新生儿血培养中凝固酶阴性葡萄球菌的脉冲电场凝胶电泳分型  

Coagulase-negative staphylococcal typing by pulsed field gel electrophoresis in neonatal blood isolates

作　　者：王亚娟[1] 沈叙庄[2] 高薇[2] 俞桑洁[2] 林影[1] 王慧欣[1] 杨永弘[2] 

机构地区：[1]首都医科大学附属北京儿童医院新生儿科,100045 [2]首都医科大学附属北京儿童医院微生物免疫室,100045

出　　处：《中国新生儿科杂志》2008年第4期208-211,共4页Chinese Journal of Neonatology

摘　　要：目的通过对凝固酶阴性葡萄球菌(CNS)菌株进行分型以示CNS菌种间及菌种内的异质性和亲缘性,协助新生儿败血症的诊断。方法将本院新生儿病房2001年11月至2003年3月血培养为CNS的患儿列入本研究。对入选的CNS菌株用脉冲电场凝胶电泳方法分离菌株。结果共有80例患儿入选,其中9例患儿分离出≥2株CNS菌株。血培养为CNS的临床分离菌株共有90株。在临床诊断的27例(33.8%)败血症中,表皮葡萄球菌18例(66.7%),溶血葡萄球菌7例(25.9%),人葡萄球菌2例(7.4%)。脉冲电场凝胶电泳对90株入选菌株共分为50型,其中表皮葡萄球菌37型,溶血葡萄球菌10型,人葡萄球菌2型,华纳葡萄球菌1型。在临床分离的90株CNS菌株中,共有6组图形完全一致,属于同一菌株。其中两组(4株CNS菌株)分别来自2例患儿不同时期的血培养结果,故脉冲电场凝胶电泳可以协助临床明确诊断败血症。结论脉冲电场凝胶电泳是一种敏感性高的CNS菌株分型方法,可协助临床诊断败血症。Objective To determine whether Coagulase-negative Staphylococci （CNS） isolated from blood cultures of neonates represent single or multiple clones, and to ascertain by pulse-field gel electrophoresis （PFGE） analysis in order to diagnose neonatal sepsis. Methods To study the CNS strains which were isolated from blood cultures of neonates in neonatal unit of Beijing Children ~ Hospital over the period from November 2001 to March 2003 by using PFGE. Results Ninty CNS were isolated from blood cultures of 80 neonates in this neonatal unit. Among the 27 cases of clinically comfirmed CNS sepsis, 18 cases（66. 7% ） were Staphylococcus epidermidis, which was the leading cause, and then S. hemolyticus 7 cases （ 25.9% ）, S. hominis 2 cases （7.4%）. Numerous genotypes were identified in these 90 isolates by using PFGE. Overall, there were 50 different types （all different from each other by 〉 3 bands）, including 37 types with Staphyloccocal epidermidis, 10 types with S. haemolyticus, 2 types with S. hominis and 1 type with S. warneri. The genetic heterogeneity of the CNS strains was clearly demonstrated in the macro-restriction fragment profiles and the dedrograms. Among 90 CNS there were 6 groups of PFGE genotypes which were totally identical strains. 2 groups （4 CNS isolates） were isolated from blood cultures of 2 patients in different time and they were diagnosed sepsis in no question. Conclusion PFGE is a sensitive genotyping method. It can identify endemic clones of CNS, it can aid physicians to diagnose sepsis, and it can discriminate between carriage and disease isolates groups of CNS.

关 键 词：葡萄球菌属 电泳 凝胶 脉冲场 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]