Methicillinresistant Staphylococcus aureus MRSA lactam methicillin S aureus
- Slides: 25
Methicillin-resistant Staphylococcus aureus (MRSA) § β-lactam계 항생제인 methicillin에 내성을 보이는 S. aureus strain ( Jevons PM. ‘Celbenin'-resistant staphylococci. Br Med J 1961; 124 -125 ) § 문제점 : 1. 다른 non-β-lactam antibiotics에도 저항 -> 치료에 잘 반응하지 않으며 치명적일 수 있음 2. 국내 일부 병원에서는 MRSA가 전체 S. aureus 감염의 80%에 달함 § 분류 : § Health care-associated MRSA (HA-MRSA) ; Health care에 노출된 후 일어나는 MRSA 감염 § Community-Acquired MRSA (CA-MRSA) ; HA-MRSA의 risk factor에 노출되지 않은 지역사회 건강인의 MRSA 감염
연구 방법 코 안을 면봉으로 검체 추출 Transfer to Staphylococcal broth, overnight at 35℃ Subculture to mannitol salt agar (MSA) & mannitol salt agar with oxacillin (MSO)
Coagulase : + DNase test : + fem. A gene by PCR S. aureus mec. A gene by PCR Cefoxitin (30 ug) and oxacillin disk(1 ㎍) diffusion test MRSA
Mannitol salt agar § Phenol red(p. H 지시약) + 7. 5% Na. Cl + 1% mannitol § 균 배양-> mannitol을 분해하여 산을 생산 : S. aureus S. epidermidis 붉은색 -> 노란색 으로 색 변화
Coagulase test § 혈장 0. 1 m. L (fibrinogen) + 생리식염수 0. 4 m. L + 세균 집락 (free coagulase) -> 4시간 후 피브린 응고 형성 S. aureus S. epidermidis
Agarose gel electrophoresis of amplified 372 -bp DNA fragments of the fem. A genes of S. aureus isolates by PCR M 1 2 3 4 5 6 7 8 9 10 11 372 bp ► Lane M : a 100 bp size marker Lanes 1 -9 : S. aureus strains Lanes 10 : fem. A-positive control (ATCC 33591) Lane 11 : fem. A-negative control (S. epidermidis ATCC 2228)
Agarose gel electrophoresis of amplified 554 -bp DNA fragments of the mec. A genes of MRSA isolates by PCR M 1 2 3 4 5 6 7 8 9 10 554 bp ► Lane M : a 100 bp size marker Lanes 1 -9 : MRSA strains Lanes 10 : mec. A-positive control (ATCC 33591) Lanes 11 : mec. A-negative control (ATCC 25923) 11
MRSA와 MSSA의 cefoxitin 디스크 확산 검사 MRSA MSSA
환자로부터 분리된 MRSA의 항생제 감수성 결과 Organisms (No. tested) MIC(㎍/m. L) Antimicrobial agent Range 50% 90% susceptibility % Ampicillin 16 - 64 32 32 0 Cephalothin 32 - ≥ 128 0 Ciprofloxacin ≤ 0. 05 - 128 32 128 3 Clindamycin ≤ 0. 5 - ≥ 128 7 MRSA Erythromycin ≤ 0. 5 - ≥ 128 3 Fusidic acid 0. 125 - ≥ 128 13 (n=30) Gentamicin 1 - ≥ 128 3 Mupirocin 0. 125 - 32 1 16 53 Oxacillin 128 - ≥ 128 0 Rifampin ≤ 0. 5 - 4 1 4 67 Tetracycline ≤ 0. 5 - ≥ 128 128 3 Vancomycin 0. 5 - 2 2 2 100 환자의
건강인으로 부터 분리된 MRSA의 항생제 감수성 결과 Organisms (No. tested) 건강인의 MRSA (n=31) MIC(㎍/m. L) Antimicrobial agent Range 50% 90% susceptibility % Ampicillin 1 - 64 32 64 0 Cephalothin ≤ 0. 5 - 64 2 32 81 Ciprofloxacin ≤ 0. 5 - ≥ 128 ≤ 0. 5 128 84 Clindamycin ≤ 0. 5 - ≥ 128 ≤ 0. 5 ≥ 128 84 Erythromycin ≤ 0. 5 - 64 ≤ 0. 5 64 52 Fusidic acid ≤ 0. 06 - ≥ 128 ≤ 0. 06 32 77 Gentamicin ≤ 0. 5 - ≥ 128 64 ≥ 128 42 Mupirocin ≤ 0. 06 - 0. 25 100 Oxacillin 4 - ≥ 128 16 64 0 Rifampin ≤ 0. 5 - ≤ 0. 5 100 Tetracycline ≤ 0. 5 - 64 ≤ 0. 5 16 74 Vancomycin 0. 125 - 2 2 2 100 0. 125
MRSA 항생제 감수성 결과 Organisms (No. tested) 환자의 MRSA (n=30) Antimicrobial agent susceptibility % Organisms (No. tested) Antimicrobial agent susceptibility % Ampicillin 0 Cephalothin 81 Ciprofloxacin 3 Ciprofloxacin 84 Clindamycin 7 Clindamycin 84 Erythromycin 3 Erythromycin 52 Fusidic acid 13 Fusidic acid 77 Gentamicin 397 Gentamicin 42 Mupirocin 53 Mupirocin 100 Oxacillin 0 Rifampin 67 Rifampin 100 Tetracycline 3 Tetracycline Vancomycin 100 건강인의 MRSA (n=31) Vancomycin 74 100
MRSA 감염된 환자 MRSA 건강 숙주 Vancomycin Mupirocin Rifampin Vancomycin
- Staphylococcus aureus cocci or bacilli
- Enzymes of staphylococcus aureus
- Nitrate reduction test staphylococcus aureus
- Confirmation test for staphylococcus aureus
- Nummular eczema
- Micrococcaceae family
- Staphylococcus aureus prokaryotic or eukaryotic
- Staphylococcus aureus?
- Staphylococcus
- Staphylococcus aureus
- Staphylococcus aureus
- Staphylococcus aureus kingdom
- Portage staphylococcus aureus
- Conjugation reproduction
- Mannitol salt
- Staphylococcus aureus bacteria structure
- Selective and differential media
- Classification of beta lactam antibiotics
- Fourth generation cephalosporin
- Clindamycin metabolism
- Mrsa de centro
- What is mrsa in medical terms
- Mrsa
- Mrsa
- Mrsa
- Mrsa