<原著>メチシリン耐性黄色ブドウ球菌の臨床細菌学的研究
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We performed a clinical bacteriological study using 473 clinically isolated strains of Staphylococcus aureus (S. aureus). Based on the results of a drug susceptibility test, 128 strains in which the MIC of oxacillin (MPIPC) was <4μg/ml were considered to be methicillin-sensitive S. aureus (MSSA, Group I), 125 in which the MIC was 4-64μg/ml to be moderately methicillin-resistant S. aureus (moderately-resistant MRSA, Group II), and 220 in which the MIC was ≧ 128μg/ml to be highly-resistant S. aureus (highly-resistant MRSA, Group III). In Group III, the MIC_<80> values of the β-lactam drugs, imipenem (IPM) and flomoxef (FMOX), were also ≧ 128μg/ml. In MRSA, especially in Group III, the MIC distribution of minocycline (MINO) and tosufloxacin (TFLX) showed two distinct peaks, suggesting the presence of strains also resistant to MINO and TFLX (Group IIIb). There were no S. aureus strains resistant to vancomycin (VCM) or rifampicin (RFP). In each group, strains were classified according to the coagulase type, and toxins were detected. Coagulase types II and III were frequently observed in Group I and type II in Groups IIIa and IIIb. The production rates of enterotoxin and toxic shock syndrome toxin-1 (TSST-1) were 88% and 86%, respectively in Group IIIa but 8% and 4% in Group IIIb. Group IIIb, which was the most resistant, showed lower toxin production rates than Group I. These findings suggest a decrease in toxin production in strains that acquired high resistance. Therefore, the primary nosocominal strain may be Group IIIa of coagulase type II producing both toxins. In addition, the mecA gene, which is dispensable to the resistance mechanism of MRSA, was detected by the PCR method in clinically isolated MRSA strains. The mecA gene was detected in all strains excluding 1 (N-428). The amount of penicillin binding protein 2' (PBP2') was compared between moderately-resistant Group II and highly-resistant Group III. The amount of PBP2' was lower in Group II than in Group III. Resistance was induced in 3 moderately-resistant MRSA strains and the N-428 strain without mecA by a β-lactam drugs (ceftizoxime, CZX). Resistance was induced in the moderately-resistant MRSA strains but not in the N-428 strain. Thus, MRSA was studied epidemiologically, bacteriologically, and genetically.
- 近畿大学の論文
- 1994-06-25
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