中文摘要：

目的了解广州地区耐甲氧西林金黄色葡萄球菌（methicillin-resistant Staphylococcus aureus,MRSA）分子型别及其对临床常用抗生素的耐药情况,为防控MRSA感染提供依据。方法收集2010年10月至2011年4月广州地区两家教学医院临床分离的MRSA 142株,应用SCCmec、spa、多位点序列分型（multilocus sequence typing,MLST）、脉冲场凝胶电泳（pulsed-field gel electrophoresis,PFGE）等方法进行分子分型,检测这些菌株对苯唑西林、克林霉素等17种临床常用抗生素的药物敏感性,分析临床MRSA的耐药情况。结果 142株MRSA中121株为医院获得型金葡菌（HA-MRSA）,20株为社区获得型金葡菌（CA-MRSA）,1株未定型MRSA。这些MRSA可分为16种spa型,8种ST型及13种PFGE型。HA-MR-SA中的ST239-MRSA-Ⅲ-t030、ST239-MRSA-Ⅲ-t037和ST5-MRSA-Ⅱ-t002为主要流行克隆,也发现CA-MRSA中ST59-MR-SA-Ⅳ-t437克隆的流行,且这些流行克隆有特定的耐药谱。结论广州地区流行的金葡菌仍以HA-MRSA为主,同时也有一定量的CA-MRSA检出和传播,且CA-MRSA的多重药物敏感性已在下降。

英文摘要：

Objective To determine the molecular types and drug susceptibilities of methicillin-resist- ant Staphylococcus aureus （MRSA） prevailed in Guangzhou, China. Methods A total of 142 MRSA isolates were collected between October 2010 and April 2011 from two teaching hospitals in Guangzhou. The molecular typing methods, such as staphylococcal cassette chromosome mec （SCCmec） typing, staphylococcal protein A （spa） typing, multilocus sequence typing （MLST）, and pulsed-field gel eleetrophoresis （PFGE）, were applied for all MRSA strains, and the drug susceptibilities to 17 kinds of antibiotics were also determined. Results In the 142 MRSA isolates, there were 121 hospital-associated isolates （HA-MRSA）, 20 communityassociated isolates （CA-MRSA）, and 1 non typeable MRSA. Sixteen spa types, eight sequence types （ST）, and thirteen PFGE types were found. The major predominant clones were ST239-MRSA-Ⅲ-t030, ST239-MRSA-Ⅲ-t037 and ST5-MRSA-Ⅱ-t002 that belong to HA-MRSA. Furthermore, colne ST59-MRSA-Ⅳ-t437 that belongs to CA-MRSA was also found to be prevailed in Guangzhou. The major prevailed clones with specific drug resistant profiles were found. Conclusion HA-MRSA is still the most predominant MRSA in Guangzhou, and CA-MRSA with decreasing drug susceptibility is also found. It is the time to monitor the prevalence of CAMRSA and drug resistance of MRSA.