摘要
目的研究我国多家中心耐甲氧西林金黄色葡萄球菌(MRSA)葡萄球菌染色体 mec盒(SCCmec)分型,调查金黄色葡萄球菌(SA)中杀白细胞毒素(PVL)、肠毒素 SEC、SEH 的分布。方法收集5家教学医院分离的483株 SA,琼脂稀释法测定15种抗菌药物 MIC,PCR 法检测毒素 PVL、SEC、SEH,并进一步对 MRSA 用多重 PCR 方法进行 SCCmec 分型。结果 MRSA 的平均分离率是53.9%,上海为79.5%、北京为56.4%、沈阳为50.0%、浙江为35.0%、武汉为31.6%,上海与其他医院相比差异有统计学意义(x^2=506.96,P<0.05)。SCCmec 分型以Ⅲ型为主(66.7%,范围64.3%～90.3%),但沈阳以Ⅱ型为主(85%),沈阳与其他4家医院分型差异有统计学意义(x^2=335.95,P<0.05)。未检测到Ⅰ、Ⅳ、Ⅴ型。PVL^+菌株的平均分离率是6.8%,武汉为15.8%、北京为7.1%、沈阳为5%、上海为2.6%、浙江为2.5%,武汉检出率与其他医院相比差异有统计学意义(x^2=487.24,P<0.05);PVL^+菌株在 MRSA 中的分离率为5.0%,高于 MSSA 的9.0%,但差异无统计学意义(x^2=3.01,P>0.05);门诊分离率为8.9%,高于住院的6.6%,差异有统计学意义(x^2=3.89,P<0.05)。未检测到 SEC、SEH。结论 5家教学医院 MRSA 分离率、SCCmec 分型及毒素 PVL 检出率存在差别。PVL^+菌株在病房与门诊的分布存在显著差异,而在 MRSA 与 MSSA 中的分布无明显差别。
Objective To investigate the distribution characteristics of SCCmec typing of methicillin-resistant Staphylococcus aureus （MRSA）, and Paton-Valentine Leukocidin （PVL）, enterotoxin SEC, SEH of staphylococcus aureus （SA） at multiple centers in China. Methods Four hundred and eighty- four SA were collected from five teaching-hospitals and minimal inhibitory concentration （MIC） of 15 antimicrobial agents were determined by agar dilution method. SCCmec typing was confirmed by multiplex PCR; toxins PVL, SEC and SEH were determined by PCR. Results The average rate of MRSA isolates was 53.9%. The prevalence of MRSA in Shanghai, Beijing, Shenyang, Zhejiang, and Wuhan were 79. 5%, 56. 4%, 50. 0%, 35.0% and 31.6%, respectively. There was significant difference between Shanghai and other hospitals（χ^2= 506. 96 ,P 〈0. 05）. SCCmec typing showed that most isolates from Shenyang were type I1 （85%） whereas SCCmec type lU was the most common type in other hospitals （66. 7% , ranging from 64. 3%-90. 3% ）. The difference between Shenyang and other hospitals were significant （χ^2 =335. 95, P 〈 0. 05 ）. We had not detected the type Ⅰ , type Ⅳ and type Ⅴ. The average rate of PVL ^＋ isolates was 6. 8% in five hospitals （ranging from 2. 5% -15. 8% ）. The rate of PVL^＋ in Wuhan was significantly higher than in others（χ^2= 487. 24,P 〈 0. 05 ）. The PVL^＋ isolate rate of MRSA was not significantly lower than that of MSSA （5.0% vs. 9. 0%, χ^2= 3.01, P 〉 0. 05 ） ; the rate of outpatients isolates was significantly higher than that of inpatients isolates （ 8.9% vs. 6. 6%, χ^2 = 3.89, P 〈 0. 05 ）. SEC and SEH were not detected. Conclusions Our data documented a unique geographic distribution of MRSA prevalence, SCCmec typing and PVL ^＋ isolation rate. PVL^＋ isolation rates between outpatients and inpatients were significantly different, but not between in MRSA and MSSA.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2007年第5期499-504,共6页
Chinese Journal of Laboratory Medicine
关键词
金黄色葡萄球菌
耐甲氧西林
葡萄球菌染色体mec盒
杀白细胞毒素
肠毒素
Staphylococcus aureus
Methicillin resistant
Staphylococcal cassette chromosome mec
Paton-valentine leukocidin
Enterotoxin
