摘要
目的分离及鉴定临床标本中携带杀白细胞素基因（pvl）的耐甲氧西林金黄色葡萄球菌（pvl^＋-MRSA）并了解pvl^＋-MRSA感染和分子特征。方法采用药敏试验检测259株MRSA耐药性。采用头孢西丁纸片法和PCR扩增mecA基因确定上述MRSA菌株中pul^＋MRSA。分别采用多重PCR和多位点序列分析法（MLST）对pvl^＋-MRSA进行葡萄球菌染色体mec（SCCmec）和序列型（ST）分型。采用脉冲场凝胶电泳（PFGE）和聚类分析了解pul^＋-MRSA遗传和流行特征。分析pul^＋-MRSA不同感染类型及其所致疾病种类差异。结果259株MRSA中鉴定出51株pul^＋-MRSA（19．7％，51／259），其中29株来自社区感染患者、22株来源于医院感染患者。ST59-SCCmecⅢ是本地区pul^＋-MRSA主要型别（35．3％，18／51），其次为ST59-SCCmecⅣ（25．5％，13／51），但PFGE检测结果显示本地区分离的倒pul^＋-MRSA无优势克隆系。儿童和中青年患者（≤44岁）标本中pvl^＋-MRSA分离率（66．7％，34／51）明显高于≥45岁患者（P〈0．05）。pvl^＋-MRSA所致主要病种为皮肤和软组织感染（47．1％，24／51）（P〈0．05），其次为肺炎（17．6％，9／51）。pvl^＋-MRSA对左氧氟沙星、庆大霉素和利福平耐药性较低（7．8％-21．6％），未发现莫西沙星、呋喃妥因和利奈唑胺耐药菌株。结论本地区人群中pul^＋-MRSA感染率较高，ST59-SCCmecⅢ和ST59-SCCmeⅣV型为其主要流行型别。儿童和中青年对pvl^＋-MRSA易感，所致疾病以皮肤软组织感染和肺炎为主。
Objective To isolate and identify the methieillin-resistant Staphylococcus aureus （MRSA） strains carrying Panton-Valentine leukocidin genes （pvl^＋-MRSA） from clinical samples and to fur- ther understand their molecular characteristics and infections caused by them. Methods Drug susceptibility test was performed to detect the drug resistance in 259 MRSA strains, pvl^＋-MRSA strains were screened out from those MRSA strains using cefoxitin slip test and mecA gene detection by PCR. Multiple PCR and muhi- locus sequence typing （MLST） were used for SCCmec and ST typing. Pulsed-field gel electrophoresis （PFGE） and cluster analysis were used to understand the genetic and epidemic features of the pvl^＋-MRSA strains. Different types of infections and diseases caused by the pvl^＋-MRSA strains were analyzed . Results Among the 259 MRSA strains, 51 pvl^＋-MRSA strains were identified （19.7%, 51/259）, of which 29 and 22 strains were respectively isolated from patients with community-acquired and hospital-acquired infections. ST59-SCCmeclII （35.3%, 18/51 ） was the predominant type of the 51 pvl^＋-MRSA strains, followed by ST59-SCCmeclV（25.5%, 13/51 ）. But no predominant clone among those strains was revealed by the re- sult of PFGE. Children, young- and middle-aged patients （ ≤44 years old） had a significantly higher posi- tive rate ofpvl^＋-MRSA than patients aged ≥45 years （P〈O. 05）. Skin and soft tissue infection （47.1% , 24/51 ） was the most common disease caused by the pvl^＋-MRSA strains （P〈0.05）, followed by pneumonia （ 17.6% , 9/51 ）. The pvl＋-MRSA strains showed lower resistance to levofloxacin, gentamycin and rifam- picine （7.8%-21.6%）. No moxifloxacin-, nitrofurantoin- or linezolid-resistant pvl^＋-MRSA strains were identified. Conclusion The rate of pvl^＋-MRSA infection is high in the local population. ST59-SCCmec m and ST59-SCCmeclV are the predominant types of pvl^＋ MRSA strains. Children, young- and middle-aged persons are the suscept
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2017年第4期269-274,共6页
Chinese Journal of Microbiology and Immunology
基金
浙江省医药卫生科技计划项目（2012KYBl71）
浙江省卫生高层次创新人才培养工程项目（2012-241）
关键词
耐甲氧西林金黄色葡萄球菌
感染
杀白细胞素
分子分型
疾病类型
Methicillin-resistant Staphylococcus aureus
Infection
Panton-Valentine leucocidin
Molecular typing
Disease type
