2015-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/706761摘要：曱氧苯青黴素抗藥性金黃色葡萄球菌（MRSA)是臨床上重要的致病菌之一，可以引起人體各種 部位的感染。當發生MRSA複雜性菌血症或骨關節感染，抗生素療程較長，需要將針劑型抗生素轉 為口服抗生素治療。因此，治療MRSA的口服抗生素是一個重要的議題。然而，台灣之前相關的研 究發現MRSA對於大部分的口服抗生素產生高比例的抗藥性，目前可選擇的口服抗生素包括下列四 種：fusidic acid、fosfomycin、linezolid及rifampin ;但MRSA對這四種口服抗生素的抗藥性及相關 抗藥機轉也在世界上廣泛的報導。台灣全國性針對這四種口服抗生素抗藥性的長期監測及抗藥性基 因的分析較少，且對相關抗藥性基因之MRSA是否產生特定分子分型散播的資料相對缺乏。本研究 計晝，即針對上述問題加以設計；利用全國微生物抗藥性監測計晝在不同年份所收集的MRSA菌株， 測定不同口服抗生素的感受性和相關的抗藥性基因，另外會鑑定MRSA菌株的分子分型，用以分析 帶有特定抗藥性基因之MRSA出現特殊分子分型的散播與否。<br> Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen to cause various infections. Oral antibiotics against MRSA play a role in the context of complicated bacteremia and osteo-articular infections, since prolonged antibiotics therapy with intravenous-oral switch is anticipated under such circumstances. Given that the previous studies showed high resistant rates of many oral antibiotics against MRSA in Taiwan, the attractive choices included fusidic acid, fosfomycin, linezolid, and rifampin. Resistance to these antibiotics and their associated resistant mechanisms has been documented worldwide. Nevertheless, only limited studies in Taiwan reported longitudinal monitor of the susceptibilities of MRSA isolates to these agents, and few to characterize the resistant genes to these agents. In addition, studies regards clonal spread of MRSA with certain resistant genes are lacking in Taiwan. According to the rational described above, this study is aimed to monitor the temporal trends and geographic difference of susceptibilities of MRSA isolates collected by Taiwan Surveillance of Antimicrobial Resistance (TSAR) program to oral anti-MRSA agents, and to further detect their resistant mechanisms and sequence types. Furthermore, this study will also analyze whether these drug resistant MRSA had clonal spreads in Taiwan or not.曱氧苯青黴素抗藥性金黃色葡萄球菌抗藥性分子分型Methicillin-resistant Staphylococcus aureusresistancemolecular typing