玉（1963- ），男，教授，主任医师，主要从事细菌和耐药的基础及临床研究。 E-mail:qlliyu@tom.com
作者简介:毕少杰（1981- ），男，主治医师，硕士研究生，主要从事细菌耐药的研究。
基金资助:
山东省科技攻关项目（2006GG2202013）。

Prevalence and screening methods of heteroresistant vancomycin intermediate staphylococcus aureus in Jinan region

BI Shaojie1， YU Jing2, LIU Ting3, LIU Mingtao4， SHENG Meiyan4, LI Yu4

1. Department of Cardiology, Second Hospital of Shandong University, Jinan 250033, China;
2. Shandong Medical College, Jinan 250002, China;
3. Department of Clinical Laboratory, Second Hospital of Shandong University, Jinan 250033, China;
4. Department of Respiratory, Qilu Hospital of Shandong University, Jinan 250012, China

Received:2010-02-11 Online:2010-06-16 Published:2010-06-16

摘要/Abstract

摘要：

目的了解济南地区临床MRSA标本中异质性万古霉素中介金葡菌(hVISA)的分离率，并对三种筛选方法进行探讨。方法对216株临床分离的耐甲氧西林金葡菌（MRSA）分别进行2μg /mL万古霉素（BHIV2)、4μg/mL万古霉素（BHIV4)及5μg/mL替考拉宁（BHIT5)脑心浸液琼脂筛选法初筛，对阳性菌株进行macroEtest(MET)法及改良菌群分析策略-曲线下面积法（PAP-AUC）确认。结果 BHIV2、BHIV4、BHIT5筛选法初筛的菌株数分别为143、19和110株，初筛菌株最终确认29株，确认率分别为16.1%、73.7%和19.1%，则济南地区hVISA的分离率至少为13.4%（29/216）。结论在济南地区临床分离的MRSA菌中hVISA占有一定比例；在三种筛选方法中，BHIV2和BHIT5筛选法的敏感性高于BHIV4筛选法，特异性低于BHIV4筛选法，而BHIV2和BHIT5筛选法之间无差异。

关键词: 金黄色葡萄球菌；万古霉素；异质性耐药

Abstract:

Objective To investigate the prevalence of heteroresistant vancomycin-intermediate staphylococcus aureus and compare three screening methods. Methods 216 strains of methicillin-resistant staphylococcus aureus(MRSA) were preliminarily screened by brain heart infusion agar with 2mg/liter vancomycin (BHIV2), 4mg/liter vancomycin (BHIV4) or 5mg/liter teicoplanin (BHIT5). Positive strains were confirmed by macroEtest(MET) and population analysis profile-area under the curve（PAP-AUC）. Results In 216 strains of clinical MRSA, isolating rate of hVISA was at least 13.4%. In BHIV2, BHIV4 and BHIT5 screening methods, the preliminarily screened positive strains were 143, 19 and 110, respectively, with finally confirmed rates of 16.1%, 73.7% and 19.1%, respectively. Conclusion Some certain strains of hVISA exist in MRSA isolated from clinics of Jinan region . Among the three methods, sensitivities in BHIV2 and BHIT5 methods are higher than that in BHIV4 method. However, specificities in BHIV2 and BHIT5 methods are lower than that in BHIV4 method. There are no significant differences in sensitivity and specificity between BHIV2 and BHIT5 methods.

Key words: Staphylococcus aureus； Vancomycin； Heteroresistance

中图分类号:

R446.5

毕少杰1，于晶2，刘婷3，刘明涛4，盛美艳4，李玉4. 济南地区异质性万古霉素中介金葡菌的分离率及方法研究[J]. 山东大学学报(医学版), 2010, 48(6): 41-.

BI Shaojie1， YU Jing2, LIU Ting3, LIU Mingtao4， SHENG Meiyan4, LI Yu4. Prevalence and screening methods of heteroresistant vancomycin intermediate staphylococcus aureus in Jinan region[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(6): 41-.

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