异质性万古霉素中介金黄色葡萄球菌的分离及检测方法的建立

摘要

目的 了解异质性万古霉素中介金黄色葡萄球菌(h-VISA)的分离情况,并筛选简便可行的h-VISA的检测方法.方法 采用琼脂稀释法和E-test法对分离出的113株金黄色葡萄球菌进行检测,筛选出的可疑h-VISA用菌谱分析法进行确认,并对文献推荐的几种方法的筛选效果进行比较.结果 检测到1株万古霉素的MIC为3 μg/mL和2株MIC为4 μg/mL的MRSA,为万古霉素敏感性减低的金黄色葡萄球菌,其中1株MIC为4 μg/mL的MRSA经菌谱分析法证实为h-VISA,本次113株实验菌株h-VISA的检出率为0.88%.结论 通过实验证实K-B法并不是检测h-VISA的理想方法,而菌谱分析法则较为有效,分离率为8.3%,且在本实验中灵敏度可达10-8.本院分离的MRSA中已出现万古霉素敏感性减低菌株,并分离出1株h-VISA,可见,MRSA对万古霉素的异质性中介耐药不容忽视,应引起国内医学界的广泛重视.%Objective To investigate the prevalence of heterogeneous vancomycin intermediate Stapylococus aureus (h-VlSA) and develop a new method for the detection of h-VlSA .Methods 113 strains of Staphylococcus aureus (SA) were screened by agar dilution method and E-test method .The resistant strains were confirmed by population analysis .Results Three strains of SA were with reduced susceptibility to vancomycin ,including one strain with minimal inhibitory concentration (MIC) for 3 μg/mL and two strains with MIC for 4 μg/mL .One strain with MIC for 4 μg/mL was confirmed as h-VlSA ,and the detection rate was 0 .88% (1/ 113 ) .Conclusion Population analysis could be more effective than disc agar diffusion method ,and the former might be with high sensitivity to 10 .More attention should be paid to the emerge of strains with reduced susceptibility to vancomycin and h -VISA .