胶东地区不同家禽MSSA和MRSA的流行分布与耐药性分析

Prevalence and antimicrobial resistance of MSSA and MRSA isolated from different poultry

关键词:  MRSA  MSSA  家禽  spa分型  流行分布  耐药性

Key words:  MSSA  MRSA  Poultry  spa Prevalence  Antimicrobial Resistance

摘要:

通过了解胶东地区肉鸡、蛋鸡和水禽（鸭、鹅）中甲氧西林敏感/耐药金黄色葡萄球菌(MSSA/MRSA)的流行情况及耐药现状，为临床合理用药、有效控制耐药菌株的流行传播提供依据。采用细菌常规分离培养、质谱/PCR鉴定、微量肉汤稀释法和spa分型等方法，对2021年8月至10月在胶东地区采集的2730份禽源咽拭子进行MSSA及MRSA分离鉴定、spa分型及药敏试验，利用SPSS26.0 软件和BioNumericsv7.6 软件进行数据处理分析。2730份禽源咽拭子中共获得金黄色葡萄球菌742株（27.18%），其中MSSA 528株（19.34%），MRSA 214株（7.84%）。三种家禽菌株分离率依次为水禽（38.33%）、蛋鸡（28.45%）、肉鸡（20.33%）。351株代表性金黄色葡萄球菌共获得16种spa型别， MSSA(70.80%)和MRSA（95.30%）均是以t899为主 。部分型别仅在蛋鸡（t010、t002、t3155）或肉鸡（t571、t011）或水禽（t1793、t5268、t267）中分离到。MSSA和MRSA对青霉素类、喹诺酮类等多种药物显示出高水平耐药，分别对8种和13种抗菌药的耐药率在62.89%以上 ，MRSA对7种药物完全耐药（100%）。除磺胺异噁唑、万古霉素、复方新诺明、多西环素、利奈唑胺5种药物外（0.24＜P＜0.97），MRSA对其余13种药物耐药率均极显著高于MSSA（P＜0.01)。199株代表性菌株中共191株多重耐药，总体多重耐药率高达95.98%。其中，89株（91.75%）MSSA多重耐药菌株主要分布在6~8耐，102株MRSA（100%）主要分布在9~10耐。综上结果表明：金黄色葡萄球菌及MRSA在胶东地区家禽中分布较为广泛，且MRSA是以t899为主的克隆传播；胶东地区不同家禽中金黄色葡萄球菌的携带存在差异，水禽携带MSSA和MRSA的现象较其它两种家禽更为普遍；胶东地区禽源金黄色葡萄球菌对多种抗菌药普遍耐药，且MRSA较MSSA耐药更为严重，均为多重耐药菌株。实际临床用药中应尽量减少大环内酯类、喹诺酮类、青霉素类等高度耐药抗生素的使用频率，有针对性地选用敏感抗生素，以缓解严重的耐药现状。

Abstract:

To understand the prevalence and antimicrobial resistance of methicillin-sensitive / resistant S. aureus (MSSA / MRSA) in broiler, layer and waterfowl (duck and goose) in Collagenous East region, so as to provide basis for clinical rational drug use and effective control of the epidemic and transmission of drug-resistant strains. A total of 2730 avian derived throat swabs collected in Qingdao area from August to October 2021 were screened for MSSA and MRSA isolation and identification, spa type and susceptibility testing by routine isolation and culture of bacteria, mass spectrometry / PCR identification, microbroth dilution and spa typing methods, and SPSS26.0 and BioNumerics v7.6 waresoft were used to analyze the experimental data. A total of 742 isolates(27.18%) of S. aureus were obtained from 2730 throat swabs of avian origin, including 528 isolates of MSSA (19.34%)and 214 isolates of MRSA (7.84%). The isolation rates of the three poultry strains were waterfowl (38.33%), laying hens (28.45%), broilers (20.33%). A total of 16 spa types were obtained from 351 S. aureus isolates , and t899 were predominant in MSSA (70.80%) and MRSA (95.30%). Some types were isolated only in laying hens (t010, T002, t3155) or broilers (t571, t011) or waterfowl (t1793, t5268, t267). MSSAand MRSA showed high-level resistance to many antimicrobials including penicillins and quinolones, with resistance rates above 62.89% against eight and 13 antimicrobials, respectively, and MRSA was completely resistant to seven drugs (100%), which was more highly resistant (P < 0.01) to all 13 drugs tested than MSSA, with the exception of five drugs: sulfaisoxazole, vancomycin, Compound sulfamethoxazole doxycycline and linezolid (0.24 < p < 0.97). 191multiple-drug resistant(MDR) strains, and the overall MDR rate was up to 95.98%. Among them, 89 strains(91.75%) of MSSA are MDR strains, which are mainly resistant to 6~8 classes of anticrobials and 102 MDR strains(100%) of MRSA are mainly resistant to 9~10 classes of them. In summary, the results show that S. aureus and MRSA are widely distributed in poultry in Collagenous East region, and MRSA is clonally transmitted with t899 predominance; There were differences in the carriage of S. aureus among different poultry in Collagenous East region , and the phenomenon of MSSA and MRSA carriage among waterfowl was more prevalent than that among the other two poultry species; Avian origin S. aureus in Collagenous East region was generally resistant to several antimicrobials, and MRSA was more severely resistant than MSSA , all of which were MDR strains. The frequency of highly resistant antibiotics, such as macrolides, quinolones, and penicillins, should be minimized in the actual clinical use, and sensitive antibiotics should be selected in a targeted manner to alleviate the severe resistance status.