皮肤感染耐甲氧西林金黄色葡萄球菌耐药性研究及耐药基因的检测
|
摘要
目的：(1)了解皮肤感染耐甲氧西林金黄色葡萄球菌(Methicillin-resistant Staphylococcus aureus, MRSA)的感染及耐药情况；(2)检测表型耐药鉴定出的MRSA中mecA、PVL基因的表达情况；(3)检测耐甲氧西林金黄色葡萄球菌的SCCmec基因型及耐药基因。方法：收集2010年1月-8月新疆医科大学第一附属医院皮肤科门诊就诊的242例皮肤和软组织感染患者,(1)应用K-B纸片扩散法分离MRSA,并检测MRSA对9种抗菌药物的耐药性；(2)应用聚合酶链反应方法(Polymerase- Chain Reaction, PCR)对表型耐药检测出的MRSA进行necA基因检测,(3)应用PCR法进行SCCmec基因型和耐药基因的检测。结果：(1)MRSA的检出率为8.7%(21/242),；(2)应用K-B纸片法对9种抗生素的药敏试验结果为：青霉素100%、头孢唑林47.62%、红霉素42.86%、四环素38.09%、克林霉素33.33%、庆大霉素28.57%、氯霉素23.81%,环丙沙星19.05%、万古霉素0%；(3)应用PCR方法检测耐甲氧西林金黄色葡萄球菌mecA阳性21株,检出率为100%,PVL阳性12株,检出率为57.1%,本次实验中SCCmec型以Ⅳ型为主,占57.1%(12/21),Ⅰ、Ⅱ、Ⅲ型检出率分别为4.8%(1/21)、9.5%(2/21),28.6%(6/21)。最常见的耐药基因是erm,检出率为49.8%(9/21),ant(4,,4”)未检出；aac(6,)/aph(2”)、aph(3,)-Ⅲ、tetM检出率分别为28.6%(6/21)、23.8%(5/21)、38.1%(8/21)。结论：(1)我院皮肤科门诊MRSA的检出率低于国内外其它地区的报道；(2)MRSA呈现多重耐药,尚未发现万古霉素耐药株；(3)我院皮肤科门诊患者皮肤感染MRSA中耐药基因的携带率较低。
Objective:(1)To investigate the resistance of Methicillin-resistant Staphylococcus aureus(MRSA); (2)To detect the mecA, pvl gene in polymerase chain reaction(PCR);(3)To detect the antibiotic-resistant genes gene and SCCmec genetype in polymerase chain reaction (PCR). Methods:(1)Antibiotic resistance of 242 pationts which isolated from clinical specimen in Xinjiang Medical University, First Affiliated Hospital dermatological department from Jan.2010 to Aug.2010 was studied by K-B disc diffusion method; (2)The mec and pvl genes were detected with PCR; (3). SCCmec genetype and antibiotic-resistant were detected with PCR. Results:(1) The detection ratio of MRSA is 8.7% (21/242), We detected 9 antimicrobial agents by K-B Disc Diffusion Method.of 100% strains were resistant to penicillin and 47.62% to Cephazolin,42.86% to erythromycin,38.09% to tetracycline,33.33% to clindamycin, 28.57% to gentamicin,23.81% to chloramphenicol,19.05% to Ciprofloxacin,0 to vancomycin; (2) The results of PCR showed that all MRSA strains were mecA positive, The ratio of mecA is 100%, and pvl is 57.1%; (3) SCCmecIV genetype is 57.1%,Ⅰ、Ⅱ、Ⅲgenetype is 4.8%,9.5%,28.6%;and aac(6')/aph(2")、aph(3')Ⅲ、tetM、erm is respectively 28.6%、23.8%、38.1%、49.8%.Conclusion:(1) The detection ratio of MRSA is low; (2) Isolates of MRSA posed a serious situation of multidrug-resistance; (3) There are low positive percentages of antibiotic resistant genes in the isolates.
Objective:(1)To investigate the resistance of Methicillin-resistant Staphylococcus aureus(MRSA); (2)To detect the mecA, pvl gene in polymerase chain reaction(PCR);(3)To detect the antibiotic-resistant genes gene and SCCmec genetype in polymerase chain reaction (PCR). Methods:(1)Antibiotic resistance of 242 pationts which isolated from clinical specimen in Xinjiang Medical University, First Affiliated Hospital dermatological department from Jan.2010 to Aug.2010 was studied by K-B disc diffusion method; (2)The mec and pvl genes were detected with PCR; (3). SCCmec genetype and antibiotic-resistant were detected with PCR. Results:(1) The detection ratio of MRSA is 8.7% (21/242), We detected 9 antimicrobial agents by K-B Disc Diffusion Method.of 100% strains were resistant to penicillin and 47.62% to Cephazolin,42.86% to erythromycin,38.09% to tetracycline,33.33% to clindamycin, 28.57% to gentamicin,23.81% to chloramphenicol,19.05% to Ciprofloxacin,0 to vancomycin; (2) The results of PCR showed that all MRSA strains were mecA positive, The ratio of mecA is 100%, and pvl is 57.1%; (3) SCCmecIV genetype is 57.1%,Ⅰ、Ⅱ、Ⅲgenetype is 4.8%,9.5%,28.6%;and aac(6')/aph(2")、aph(3')Ⅲ、tetM、erm is respectively 28.6%、23.8%、38.1%、49.8%.Conclusion:(1) The detection ratio of MRSA is low; (2) Isolates of MRSA posed a serious situation of multidrug-resistance; (3) There are low positive percentages of antibiotic resistant genes in the isolates.
引文
[1]Chambers HF. The changing epidemiology of Staphyl-ococcus aureus[J]. Emerg Infect Dis,2001,7(2):178-182.
[2]周一平.近8年细菌检出情况分析[J].感染、炎症、修复,2005,6(3)：138-140
[3]郑中柱.北印度三级医疗中心烧伤患者院内感染的前瞻性研究[J].感染、炎症修复,2005,6(4)：252-253
[4]From the Centers for Disease Cont rol and Prevention. Staphylococcus aureus to vancomycin United States[J]. MMWR,2002,51(26):565-567.
[5]李春辉.社区获得性耐甲氧西林金黄色葡萄球菌感染研究进展[J].中国感染控制杂志,2008,7(6)：430-434.
[6]Saravolatz L D, Markowitz N, Arking L, et al. Methicillin-resistant Staphylococcus aureus. Epidemiologic observat-ions during a community-acquired outbreak[J]. Ann Intern Med,1982,96(1):11-16.
[7]于一云,王红.耐甲氧西林金黄色葡萄球菌流行病学和耐药机制研究新进展[J].感染、炎症、修复,2008,2(9)：120-122.
[8]Scanvic A, Denic L, Gaillon S, et al. Duration of colonization by methicillin-resistant Staphylococcus aureus after hospital discharge and risk factors for prolonged carri- age[J]. Clin Infect Dis,2001,32:1393-1398.
[9]谭谦,刘相名,周宏祁等.抗-耐甲氧西林金黄色葡萄球菌抗体的体外抑菌作用[J].中华医院感染学杂志,2003,13(1)：4-6
[10]李雅卿,黄卫红.耐甲氧西林金黄色葡萄球菌医院感染临床分析[J].中华医院感染学杂志,2002,12(2)：151-152
[11]Hartman BJ, Tomas A. Low affinity penicillin-binding protein associated with(3-lactam resistance in Staphylococcus aureus[J],. J Bactl984,158:513-516.
[12]姚春艳,府伟灵.葡萄球菌医院感染的耐药分析[J].中华医院感染学杂志,2004,14(1)：104-106
[13]Staali L, Monteil H, Colin DA. The staphylococcal poreforming leuko toxins open Ca2+ channels in the membrane of human polymorphonuclear neutrophils[J]. J Membr Biol[J],1998,162:209-216.
[14]Baba Moussa L, Werner S, Colin DA, et al. Discoupling the Ca2+ activation from the pore-forming function of the bicomponent Panton-Valentine leucocidin in human PMNs[J]. FEBSLett.1999,461:280-286.
[15]Mishaan AM, Mason EO Jr, Martinez-Aguilar G, et al. Emergence of a predominant clone of community-acquired Staphylococcus aureus among children in Houston,[J], Texas. Pediatr Infect Dis J 2005,24:201-206.
[16]Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus Minne- sota and North Dakota,1997-1999. MMWR MorbMortal Wkly Rep[J],1999,48(NO MM32):707-710.
[17]杨清宇,刘荣森.耐甲氧西林金黄色葡萄球菌的研究[J].中华医院感染学杂志,2004,4(14)：478-480.
[18]纪冰,马筱玲,胡白,等.引起社区获得性皮肤软组织感染的病原菌分布及主要致病菌的药物敏感性分析[J].中国现代医学杂志.2007,3(17)：329-332.
[19]艾效曼,张秀珍Mohnarin2008年度报告：华北地区细菌耐药监测[J].中国抗生素杂志,2010,35(7)：490-496.
[20]汪玥,孙自镛Mohnarin 2008年度报告：中南地区细菌耐药监测[J].中国抗生素杂志,2010,35(7)：520-528.
[21]戴立人,向友华.耐甲氧西林金黄色葡萄球菌医院内感染及其监测[J].中华医学杂志,1992,72(8)：465.
[22]Eady EA, Cove J H. Staphylococcal resistance revisited:community- acquired methicillin-resistant Staphylococcus aureus an emerging problem for the manage-ment of skin and soft tissue infections[J]. Curr Opin Infect Dis,2003,16:103-124.
[23]Bukharie H A, Abdelhadi M S, Saeed I A, et al. Emergence of methicillin- resistant Staphylococcus aureus as a community pathogen[J]. Diagn Microbiol Infect Dis, 2001,40(1):1-4.
[24]崔俊昌,刘又宁.鼻腔金黄色葡萄球菌携带与医院内感染[J].军医进修学院学报.2005；26(02)：149-151.
[25]Creech CB 2nd, Kernodle DS, Alsentzer A, et al. Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr Infect Dis J.2005 Jul;24(7):617-621.
[26]Rojas H, Femandez LN, Espino HM, et al. Patterns of drug resistance in Staphylococcus aurens from human clinical isolates[J]. Rev Cubana Med Trop, 2001,53(1):53-58.
[27]王辉.耐苯畔青霉素葡萄球菌对16种抗生素敏感性特征[J].中华微生物和免疫学杂志,1995,15(6)：430-433.
[28]吴镝,曹晋桂,何晓锋等.耐甲氧甲林葡萄球菌的耐药性分析及临床意义[J].空军总医院学报,2002,18(3)：169-171.
[29]朱霞.MRSA感染的高危因素分析及预防[J].中国航天医药杂志,2003,5(1)：59.
[30]Dietrich DW, Auld DB, Mermel LA. Community-acquired methicillin resistant Staphylococcus aureus in southern New England children[J].. Pediatrics 2004;113, 347-352
[31]Kaplan SL, Hulten KG, Gonzalez BE, et al. Three-year surveillance of community acquired Staphylococcus aureus infections in children[J].. Clin Infect Dis 2005;40: 1785-1791
[32]纪冰,马筱玲.社区获得性耐甲氧西林金黄色葡萄球菌研究进展[J].国际检验医学杂志,2006,3(27)：276-279.
[33]Lim D, St rynadka NC. St ructural basis for the beta lactam resistance of PBP2a from methicillin-resistant Staphylococcus aureus[J].. Nat Struct Biol,2002,9(11):870-876.
[34]祁伟,宋诗铎,官兰,等.耐甲氧西林金黄色葡萄球菌mecA基因在大肠杆菌中的表达[J].中华传染病杂志,2002,20(5)：301-303.
[35]欧阳范献,鲍时翔.mec复合体和SCCmec盒与MRSA耐药性的研究进展[J].中国感染控制杂志.2004,10(3)：375-377.
[36]EnrightMC, Robinson DA, Randle G, et al. The evolutionary history of methicillin-resistant Staphylococcus aureus(MRSA) (J). Proc Natl Acad Sci USA 2002,99 (11):7687-7692.
[37]朱以军,李向阳.耐甲氧西林金黄色葡萄球菌的耐药机制及检测[J]..国外医学.临床生物化学与检验学分册,2005,1(26)：26-31.
[38]朱佩琼,裘云庆.耐甲氧西林金黄色葡萄球菌耐药机制的研究近况[J].国外医学.流行病学传染病学分册,2004,(31)：314-316.
[39]Ito T, Okuma K, Ma XX, et al. Insights on antibiotic resistance of Staphylococcus aureus from its whole genome:genomic island SCC[J].. Drug Resist Updat,2003,6 (1):41-52.
[40]Marta Aires De Sousa, Herminia de Lencastre. Bridges from hospitals to the laborat-ory.genetic portraits of methicillin-resistant Staphylococcus aureus clones. FEMS immunol Med Microbiol,2004,40(2):101-111.
[41]Qi W, Ender E, O'Brien F, et al. Molecular epidemiology of methicillin- resistant Staphylococcus aureus in Zurich, Switzerland(2003):prevalence of type IV SCCm- ec and a new SCCmec element associated with isolates from intravenous drug users. J Clin Microbiol,2005,43(10):5164-5170.
[42]Kaneko J, Kamio Y. Bacterial two-component and hetero-heptameric pore-forming cytolytic toxins:structure, pore-forming mechanism, and organization of the gene [J].Biosci Biotechnol Biochem,2004,69(5):981-1003.
[43]祁伟,吕星,程玉谦.社区获得性耐甲氧西林金黄色葡萄球菌[J].国际流行病学传染病学杂志,2007,2,(34)：55-57.
[44]Genestier AL, Michallet MC, Prevost G, et al. Staphylococcus aureus Panton-valen-tine leukocidin durectly targets mitochondria and induces Bax independent apoptosis of human neutrophils[J]. J. Clin Invest,2005,115(11):3117-3127.
[45]王凤玲,侯英荣,冯秀河.耐甲氧西林金黄色葡萄球菌耐药基因及致病毒素基因的研究进展[J].中国感染与化疗杂志,2010,1(10)：72-75.
[46]Holmes A, Ganner M, McGuane S, et al. S taphy lococcus aureus isolates carrying Panton-Valentine leukocidin genes in England Wales:frequency, characterizati-on and association with clinical disease[J]. J Clin Microbiol,2005,43(5):2384-2390.
[47]Eguia JM, Chambers HF. Community-acquried methicillin -resistant Staphylococus aureus:epidemiology and potential virulence factors. Cur Infect Dis Rep,2003,5(6): 459-466.
[48]Krakauer T. Immune response to staphylococcal superanti gens[J]. Immunologic Res, 1999,20(2):163-173.
[49]Recsei P, Kreiswirt h B, O Reilly M, et al. Regulation of exoprotein gene expression in Staphylococcus aureus by agar[J]. Mol Gen Genet,1986,202(1):58261.
[50]王慎,张兴善.中毒性休克综合征毒素-1引起新生儿早期出疹病[J].国外医学妇幼保健分册,1999,10(1)：40.
[51]王敏,付炅,李先平.金黄色葡萄球菌中毒休克综合征毒素1基因的检测[J].中国生物制品学杂志,2008,21(4)：2952297.
[52]Berger-Bachi B, Robrer S. Factors influencing methicillin resistance in staphylococ-ci[J]. Arch Microbiol,2002,178(3):165-171.
[53]Berger-Bachi B, Robrer S. Factors influencing methicillin resistance in Staphylococ-ci[J]. Arch Microbiol,1992,42:19-34.
[54]张怡滨,宋诗铎.基因femA和耐甲氧西林金黄色葡萄球菌不均一耐药性的关系[J].国外医药抗生素分册,2000,21(3)：123-126.
[55]Berger-bachi B. Factors affecting methicillin resistance in Staphylococcus aureus[J]. Int J Antimicrob Agents,1995,6(1):13-21.
[56]McKinney TK, Sharma VK, Craig WA,et al.Transcription of the gene mediating methicillin resistance in Staphylococcus aureus(mecA)is corepressed but not coinduced by cognate mecA and P-lactamase regulators[J]. J B acteriol,2001, 183(23):6862.
[57]朱以军,李向阳.耐甲氧西林金黄色葡萄球菌的耐药机制及检测[J].国外医学·临床生物化学与检验学分册,2005,1(26)：26-31.
[58]汪复.2006年中国CHINET细菌耐药监测[J].中国抗感染化疗杂志,2008,8(1)：1.
[59]Oldfield EC 3rd. No Mercy from MRSA. Rev Gostroenterol Disord[J],2004,4 (2): 95-98
[60]Jarvis WR, Schlosser J, Chinn R Y, et al. National prevalence of methi-cillin-resistant Staphylococcus aureus in inpatients at US health care facilities, 2006[J]. Am J Infect Control,2007,35(10):631.
[61]Jarvis WR, Schlosser J, Chinn R Y, et al. National prevalence of Methicil-lin-resistant Staphylococcus aureus in inpatients at US health care facilities, 2006[J]. Am J Infect Control,2007,35(10):631.
[62]历夏女.MRSA耐药性的挑战与防治策略[J]..海峡药,2006,18(4)：273-275.
[63]马越,姚雷,陈鸿波,等.临床常见细菌的耐药性问题[J]..中国抗生素杂志,2002,27(3)：129-137.
[64]Trautmann M, Pollitt A, Loh U, et al. Implementation of an intensified infection control program to reduce MRSA transmissions in a German tertiary care hospital [J]. Am J Infect Control,2007,35(10):643.
[65]Fridkin SK, Hageman JC, Morrison M, et al. Methicillin resistant Staph-ylococcus aureus disease in three communities[J]. New Engl J Med,2005,352: 143-1444.
[66]Tiemers ma E W, Bronz waer SL, Lyytik ajnen O, et al. Methicillin-Resistant Staphylococcus aureus in Europe,1999-2002. Emerging Infect Dis[J],2004,9: 1627-1634.
[67]Maguire G P, Auther A D, Boustead P J, et al. Clinical experience and outcomes of community-acquired and nosocomial Methicillin resistant Staphylococcus aureus in a northern Australian hospital[J]. J Hosp Infect,1998,38:273-281.
[68]Nimmo GR, Coombs G W, Pearson JC, et al. Methicillin-resistant Staphylococcus aureus in the Australian community:an evolving epidemic[J]. Med J Aust,2006, 184:384-388.
[69]Dinusha W, Dietrich M D, Dianne B, et al. Community-acquired methici-llin-resistant Staphylococcus aureus in Southern New England Children[J]. Pediatrics,2004,11(4):e347-e352.
[70]李家泰,Weinstein AJ,杨敏(代表中国细菌耐药监测研究组).中国细菌耐药监测研究[J].中华医学杂志。2001,81(1)：8-16.
[71]李家泰,齐慧敏,李耘(代表中国细菌耐药监测研究组).2002-2003年中国医院和社区获得性感染革兰阳性细菌耐药监测研究[J].中华检验医学杂志,2005,28(3)：254-265.
[72]章锐锋,徐志江.社区获得性MRSA感染的临床特征和耐药性分析[J].中国微生物学和免疫学杂志,2004,24(7)：573-576.
[73]纪冰,马筱玲.社区获得性耐甲氧西林金黄色葡萄球菌研究进展[J].国际检验医学杂志2006,3(27)：276-277.
[74]Nathwani D, Morgan M, Masterton RG, et al. Guidlines for UK practice for the diagnosis and managemeof methicillin-resistant Staphylococcus aureus(MRSA)infections presenting in the community[J]. J Antimicrob Chemother,2008,61(5):976
[75]Dancer SJ. The effect of antibiotics on methicillin-resistant Staphylococcus aureus [J]. J Antimicrob Chemother,2008,61(2):246
[76]于一云,王红.耐甲氧西林金黄色葡萄球菌治疗研究新进展[J].临床和实验医学杂志,2008,3(7)：172-174.
[77]刘永芳,吕晓菊.万古霉素的临床应用及耐药现状[J].华西药学,2005,20(1)：199.
[78]Hidayat LK, Hsu DI, Quist R, et al. High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections:efficacy and toxicity[J]. Arch Intern Med,2006,166(19):2138
[79]逢崇杰,巩路,田彬,等.替考拉宁和万古霉素对临床分耐甲氧西林葡萄球菌体外抗菌活性比较[J].中国抗感染化疗,2005,5(6)：360.
[80]戚佳叶,王林.耐甲氧西林葡萄球菌耐药形势和治疗药物[J].中国高等医学教育,2007,7：94-95.
[81]顾觉奋,施媚.抗MRSA抗生素研究新进展[J].国外医药抗生素分册,2004,25(5)：216-220.
[82]王超,王婧.耐甲氧西林金黄色葡萄球菌的临床治疗[J].中国医刊,2007,57(3)：18-20.
[83]李勇勇,黄文祥.耐甲氧西林金黄色葡萄球菌的感染现状与治疗进展[J].国外 医药抗生素分册,2010,1(31)：19-23.
[84]Hussain F M, Boyle-Vavra S, Bethel CD, et al. Current trend in community-acquired methicillin resistant Staphylococcus aureus at a tertiary care pediatric facility. Pediatr Infect Dis[J]J,2000,19(12):1163-1166.
[85]Gemmell CG, Edwards DI, Fraise AP, et al. Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus(MRSA)infections in the UK[J]. J Antimicrob Chemother,2006,57(4):589
[86]李格,贾海忠.耐甲氧西林金黄色葡萄球菌感染引起的顽固发热病案[J].中医杂志,2006,56(11)：850.
[817]杨明炜,陆付耳,徐丽君,等.20种清热解毒中药对耐甲氧西林金黄色葡萄球菌体外抑菌的初步观察[J].中国药师,2006,9(2)：141-142.
[88]Fire A, Xu S, Montgomery MK, et al. Potent and specific genetic interference by double-stran ded RNA incaenorhabditis elegans[J]. Nature,1998,391(6669):806
[89]Yanagihara K, Tashiro M, Fukuda Y, et al. Effects of short interfering RNA against methicillin-resistant Staphylococcus aureus coagulase vitro and vivo[J]. J Antimicrob Chemother,2006,57:122
[90]高美英.抗生素耐药性的挑战与控制对策[J].医药导报,2004,23(4)：210-212.
[91]Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus infections among competitive sports participants:Colorado, Indiana, Pennsylvania, and Los Angeles County,2000-2003[J]. MMWR Morb Mortal Wkly Rep,2003,52(33):793-795.
[92]王丽珍,张天托.耐甲氧西林金黄色葡萄球菌感染的现状和研究进展[J].国际呼吸杂志,2006,12(20)：917-919.
[93]Kreiswirth B, Kornblum J, Albeit RD, et al. Evidence for a clonal origin of methicillin resistance in Staphylococcus aureus[J]. Science,1993,259 (5092): 227-230.
[94]Fang FC, McClelland M, Guiney DG, et al. Value of molecular epidemiologic analysis in a nosocomial methicillin-resistant Staphylococcus aureus outbreak[J]. JAMA,1993,270(1):1323-1328.
[95]Goering RV, Duensing TD. Rapid field inversion gel electrophoresis in combination with an rRNA gene probe in the epidemiological evaluation of staphylococci[J]. J Clin Microbiol,1990,28(3):426-429.
[96]Del Vecchio VG, Petroziello JM, Gress MJ, et al. Molecular genotyping of methicillin-resistant Staphylococcus aureus via fluorophore-enhanced repetitive- sequence PCR[J]. J Clin Microbiol,1995,33(8):2141-2144.
[97]Ito T. Okuma K, Ma XX, et al. Insights on antibiotic resistance of Staphylococcus aureus from its whole genome:genomic island SCC[J]. Drug Resist Updat,2003, 6(1):41-52.
[98]Marta Aires De Sousa, Herminia de Lencastre. Bridges from hospitals to the laboratory:genetic portraits of methicillin-resistant Staphylococcus aureus clones[J]. FEMS Immunol Med Microbiol,2004,40(2):101-111.
[99]Qi W, Ender E, O'Brien F, et al. Molecular epidemiology of Methicill-in-resistant Staphylococcus aureus in Zurich, Switzerland(2003):prevalence of type IV SCCmec and a new SCCmec element associated with isolates from intravenous drug users[J]. J Clin Microbiol,2005,43(10):5164-5170.
[100]Said-Salim B, Mat hema B, Kreiswirt h BN. Community-acquired methicillin resistant Staphylococcus aureus:an emerging pat hogen[J]. Infect Cont rol Hosp Epidemiol,2003,24:451-455.
[101]Bignardi GE, Woodford N, Chapman A, et al. Detection of the mecA gene and phenotypic detection of resistance in Staphylococcus aureus with borderline or low-level methicillin resistance.[J]J Antimicrob Chemother,1996,37:53
[102]Tokue Y, Shoji S, Satoh K, Watanabe A, Motomiya M. Comparion of a Polymerase Chain Reaction assay and a conventional microbiologic method for detection of methicillin resistant Staphylococcus aureus[J]. Antimicrob Agents Chemother.1992,30:6-9
[103]Brakstad O, Aasbakk K, Maeland J. Detection of Staphylococcus aureus by Polymerase Chain Reaction Amplification of the nuc gene[J]. J Clin Microbiol. 1992;30:1654-1660
[104]Bignardi GE, Woodford N, Chapman A, et al. Detection of the mecA gene and phenotypic detection of resistance in Staphylococcus aureus with borderline or low-level methicillin resistance[J]. J Antimicrob Chemother,1996,37:53
[105]Vandenesch F, Etienne J. How to prevent transmission of MRSA in the open community?[J]. Euro surveill,2004,9(11):5.
[106]Diep BA, Sensabargh GF, Somboona NS, et al. Widespread skin and soft tissue infections to two met hicillin-resistant Staphylococcus aureus st rains harboring the genes for Panton-Valentine leucocidin[J]. J Clin Microbiol,2004,42(5):2080-2084.
[107]Said-Salim B, Mathema B, Braughton K, et al. Differential distribution and expres-sion of panton-valentine leucocidin among community-acquired methicillin resist- ant Staphylococcus aureus strains[J]. J Clin Microbiol,2005,43(7):3373
[108]Michael M. Idcp snapshots[J]. Infect Dis Clin Prac,2002,11(6):3-7
[109]Vandenesch F, Naimi T, Mark C, et al. Community acquired methicillin-resistant Staphylococcus aureus carrying panton valentine leukocidin genes: worldwide emergence.[J]Emerg Infect Dis,2003,9(8):978-984.
[110]Eguia JM, Chambers HF. Community-acquried methicillin-resistant Staphylococus aureus:epidemiology and potential virulence factors[J]. Cur Infect Dis Rep,2003,5(6):459-466.
[111]Robert J, Etienne J, Bertrand X. Methicillin-resistant Staphylococcus aureus pro-ducing Panton-Valentine leukocidin in a retrospective case series from 12 French hospital laboratories,2000-2003[J]. Clin Microbiol Infect.2005 Jul;11(7):585-587
[112]Francis J S, Carroll K. Community-acquired MRSA:a notable adversary[J]. South Med J,2005,98(11):1061
[113]Martinez- Aguilar G, Avalos-Mishaan A. Community-acquired, methicillin resistant and methicillin-susceptible Staphylococcus aureus musculoskeletal infections in children[J]. Pediatr Infect Dis J,2004,23(8):701.
[114]Ko Ks, LeeJY, SuhJY, et al. Distribution of major genotypes among methicillin-resistan Staphylococcus aureus clones in Asian countries[J]. J Clin Microbiol,2005,43(1):421-426.
[115]Ip M, Yung RW, Ng TY, et al. Contemporary methieillin-resistant Staphylococcus aureus clones in Hong Kong[J]. J Clin Microbiol,2005, 43(10):5069-5073.
[116]Aires de Sousa M, Crisostomo Ml, Sanches IS, et al. Frequent recovery of a single clonaltype of methieillin-resistant Staphylococcus aureus from patients in two hospitals in Taiwan and China[J]. J Clin Mierobiol,2003,41 (1):159-163.
[117]EnrightM C, Robinson D A, Randle G, et al. The evolutionary history of methicillin resistant Staphylococcus aureus(MRSA)[J]. Proc Natl Acad Sci USA, 2002,99(11):7687-7692.
[118]Kunyan Z, Jo-Ann McClure, Sameer Elsayed, et al. Novel multiplex PCR assay for characterization and concomitant subtyping of staphylo-coccal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus[J]. J Clin Microbiol,2005,43(1):5026-5033.
[119]杜娜,胡比杰,褚云卓等.我国五家教学医院耐甲氧西林金黄色葡萄球菌SCCmec分型及毒素基因的检测[J].中华检验医学杂志,2007,30：5.
[120]Fridkin SK, Hageman JC, Morrison M, et al. Methicillin resistant Staphylococcus aureus disease in t hree communities[J]. New Engl J Med,2005,352:1436-1444.
[121]Gorwitz, R. J., D. B. Jernigan, J. H. Powers, J. A. Jernigan, and Participants in the CDC-Convened ExPerts' Meeting on Management of MRSA in the Community.2006. Strategies for clinical management of MRSA in the community:summary of an experts'meeting convened by the Centers for Disease Control and Prevention.
[122]Delaney JA, Schneider-Lindner V, Brassard P, Suissa S. Mortality after infection with methicillin-resistant Staphylococcus aureus(MRSA)diagnosed in the community[J]. BMC Med.2008:6:2.
[123]Oliveira DC, Milheirico C, de Lencastre H. Redefining a structural variant of staphylococcal cassette chromosome mec, SCCmec typeVI[J]. Antimicrob Agents Chemother,2006,50(10):3457-3459.
[124]Takano T, Higuchi W, Otsuka T, et al. Novel characteristics of community-acquired methicillin-resistant Staphylococcus aureus strains belo- nging to multilocus sequence type 59 in Taiwan[J]. Antimicrob Agents Chemother,2008, 52(3):837-845.
[125]Zhang KY, McClure JA, Elsayed S, et al. Novel staphylococcal cassette chromosome mec type, tentatively designated typeⅧ, harboring class A mec and type 4 ccr gene complexes in a Canadian epidemic strain of methicillin-resistant Staphylococcus aureus[J]. Antimicrob Agents Chemother,2009,53(2):531-540.
[126]Ito T, Katayama Y, Asada K, et al. Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureus[J]. Ant- imicrob Agents Chemother, 2001,45(5):1323-1336.
[127]茆海丰,邵世和.耐甲氧西林金黄色葡萄球菌SCCmec基因分型研究与耐药基因检测[J].中华医院感染学杂志,2010,1(20)：12-15.
[128]Yu F, ChenZ, Liu C, et al. Prevalence of Staphylococcus aureus carrying Panton-Valentine leukocidin genes among isolates from hospitalised patients in China.[J]Clin Microbiol Infeet,2008,14:381-384.
[129]糜祖煌,陆亚华.葡萄球菌耐药基因检测[J],.现代实用医学2004,16：67-68.
[130]SakoulasG, Gold HS, Venkataraman L, et a.1 Methicillin-resistant staphylococcus aureus:comparison of susceptibity testing methods and analysis of mecA-positive susceptible strains[J]. J Clin Microbiol,2001,39:3946-3951.
[131]糜祖煌,陆亚华.氨基糖苷类修饰酶及其基因检测[J].现代实用医学,2004,16：13-14.
[132]陆亚华,时庭文.耐甲氧西林金黄色葡萄球菌耐药性及耐药基因研究[J].中华检验医学杂志,2007,7(28)：744-745.
[133]AminovRI, Garrigues-Jeanjean N. MackieRI. Molecular ecology of tetracycline resistance:development and validation of primers for detection of tetracycline resistance genes encoding ribosomal protection proteins[J]. Appl Environ Microbiol,2001,67:22-32.
[134]RobertsMC, Sutcliffe J, Courvalin P, et a.l Nomenclature for macrolide and macrolide-Lincosamide-Streptogramin B resistance determinants[J]. Antimicrob AgentsChemother,1999,43:2823-2830.
[135]姚春艳,府伟灵.葡萄球菌医院感染的耐药性分析[J].中华医院感染学杂志,2004.14：104-106.
[1]Chambers HF. The changing epidemiology of Staphyl-ococcus aureus[J]. Emerg Infect Dis,2001,7(2):178-182.
[2]From the Centers for Disease Cont rol and Prevention. Staphylococcus aureus to vancomycin United States[J]. MMWR,2002,51(26):565-567.
[3]李春辉.社区获得性耐甲氧西林金黄色葡萄球菌感染研究进展[J].中国感染控制杂志,2008,7(6)：430-434.
[4]Saravolatz L D,Markowitz N,Arking L,et al. Methicillin-resistant Staphylococcus aureus.Epidemiologic observat-ions during a community-acquired outbreak[J]. Ann Intern Med,1982,96(1):11-16.
[5]Centers for disease Control and Prevention.Four Pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus-Minnesota and North Dakota,1997-1999[J]. MMWR Morb Mortal Wkly Rep,1999,48(32):707-710
[6]Bukharie H A,Abdelhadi M S,Saeed I A,et AL.Emergence of methicillin-resistant Staphylococcus aureus as a communi-ty pathogen[J].Diagn Microbiol Infect Dis,2001,40(1):1-4.
[7]Dinusha W,Dietrich M D,Dianne B,et al.Community-acquired methicillin-resistant Staphylococcus aureus in Southern New England Children[J]. Pediatrics,2004,113(4):e347-e352.
[8]李家泰,Weinstein A J,杨敏(代表中国细菌耐药监测研究组).中国细菌耐药监测研究[J].中华医学杂志,2001,81(1)：8-16.
[9]李家泰,齐慧敏,李耘(代表中国细菌耐药监测研究组).2002-2003年中国医院和社区获得性感染革兰阳性细菌耐药监测研究[J].中华检验医学杂志,2005,28(3)：254-265.
[10]李有信,冯吉吉.医院内耐甲氧西林金黄色葡萄球菌感染分析[J].中华医院感染学杂志,2003,13(1)：84-85.
[11]Thompson K,Torriani F. Community-associated Methicillin-resistant Staphyloc-occus aureus in the patient with HIV infection. Curr HIV/AIDS Rep,2006,3:107-112.
[12]Rybak M J,Laplante K L. Community-associated methicillin-resistant staphyloco-ccus aureus:a review. Pharmacotherapy,2005,25:74-85.
[13]EadyEA,CoveJH. Staphylococcal resistanc revisited:com-munity acquired meth-icillin resistant Staphylococcus aureus an emerging problem for the managem- ent of skin and soft tissue infections. Curr Opin Infect Dis,2003,16:103-124.
[14]JohnCC,SchreiberJR. Therapies and vaccines for emerging bacterial infections:learning from methicillin resistant Staphylococcus aureus. Pediatr Clin North Am,2006,53:699-713.
[15]Stevenson KB,Searle K,Stoddard GJ,et al. Methicillin resistant staphylococcus aureus and vancomycin-resistant enterococci in rural communities,western united states. Emerging Infect Dis,2005,6:899-900.
[16]Naimi TS,Le Dell KH,Como-Sabetti K,et al. Comparison of community and healthcare associated methicillin resistant Staphylococcus aureus infection. JAMA,2003,290:2976-2984.
[17]Vandenesch F,Etienne J. How to prevent transmission of MRSA in the open comm- unity[J]. Euro surveill,2004,9(11):5.
[18]Hartman BJ,Tomas A. Low affinity penicillin-binding protein associated With β-lactam resistance in Staphyloc occus aureus. J Bact,1984,158:513-516.
[19]樊剑锋,马琳,杨永弘.耐甲氧西林金黄色葡萄球菌的研究现状.中华儿科杂志,2002,10(40)：635-636.
[20]Aires de Sousa M,de Lencastre H. Evolution of sporadic isolates of methicillin-resistant Staphylococcus aureus(MRSA)in hospitals and their similarities to isolates of community-acquired MRSA. J Clin Microbiol,2003,41(8):3806-3815.
[21]Crum NF. The emergence of severe,community-acquired Methicillin-resistant staphylococcus aureus infections. Scand J Infect Dis,2005,37:651-656.
[22]Chi CY,Wong WW,Fung CP,et al. Epidemiology of community-Acquired Staph-ylococcus aureus bacteremia. J Microbiol Immunol Infect,2004,37(1):16-23.
[23]O'Brien FG,Lim TT,Chong FN,et al. Diversity among commu-nity isolates of methicillin-resistant Staphylococcus aureus in Australia. J Clin Microbiol, 2004,42(7):3185 3190.
[24]Bukharie HA,Abdelhadi MS,Saeed IA,et al. Emergence of methicillin-resistant Staphylococcus aureus as a community pathogen.Diagn Microbiol Infect Dis,2001, 40(122):1-4.
[25]Martinez-Aguilar G,Hammerman WA,Masan EO Jr,et al. Clindamycin treatment of invasive infections caused by community-acquired,methicillin-resistant and methicillin-susceptible Staphylococcus aureus in children,Pediatr infect Dis J,2003, 22(7):593-598.
[26]Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus infections among competitive sports participants:Colorado,I ndiana, Pennsylvania, and Los Angeles County,2000-2003[J]. MMWR Morb Mortal Wkly Rep,2003,52(33):793-795.
[27]潘军,刘文恩.社区感染耐甲氧西林金黄色葡萄球菌研究进展[J].国际检验医学杂志,2009,30(2)：152-154.
[2]周一平.近8年细菌检出情况分析[J].感染、炎症、修复,2005,6(3)：138-140
[3]郑中柱.北印度三级医疗中心烧伤患者院内感染的前瞻性研究[J].感染、炎症修复,2005,6(4)：252-253
[4]From the Centers for Disease Cont rol and Prevention. Staphylococcus aureus to vancomycin United States[J]. MMWR,2002,51(26):565-567.
[5]李春辉.社区获得性耐甲氧西林金黄色葡萄球菌感染研究进展[J].中国感染控制杂志,2008,7(6)：430-434.
[6]Saravolatz L D, Markowitz N, Arking L, et al. Methicillin-resistant Staphylococcus aureus. Epidemiologic observat-ions during a community-acquired outbreak[J]. Ann Intern Med,1982,96(1):11-16.
[7]于一云,王红.耐甲氧西林金黄色葡萄球菌流行病学和耐药机制研究新进展[J].感染、炎症、修复,2008,2(9)：120-122.
[8]Scanvic A, Denic L, Gaillon S, et al. Duration of colonization by methicillin-resistant Staphylococcus aureus after hospital discharge and risk factors for prolonged carri- age[J]. Clin Infect Dis,2001,32:1393-1398.
[9]谭谦,刘相名,周宏祁等.抗-耐甲氧西林金黄色葡萄球菌抗体的体外抑菌作用[J].中华医院感染学杂志,2003,13(1)：4-6
[10]李雅卿,黄卫红.耐甲氧西林金黄色葡萄球菌医院感染临床分析[J].中华医院感染学杂志,2002,12(2)：151-152
[11]Hartman BJ, Tomas A. Low affinity penicillin-binding protein associated with(3-lactam resistance in Staphylococcus aureus[J],. J Bactl984,158:513-516.
[12]姚春艳,府伟灵.葡萄球菌医院感染的耐药分析[J].中华医院感染学杂志,2004,14(1)：104-106
[13]Staali L, Monteil H, Colin DA. The staphylococcal poreforming leuko toxins open Ca2+ channels in the membrane of human polymorphonuclear neutrophils[J]. J Membr Biol[J],1998,162:209-216.
[14]Baba Moussa L, Werner S, Colin DA, et al. Discoupling the Ca2+ activation from the pore-forming function of the bicomponent Panton-Valentine leucocidin in human PMNs[J]. FEBSLett.1999,461:280-286.
[15]Mishaan AM, Mason EO Jr, Martinez-Aguilar G, et al. Emergence of a predominant clone of community-acquired Staphylococcus aureus among children in Houston,[J], Texas. Pediatr Infect Dis J 2005,24:201-206.
[16]Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus Minne- sota and North Dakota,1997-1999. MMWR MorbMortal Wkly Rep[J],1999,48(NO MM32):707-710.
[17]杨清宇,刘荣森.耐甲氧西林金黄色葡萄球菌的研究[J].中华医院感染学杂志,2004,4(14)：478-480.
[18]纪冰,马筱玲,胡白,等.引起社区获得性皮肤软组织感染的病原菌分布及主要致病菌的药物敏感性分析[J].中国现代医学杂志.2007,3(17)：329-332.
[19]艾效曼,张秀珍Mohnarin2008年度报告：华北地区细菌耐药监测[J].中国抗生素杂志,2010,35(7)：490-496.
[20]汪玥,孙自镛Mohnarin 2008年度报告：中南地区细菌耐药监测[J].中国抗生素杂志,2010,35(7)：520-528.
[21]戴立人,向友华.耐甲氧西林金黄色葡萄球菌医院内感染及其监测[J].中华医学杂志,1992,72(8)：465.
[22]Eady EA, Cove J H. Staphylococcal resistance revisited:community- acquired methicillin-resistant Staphylococcus aureus an emerging problem for the manage-ment of skin and soft tissue infections[J]. Curr Opin Infect Dis,2003,16:103-124.
[23]Bukharie H A, Abdelhadi M S, Saeed I A, et al. Emergence of methicillin- resistant Staphylococcus aureus as a community pathogen[J]. Diagn Microbiol Infect Dis, 2001,40(1):1-4.
[24]崔俊昌,刘又宁.鼻腔金黄色葡萄球菌携带与医院内感染[J].军医进修学院学报.2005；26(02)：149-151.
[25]Creech CB 2nd, Kernodle DS, Alsentzer A, et al. Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr Infect Dis J.2005 Jul;24(7):617-621.
[26]Rojas H, Femandez LN, Espino HM, et al. Patterns of drug resistance in Staphylococcus aurens from human clinical isolates[J]. Rev Cubana Med Trop, 2001,53(1):53-58.
[27]王辉.耐苯畔青霉素葡萄球菌对16种抗生素敏感性特征[J].中华微生物和免疫学杂志,1995,15(6)：430-433.
[28]吴镝,曹晋桂,何晓锋等.耐甲氧甲林葡萄球菌的耐药性分析及临床意义[J].空军总医院学报,2002,18(3)：169-171.
[29]朱霞.MRSA感染的高危因素分析及预防[J].中国航天医药杂志,2003,5(1)：59.
[30]Dietrich DW, Auld DB, Mermel LA. Community-acquired methicillin resistant Staphylococcus aureus in southern New England children[J].. Pediatrics 2004;113, 347-352
[31]Kaplan SL, Hulten KG, Gonzalez BE, et al. Three-year surveillance of community acquired Staphylococcus aureus infections in children[J].. Clin Infect Dis 2005;40: 1785-1791
[32]纪冰,马筱玲.社区获得性耐甲氧西林金黄色葡萄球菌研究进展[J].国际检验医学杂志,2006,3(27)：276-279.
[33]Lim D, St rynadka NC. St ructural basis for the beta lactam resistance of PBP2a from methicillin-resistant Staphylococcus aureus[J].. Nat Struct Biol,2002,9(11):870-876.
[34]祁伟,宋诗铎,官兰,等.耐甲氧西林金黄色葡萄球菌mecA基因在大肠杆菌中的表达[J].中华传染病杂志,2002,20(5)：301-303.
[35]欧阳范献,鲍时翔.mec复合体和SCCmec盒与MRSA耐药性的研究进展[J].中国感染控制杂志.2004,10(3)：375-377.
[36]EnrightMC, Robinson DA, Randle G, et al. The evolutionary history of methicillin-resistant Staphylococcus aureus(MRSA) (J). Proc Natl Acad Sci USA 2002,99 (11):7687-7692.
[37]朱以军,李向阳.耐甲氧西林金黄色葡萄球菌的耐药机制及检测[J]..国外医学.临床生物化学与检验学分册,2005,1(26)：26-31.
[38]朱佩琼,裘云庆.耐甲氧西林金黄色葡萄球菌耐药机制的研究近况[J].国外医学.流行病学传染病学分册,2004,(31)：314-316.
[39]Ito T, Okuma K, Ma XX, et al. Insights on antibiotic resistance of Staphylococcus aureus from its whole genome:genomic island SCC[J].. Drug Resist Updat,2003,6 (1):41-52.
[40]Marta Aires De Sousa, Herminia de Lencastre. Bridges from hospitals to the laborat-ory.genetic portraits of methicillin-resistant Staphylococcus aureus clones. FEMS immunol Med Microbiol,2004,40(2):101-111.
[41]Qi W, Ender E, O'Brien F, et al. Molecular epidemiology of methicillin- resistant Staphylococcus aureus in Zurich, Switzerland(2003):prevalence of type IV SCCm- ec and a new SCCmec element associated with isolates from intravenous drug users. J Clin Microbiol,2005,43(10):5164-5170.
[42]Kaneko J, Kamio Y. Bacterial two-component and hetero-heptameric pore-forming cytolytic toxins:structure, pore-forming mechanism, and organization of the gene [J].Biosci Biotechnol Biochem,2004,69(5):981-1003.
[43]祁伟,吕星,程玉谦.社区获得性耐甲氧西林金黄色葡萄球菌[J].国际流行病学传染病学杂志,2007,2,(34)：55-57.
[44]Genestier AL, Michallet MC, Prevost G, et al. Staphylococcus aureus Panton-valen-tine leukocidin durectly targets mitochondria and induces Bax independent apoptosis of human neutrophils[J]. J. Clin Invest,2005,115(11):3117-3127.
[45]王凤玲,侯英荣,冯秀河.耐甲氧西林金黄色葡萄球菌耐药基因及致病毒素基因的研究进展[J].中国感染与化疗杂志,2010,1(10)：72-75.
[46]Holmes A, Ganner M, McGuane S, et al. S taphy lococcus aureus isolates carrying Panton-Valentine leukocidin genes in England Wales:frequency, characterizati-on and association with clinical disease[J]. J Clin Microbiol,2005,43(5):2384-2390.
[47]Eguia JM, Chambers HF. Community-acquried methicillin -resistant Staphylococus aureus:epidemiology and potential virulence factors. Cur Infect Dis Rep,2003,5(6): 459-466.
[48]Krakauer T. Immune response to staphylococcal superanti gens[J]. Immunologic Res, 1999,20(2):163-173.
[49]Recsei P, Kreiswirt h B, O Reilly M, et al. Regulation of exoprotein gene expression in Staphylococcus aureus by agar[J]. Mol Gen Genet,1986,202(1):58261.
[50]王慎,张兴善.中毒性休克综合征毒素-1引起新生儿早期出疹病[J].国外医学妇幼保健分册,1999,10(1)：40.
[51]王敏,付炅,李先平.金黄色葡萄球菌中毒休克综合征毒素1基因的检测[J].中国生物制品学杂志,2008,21(4)：2952297.
[52]Berger-Bachi B, Robrer S. Factors influencing methicillin resistance in staphylococ-ci[J]. Arch Microbiol,2002,178(3):165-171.
[53]Berger-Bachi B, Robrer S. Factors influencing methicillin resistance in Staphylococ-ci[J]. Arch Microbiol,1992,42:19-34.
[54]张怡滨,宋诗铎.基因femA和耐甲氧西林金黄色葡萄球菌不均一耐药性的关系[J].国外医药抗生素分册,2000,21(3)：123-126.
[55]Berger-bachi B. Factors affecting methicillin resistance in Staphylococcus aureus[J]. Int J Antimicrob Agents,1995,6(1):13-21.
[56]McKinney TK, Sharma VK, Craig WA,et al.Transcription of the gene mediating methicillin resistance in Staphylococcus aureus(mecA)is corepressed but not coinduced by cognate mecA and P-lactamase regulators[J]. J B acteriol,2001, 183(23):6862.
[57]朱以军,李向阳.耐甲氧西林金黄色葡萄球菌的耐药机制及检测[J].国外医学·临床生物化学与检验学分册,2005,1(26)：26-31.
[58]汪复.2006年中国CHINET细菌耐药监测[J].中国抗感染化疗杂志,2008,8(1)：1.
[59]Oldfield EC 3rd. No Mercy from MRSA. Rev Gostroenterol Disord[J],2004,4 (2): 95-98
[60]Jarvis WR, Schlosser J, Chinn R Y, et al. National prevalence of methi-cillin-resistant Staphylococcus aureus in inpatients at US health care facilities, 2006[J]. Am J Infect Control,2007,35(10):631.
[61]Jarvis WR, Schlosser J, Chinn R Y, et al. National prevalence of Methicil-lin-resistant Staphylococcus aureus in inpatients at US health care facilities, 2006[J]. Am J Infect Control,2007,35(10):631.
[62]历夏女.MRSA耐药性的挑战与防治策略[J]..海峡药,2006,18(4)：273-275.
[63]马越,姚雷,陈鸿波,等.临床常见细菌的耐药性问题[J]..中国抗生素杂志,2002,27(3)：129-137.
[64]Trautmann M, Pollitt A, Loh U, et al. Implementation of an intensified infection control program to reduce MRSA transmissions in a German tertiary care hospital [J]. Am J Infect Control,2007,35(10):643.
[65]Fridkin SK, Hageman JC, Morrison M, et al. Methicillin resistant Staph-ylococcus aureus disease in three communities[J]. New Engl J Med,2005,352: 143-1444.
[66]Tiemers ma E W, Bronz waer SL, Lyytik ajnen O, et al. Methicillin-Resistant Staphylococcus aureus in Europe,1999-2002. Emerging Infect Dis[J],2004,9: 1627-1634.
[67]Maguire G P, Auther A D, Boustead P J, et al. Clinical experience and outcomes of community-acquired and nosocomial Methicillin resistant Staphylococcus aureus in a northern Australian hospital[J]. J Hosp Infect,1998,38:273-281.
[68]Nimmo GR, Coombs G W, Pearson JC, et al. Methicillin-resistant Staphylococcus aureus in the Australian community:an evolving epidemic[J]. Med J Aust,2006, 184:384-388.
[69]Dinusha W, Dietrich M D, Dianne B, et al. Community-acquired methici-llin-resistant Staphylococcus aureus in Southern New England Children[J]. Pediatrics,2004,11(4):e347-e352.
[70]李家泰,Weinstein AJ,杨敏(代表中国细菌耐药监测研究组).中国细菌耐药监测研究[J].中华医学杂志。2001,81(1)：8-16.
[71]李家泰,齐慧敏,李耘(代表中国细菌耐药监测研究组).2002-2003年中国医院和社区获得性感染革兰阳性细菌耐药监测研究[J].中华检验医学杂志,2005,28(3)：254-265.
[72]章锐锋,徐志江.社区获得性MRSA感染的临床特征和耐药性分析[J].中国微生物学和免疫学杂志,2004,24(7)：573-576.
[73]纪冰,马筱玲.社区获得性耐甲氧西林金黄色葡萄球菌研究进展[J].国际检验医学杂志2006,3(27)：276-277.
[74]Nathwani D, Morgan M, Masterton RG, et al. Guidlines for UK practice for the diagnosis and managemeof methicillin-resistant Staphylococcus aureus(MRSA)infections presenting in the community[J]. J Antimicrob Chemother,2008,61(5):976
[75]Dancer SJ. The effect of antibiotics on methicillin-resistant Staphylococcus aureus [J]. J Antimicrob Chemother,2008,61(2):246
[76]于一云,王红.耐甲氧西林金黄色葡萄球菌治疗研究新进展[J].临床和实验医学杂志,2008,3(7)：172-174.
[77]刘永芳,吕晓菊.万古霉素的临床应用及耐药现状[J].华西药学,2005,20(1)：199.
[78]Hidayat LK, Hsu DI, Quist R, et al. High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections:efficacy and toxicity[J]. Arch Intern Med,2006,166(19):2138
[79]逢崇杰,巩路,田彬,等.替考拉宁和万古霉素对临床分耐甲氧西林葡萄球菌体外抗菌活性比较[J].中国抗感染化疗,2005,5(6)：360.
[80]戚佳叶,王林.耐甲氧西林葡萄球菌耐药形势和治疗药物[J].中国高等医学教育,2007,7：94-95.
[81]顾觉奋,施媚.抗MRSA抗生素研究新进展[J].国外医药抗生素分册,2004,25(5)：216-220.
[82]王超,王婧.耐甲氧西林金黄色葡萄球菌的临床治疗[J].中国医刊,2007,57(3)：18-20.
[83]李勇勇,黄文祥.耐甲氧西林金黄色葡萄球菌的感染现状与治疗进展[J].国外 医药抗生素分册,2010,1(31)：19-23.
[84]Hussain F M, Boyle-Vavra S, Bethel CD, et al. Current trend in community-acquired methicillin resistant Staphylococcus aureus at a tertiary care pediatric facility. Pediatr Infect Dis[J]J,2000,19(12):1163-1166.
[85]Gemmell CG, Edwards DI, Fraise AP, et al. Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus(MRSA)infections in the UK[J]. J Antimicrob Chemother,2006,57(4):589
[86]李格,贾海忠.耐甲氧西林金黄色葡萄球菌感染引起的顽固发热病案[J].中医杂志,2006,56(11)：850.
[817]杨明炜,陆付耳,徐丽君,等.20种清热解毒中药对耐甲氧西林金黄色葡萄球菌体外抑菌的初步观察[J].中国药师,2006,9(2)：141-142.
[88]Fire A, Xu S, Montgomery MK, et al. Potent and specific genetic interference by double-stran ded RNA incaenorhabditis elegans[J]. Nature,1998,391(6669):806
[89]Yanagihara K, Tashiro M, Fukuda Y, et al. Effects of short interfering RNA against methicillin-resistant Staphylococcus aureus coagulase vitro and vivo[J]. J Antimicrob Chemother,2006,57:122
[90]高美英.抗生素耐药性的挑战与控制对策[J].医药导报,2004,23(4)：210-212.
[91]Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus infections among competitive sports participants:Colorado, Indiana, Pennsylvania, and Los Angeles County,2000-2003[J]. MMWR Morb Mortal Wkly Rep,2003,52(33):793-795.
[92]王丽珍,张天托.耐甲氧西林金黄色葡萄球菌感染的现状和研究进展[J].国际呼吸杂志,2006,12(20)：917-919.
[93]Kreiswirth B, Kornblum J, Albeit RD, et al. Evidence for a clonal origin of methicillin resistance in Staphylococcus aureus[J]. Science,1993,259 (5092): 227-230.
[94]Fang FC, McClelland M, Guiney DG, et al. Value of molecular epidemiologic analysis in a nosocomial methicillin-resistant Staphylococcus aureus outbreak[J]. JAMA,1993,270(1):1323-1328.
[95]Goering RV, Duensing TD. Rapid field inversion gel electrophoresis in combination with an rRNA gene probe in the epidemiological evaluation of staphylococci[J]. J Clin Microbiol,1990,28(3):426-429.
[96]Del Vecchio VG, Petroziello JM, Gress MJ, et al. Molecular genotyping of methicillin-resistant Staphylococcus aureus via fluorophore-enhanced repetitive- sequence PCR[J]. J Clin Microbiol,1995,33(8):2141-2144.
[97]Ito T. Okuma K, Ma XX, et al. Insights on antibiotic resistance of Staphylococcus aureus from its whole genome:genomic island SCC[J]. Drug Resist Updat,2003, 6(1):41-52.
[98]Marta Aires De Sousa, Herminia de Lencastre. Bridges from hospitals to the laboratory:genetic portraits of methicillin-resistant Staphylococcus aureus clones[J]. FEMS Immunol Med Microbiol,2004,40(2):101-111.
[99]Qi W, Ender E, O'Brien F, et al. Molecular epidemiology of Methicill-in-resistant Staphylococcus aureus in Zurich, Switzerland(2003):prevalence of type IV SCCmec and a new SCCmec element associated with isolates from intravenous drug users[J]. J Clin Microbiol,2005,43(10):5164-5170.
[100]Said-Salim B, Mat hema B, Kreiswirt h BN. Community-acquired methicillin resistant Staphylococcus aureus:an emerging pat hogen[J]. Infect Cont rol Hosp Epidemiol,2003,24:451-455.
[101]Bignardi GE, Woodford N, Chapman A, et al. Detection of the mecA gene and phenotypic detection of resistance in Staphylococcus aureus with borderline or low-level methicillin resistance.[J]J Antimicrob Chemother,1996,37:53
[102]Tokue Y, Shoji S, Satoh K, Watanabe A, Motomiya M. Comparion of a Polymerase Chain Reaction assay and a conventional microbiologic method for detection of methicillin resistant Staphylococcus aureus[J]. Antimicrob Agents Chemother.1992,30:6-9
[103]Brakstad O, Aasbakk K, Maeland J. Detection of Staphylococcus aureus by Polymerase Chain Reaction Amplification of the nuc gene[J]. J Clin Microbiol. 1992;30:1654-1660
[104]Bignardi GE, Woodford N, Chapman A, et al. Detection of the mecA gene and phenotypic detection of resistance in Staphylococcus aureus with borderline or low-level methicillin resistance[J]. J Antimicrob Chemother,1996,37:53
[105]Vandenesch F, Etienne J. How to prevent transmission of MRSA in the open community?[J]. Euro surveill,2004,9(11):5.
[106]Diep BA, Sensabargh GF, Somboona NS, et al. Widespread skin and soft tissue infections to two met hicillin-resistant Staphylococcus aureus st rains harboring the genes for Panton-Valentine leucocidin[J]. J Clin Microbiol,2004,42(5):2080-2084.
[107]Said-Salim B, Mathema B, Braughton K, et al. Differential distribution and expres-sion of panton-valentine leucocidin among community-acquired methicillin resist- ant Staphylococcus aureus strains[J]. J Clin Microbiol,2005,43(7):3373
[108]Michael M. Idcp snapshots[J]. Infect Dis Clin Prac,2002,11(6):3-7
[109]Vandenesch F, Naimi T, Mark C, et al. Community acquired methicillin-resistant Staphylococcus aureus carrying panton valentine leukocidin genes: worldwide emergence.[J]Emerg Infect Dis,2003,9(8):978-984.
[110]Eguia JM, Chambers HF. Community-acquried methicillin-resistant Staphylococus aureus:epidemiology and potential virulence factors[J]. Cur Infect Dis Rep,2003,5(6):459-466.
[111]Robert J, Etienne J, Bertrand X. Methicillin-resistant Staphylococcus aureus pro-ducing Panton-Valentine leukocidin in a retrospective case series from 12 French hospital laboratories,2000-2003[J]. Clin Microbiol Infect.2005 Jul;11(7):585-587
[112]Francis J S, Carroll K. Community-acquired MRSA:a notable adversary[J]. South Med J,2005,98(11):1061
[113]Martinez- Aguilar G, Avalos-Mishaan A. Community-acquired, methicillin resistant and methicillin-susceptible Staphylococcus aureus musculoskeletal infections in children[J]. Pediatr Infect Dis J,2004,23(8):701.
[114]Ko Ks, LeeJY, SuhJY, et al. Distribution of major genotypes among methicillin-resistan Staphylococcus aureus clones in Asian countries[J]. J Clin Microbiol,2005,43(1):421-426.
[115]Ip M, Yung RW, Ng TY, et al. Contemporary methieillin-resistant Staphylococcus aureus clones in Hong Kong[J]. J Clin Microbiol,2005, 43(10):5069-5073.
[116]Aires de Sousa M, Crisostomo Ml, Sanches IS, et al. Frequent recovery of a single clonaltype of methieillin-resistant Staphylococcus aureus from patients in two hospitals in Taiwan and China[J]. J Clin Mierobiol,2003,41 (1):159-163.
[117]EnrightM C, Robinson D A, Randle G, et al. The evolutionary history of methicillin resistant Staphylococcus aureus(MRSA)[J]. Proc Natl Acad Sci USA, 2002,99(11):7687-7692.
[118]Kunyan Z, Jo-Ann McClure, Sameer Elsayed, et al. Novel multiplex PCR assay for characterization and concomitant subtyping of staphylo-coccal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus[J]. J Clin Microbiol,2005,43(1):5026-5033.
[119]杜娜,胡比杰,褚云卓等.我国五家教学医院耐甲氧西林金黄色葡萄球菌SCCmec分型及毒素基因的检测[J].中华检验医学杂志,2007,30：5.
[120]Fridkin SK, Hageman JC, Morrison M, et al. Methicillin resistant Staphylococcus aureus disease in t hree communities[J]. New Engl J Med,2005,352:1436-1444.
[121]Gorwitz, R. J., D. B. Jernigan, J. H. Powers, J. A. Jernigan, and Participants in the CDC-Convened ExPerts' Meeting on Management of MRSA in the Community.2006. Strategies for clinical management of MRSA in the community:summary of an experts'meeting convened by the Centers for Disease Control and Prevention.
[122]Delaney JA, Schneider-Lindner V, Brassard P, Suissa S. Mortality after infection with methicillin-resistant Staphylococcus aureus(MRSA)diagnosed in the community[J]. BMC Med.2008:6:2.
[123]Oliveira DC, Milheirico C, de Lencastre H. Redefining a structural variant of staphylococcal cassette chromosome mec, SCCmec typeVI[J]. Antimicrob Agents Chemother,2006,50(10):3457-3459.
[124]Takano T, Higuchi W, Otsuka T, et al. Novel characteristics of community-acquired methicillin-resistant Staphylococcus aureus strains belo- nging to multilocus sequence type 59 in Taiwan[J]. Antimicrob Agents Chemother,2008, 52(3):837-845.
[125]Zhang KY, McClure JA, Elsayed S, et al. Novel staphylococcal cassette chromosome mec type, tentatively designated typeⅧ, harboring class A mec and type 4 ccr gene complexes in a Canadian epidemic strain of methicillin-resistant Staphylococcus aureus[J]. Antimicrob Agents Chemother,2009,53(2):531-540.
[126]Ito T, Katayama Y, Asada K, et al. Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureus[J]. Ant- imicrob Agents Chemother, 2001,45(5):1323-1336.
[127]茆海丰,邵世和.耐甲氧西林金黄色葡萄球菌SCCmec基因分型研究与耐药基因检测[J].中华医院感染学杂志,2010,1(20)：12-15.
[128]Yu F, ChenZ, Liu C, et al. Prevalence of Staphylococcus aureus carrying Panton-Valentine leukocidin genes among isolates from hospitalised patients in China.[J]Clin Microbiol Infeet,2008,14:381-384.
[129]糜祖煌,陆亚华.葡萄球菌耐药基因检测[J],.现代实用医学2004,16：67-68.
[130]SakoulasG, Gold HS, Venkataraman L, et a.1 Methicillin-resistant staphylococcus aureus:comparison of susceptibity testing methods and analysis of mecA-positive susceptible strains[J]. J Clin Microbiol,2001,39:3946-3951.
[131]糜祖煌,陆亚华.氨基糖苷类修饰酶及其基因检测[J].现代实用医学,2004,16：13-14.
[132]陆亚华,时庭文.耐甲氧西林金黄色葡萄球菌耐药性及耐药基因研究[J].中华检验医学杂志,2007,7(28)：744-745.
[133]AminovRI, Garrigues-Jeanjean N. MackieRI. Molecular ecology of tetracycline resistance:development and validation of primers for detection of tetracycline resistance genes encoding ribosomal protection proteins[J]. Appl Environ Microbiol,2001,67:22-32.
[134]RobertsMC, Sutcliffe J, Courvalin P, et a.l Nomenclature for macrolide and macrolide-Lincosamide-Streptogramin B resistance determinants[J]. Antimicrob AgentsChemother,1999,43:2823-2830.
[135]姚春艳,府伟灵.葡萄球菌医院感染的耐药性分析[J].中华医院感染学杂志,2004.14：104-106.
[1]Chambers HF. The changing epidemiology of Staphyl-ococcus aureus[J]. Emerg Infect Dis,2001,7(2):178-182.
[2]From the Centers for Disease Cont rol and Prevention. Staphylococcus aureus to vancomycin United States[J]. MMWR,2002,51(26):565-567.
[3]李春辉.社区获得性耐甲氧西林金黄色葡萄球菌感染研究进展[J].中国感染控制杂志,2008,7(6)：430-434.
[4]Saravolatz L D,Markowitz N,Arking L,et al. Methicillin-resistant Staphylococcus aureus.Epidemiologic observat-ions during a community-acquired outbreak[J]. Ann Intern Med,1982,96(1):11-16.
[5]Centers for disease Control and Prevention.Four Pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus-Minnesota and North Dakota,1997-1999[J]. MMWR Morb Mortal Wkly Rep,1999,48(32):707-710
[6]Bukharie H A,Abdelhadi M S,Saeed I A,et AL.Emergence of methicillin-resistant Staphylococcus aureus as a communi-ty pathogen[J].Diagn Microbiol Infect Dis,2001,40(1):1-4.
[7]Dinusha W,Dietrich M D,Dianne B,et al.Community-acquired methicillin-resistant Staphylococcus aureus in Southern New England Children[J]. Pediatrics,2004,113(4):e347-e352.
[8]李家泰,Weinstein A J,杨敏(代表中国细菌耐药监测研究组).中国细菌耐药监测研究[J].中华医学杂志,2001,81(1)：8-16.
[9]李家泰,齐慧敏,李耘(代表中国细菌耐药监测研究组).2002-2003年中国医院和社区获得性感染革兰阳性细菌耐药监测研究[J].中华检验医学杂志,2005,28(3)：254-265.
[10]李有信,冯吉吉.医院内耐甲氧西林金黄色葡萄球菌感染分析[J].中华医院感染学杂志,2003,13(1)：84-85.
[11]Thompson K,Torriani F. Community-associated Methicillin-resistant Staphyloc-occus aureus in the patient with HIV infection. Curr HIV/AIDS Rep,2006,3:107-112.
[12]Rybak M J,Laplante K L. Community-associated methicillin-resistant staphyloco-ccus aureus:a review. Pharmacotherapy,2005,25:74-85.
[13]EadyEA,CoveJH. Staphylococcal resistanc revisited:com-munity acquired meth-icillin resistant Staphylococcus aureus an emerging problem for the managem- ent of skin and soft tissue infections. Curr Opin Infect Dis,2003,16:103-124.
[14]JohnCC,SchreiberJR. Therapies and vaccines for emerging bacterial infections:learning from methicillin resistant Staphylococcus aureus. Pediatr Clin North Am,2006,53:699-713.
[15]Stevenson KB,Searle K,Stoddard GJ,et al. Methicillin resistant staphylococcus aureus and vancomycin-resistant enterococci in rural communities,western united states. Emerging Infect Dis,2005,6:899-900.
[16]Naimi TS,Le Dell KH,Como-Sabetti K,et al. Comparison of community and healthcare associated methicillin resistant Staphylococcus aureus infection. JAMA,2003,290:2976-2984.
[17]Vandenesch F,Etienne J. How to prevent transmission of MRSA in the open comm- unity[J]. Euro surveill,2004,9(11):5.
[18]Hartman BJ,Tomas A. Low affinity penicillin-binding protein associated With β-lactam resistance in Staphyloc occus aureus. J Bact,1984,158:513-516.
[19]樊剑锋,马琳,杨永弘.耐甲氧西林金黄色葡萄球菌的研究现状.中华儿科杂志,2002,10(40)：635-636.
[20]Aires de Sousa M,de Lencastre H. Evolution of sporadic isolates of methicillin-resistant Staphylococcus aureus(MRSA)in hospitals and their similarities to isolates of community-acquired MRSA. J Clin Microbiol,2003,41(8):3806-3815.
[21]Crum NF. The emergence of severe,community-acquired Methicillin-resistant staphylococcus aureus infections. Scand J Infect Dis,2005,37:651-656.
[22]Chi CY,Wong WW,Fung CP,et al. Epidemiology of community-Acquired Staph-ylococcus aureus bacteremia. J Microbiol Immunol Infect,2004,37(1):16-23.
[23]O'Brien FG,Lim TT,Chong FN,et al. Diversity among commu-nity isolates of methicillin-resistant Staphylococcus aureus in Australia. J Clin Microbiol, 2004,42(7):3185 3190.
[24]Bukharie HA,Abdelhadi MS,Saeed IA,et al. Emergence of methicillin-resistant Staphylococcus aureus as a community pathogen.Diagn Microbiol Infect Dis,2001, 40(122):1-4.
[25]Martinez-Aguilar G,Hammerman WA,Masan EO Jr,et al. Clindamycin treatment of invasive infections caused by community-acquired,methicillin-resistant and methicillin-susceptible Staphylococcus aureus in children,Pediatr infect Dis J,2003, 22(7):593-598.
[26]Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus infections among competitive sports participants:Colorado,I ndiana, Pennsylvania, and Los Angeles County,2000-2003[J]. MMWR Morb Mortal Wkly Rep,2003,52(33):793-795.
[27]潘军,刘文恩.社区感染耐甲氧西林金黄色葡萄球菌研究进展[J].国际检验医学杂志,2009,30(2)：152-154.