Detection Of Drug Resistance Genes Of Gram-positive Cocci Resistant To Monitoring Analysis And Staphylococcus Aureus And Disinfectant Resistant Gene

PART 1Detection of antibiotic-resistant gene and disinfectant-resistant gene inStaphylococcus aureusObjective:To study the antibiotic-resistance genes and disinfectant-resistant genes ofstaphylococcus aureus isolated from the Taiyuan Centre hospital.Discuss the existing conditionsof this genes,So as to provide guidance for clinical rational use of antibiotics and disinfectants.Methods:Apply the French bioMérieux VITEK-2 compact automatic microbial analyzer toidentify 53 strains Staphylococcus aureus and determine the susceptibility of this bacteria to 15kinds of antimicrobial agents (Ampicillin/Sulbactam,Oxacillin,Benzylpenicillin, Imipenem,Erythromycin,Clindamycin,Quinupristin/Dalfopristin,Gentamicin,Rifampin,Ciprofloxacin,Trimethoprim/Sulfa,Tetracycline,Teicoplanin,Vancomycin and Linezolid). Six clinically relevantantibiotic resistance genes of Staphylococcus aureus including the beta-lactamases resistancegene mecA,TEM and femB ;the aminoglycosides resistance gene aac(6′)/aph(2″), themacrolide-lincosamide-streptogram in B resistance gene ermA,ermC,msrA and msrB; thetetracyclines resistance gene TetM, the sugar peptides resistance gene vanA and vanB and thedisinfectants resistance gene qacA were detected by polymerase chain reaction(PCR) methods.And analyse some genes sequence.Results:The resistant rates of 53 strains Staphylococcus aureus against 15 kinds of antimicrobialagents were that, Ampicillin/Sulbactam67.9%, Oxacillin67.9%, Benzylpenicillin 98.1%,Imipenem67.9%,Erythromycin84.9%,Clindamycin77.4%, Gentamicin69.8%, Rifampin47.2%,Ciprofloxacin64.2%,Trimethoprim/Sulfa11.3% and Tetracycline67.9%.But this strains were sensitive toQuinupristin/Dalfopristin, Teicoplanin,Vancomycin and Linezolid. The positive rates of 12 drugresistant genes in 53 strains SAU were that,mecA62%,TEM96%,femB91%, aac(6′)/aph(2″)72%,ermA94% ,ermC79%, msrA55%, msrB66%, TetM60%, qacA45%respectively. And the vanA,vanB were negative.Conclusion:The resistance rates of SAU toβ-lactams, aminoglycosides, MLSB class,tetracyclinewas higher. SAU is the bacteria of multi- resistant drug.There are resistance genes toβ-lactams,aminoglycosides, MLSB class, tetracycline and disinfectants in most of the SAU strains.Theclinical must pay high attention to it. PARPART 2Antimicrobial resistance surveillance of gram positive cocciObjective:To analyze the status of antimicrobial resistance of gram positive cocci isolated fromthe Taiyuan Centre hospital from 2006 to 2010,and to investigate the change of resistance.So asto provide an objective basis for clinical use of antibiotics for gram positive cocci infection.Methods:Apply French bioMérieux VITEK-2 compact automatic microbial analyzer andstandard disk diffusion method to identify and test the antimicrobial susceptibility of bacteria andthe results were analysed according to CLSI2006. Data were analysed with SPSS13.0 software.Results:The common gram-positive cocci isolated from this hospital from 2006 to 2010including methicillin-resistant Staphylococcus aureus(MRSA),Enterococci faecalis (EFA),Staphylococcus aureus(SAU), methicillin-resistant coagulase negative Staphylococci(MRCNS),Enterococci faecium(EFM) and coagulase negative Staphylococci(CNS),etc.The most commontest specimen is sputum,next is secretion. Antimicrobial susceptibility test results show that grampositive cocci resistance rate to vancomycin was 0.From 2006 to 2010,MRSA′s resistance rate tobenzylpenicillin and oxacillin were100%, to levofloxacin, ciprofloxacin, clindamycin anderythromycin were≥75%,to gentamicin ,tetracycline and rifampin were>40%.In these years, theresisitance rates to gentamicin was significantly different(P<0.001),to tetracycline and rifampinwere statistically significant(P<0.05).SAU to oxacillin and vancomycin were fully sentitive, andthe resistance rate to benzylpenicillin was>83%,to clindamycin and erythromycin were>45%,torifampin was<10%,to levofloxacin was≤20%.During this period, the resisitance rates of SAU tociprofloxacin and tetracycline were significantly different(P<0.001),and the remaining resistancerates to various antibiotics didn′t change significantly(P>0.05).The resistance rate of EFA toerythromycin was>75%,to ciprofloxacin,gentamicin and rifampin were>50%,to levofloxacin andbenzylpenicillin were>24%,to tetracycline was>16%. During this period,EFA′resistance rates tobenzylpenicillin was increased year by year and was significantly different(P<0.001).EFA′resistance rates to tetracycline was significantly different(P<0.001). The rate tolevofloxacin,ciprofloxacin and gentamicin were statistically significant(P<0.05).Conclusion: Gram positive cocci′s resistance to commonly used antibiotics is very common,andthere is an increasing tendency,so we must to grasp the changes of drug resistance and rationaluse antimicrobial drugs,improve the cure rate of hospital infection.