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研究生:紀婕汝
研究生(外文):Chieh-Ju
論文名稱:金黃色葡萄球菌抗藥性與mecA基因的研究
論文名稱(外文):Studies of mecA and Drug resistance in Staphylococcus aureus
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:生化暨生物科技研究所
學門:生命科學學門
學類:生物科技學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:39
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中文摘要
金黃色葡萄球菌(Staphylococcus aureus)是造成人體感染最常見的革蘭氏陽性球菌,也是院內感染及社區感染中常見的致病菌,除了可以造成人體局部或全身各部位的感染外,有些菌株甚至可以分泌毒素造成某些臨床症狀。金黃色葡萄球菌的治療,還是以Beta-lactam的藥物為主。但當金黃色葡萄球菌得到mecA 基因後,將會對Beta-lactam的甲氧苯青黴素(methicillin)產生抗藥性,這種金黃色葡萄球菌就是一般稱為(Methicillin-resistance Staphylococcus aureus; MRSA),而成為治療上的難題。過去的研究已經證明MRSA,可以藉由診斷mecA的核酸片段(1282-1814 nt)來確診。在其它相關的研究中,也發現S. aureus在不同的地區,所流行的S. aureus菌株都呈現有其抗藥性的特殊性,但有的經過調查研究之後才發現來源相同。為了更進一步探討MRSA菌株的流行病學,並且了解台灣本土MRSA菌株的重要特性,以及MRSA菌株的感染與臨床症狀之相關性,在本研究中利用了聚合酶連鎖反應(polymerase chain reaction; PCR)的方法,分析台灣中部地區296位感染病患之臨床分離出的S. aureus菌株,並確認是否具mecA 基因、是否與臨床症狀有相關、以及細菌抗藥的情形,來建立台灣中部地區的S. aureus菌株相關資料,並提供本地區醫院臨床治療的參考,希望藉此可提升醫療品質並減少醫療資源不必要的支出。

英文摘要
The Staphylococcus aureus is the most infectious gram-positive pathogen in human diseases ranging from local to systemic infections, and it is also the causing strain for hospital- and community acquired- infections. Some S. aureus produce toxins to cause an even worst clinical complication. To date, there are more than 30 different toxins have been detected by different strains of S. aureus, and different symptoms related to the toxins are also reported. An early diagnosis for S. aureus to determine their identity will be significant in clinical application, especially when methicillin resistant S. aureus (MRSA) are involved in the infection. MRSA are S. aureus strain acquired a mecA gene from phage transduction. In this study, we launched a study to determine the role of MRSA in its clinical significance. Using the polymerase chain reaction (PCR) strategy, we have analyzed mecA genes from 296 different MRSA isolates in central Taiwan region, along with their toxin genes to determine the their crucial relationships with clinical complications, as well as their drug-resistant statuses. Therefore, a central Taiwan database for MRSA related information should be able to establish through this research, which might be important for hospitals in the region as well as to improve the medical quality, and prevent the resource wasting in treatments for S. aureus.


中文摘要………………………………………………………………..4
英文摘要………………………………………………………………..5
縮寫字…………………………………………………………………..6

第一章 背景介紹(Background)
1-1金黃色葡萄球菌(Staphylococcus aureus)…………………………..7
1-2 Methicillin-resistant S. aureus(MRSA)……………………………...7
1-3社區型金黃色葡萄球菌…………………………………………… .8
1-4 MRSA的抗藥機制(mecA 基因)……………………………………9
1-5 MRSA的其他抗藥基因……………………………………………11
1-6毒素基因與臨床症狀的相關性……………………………………12
1-7 MRSA的診斷……………………………………………………....13
1-8研究動機……………………………………………………………15


第二章 材料與方法
2-1 菌株樣本……………………………………………………………16
2-2 藥敏試驗…………………………………………………………….16
2-3 DNA的萃取(DNA extraction)…………………………………… 16
2-4 聚合酶連鎖反應(polymerase chain reaction, PCR)………………...17
2-5 統計分析……………………………………………………………..18

第三章 結果
3-1 臨床資料統計結果……………………………………………….19
(表一) 28
3-2 藥敏試驗結果…………………………………………………….19
(表二) 29
3-3 mecA PCR測定結果…………………………………………….20
(表三) 30
(圖一) 31

(圖二) 32
(圖三) 33
(圖四) 34

3-4 結論………………………………………………………………21

第四章 討論……………………………………………………………22

第五章 附錄……………………………………………………..…….24
(附圖一) 24
(附圖二) 25
(附圖三) 26
(附圖四) 27
第六章 圖與表………………………………………………………....28

第七章 參考文獻……………………………………………………….35




參考文獻
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