耐甲氧西林金黄色葡萄球菌基因分型研究  

Genetic types of methicillin-resistant staphylococcus aureus

作　　者：李囡[1] 范红[1] 陈慧莉[1] 谢轶[1] 陆小军[1] 张磊[1] 王军[1] 应斌武[1] 

机构地区：[1]四川大学华西医院实验医学科临床分子生物实验室,四川成都610041

出　　处：《中国现代医学杂志》2008年第15期2122-2126,2130,共6页China Journal of Modern Medicine

基　　金：美国纽约中华医学基金会(CMB)"感染性疾病研究"项目资助(No:06838)

摘　　要：目的了解本地区耐甲氧西林金黄色葡萄球菌(MRSA)流行株的来源和遗传背景。方法回顾分析华西医院127例MRSA感染者的病例资料,用SCCmec多重PCR技术、葡萄球菌A蛋白(spa)分型技术和多位点测序分型技术对其中10株MRSA临床分离株进行基因分型,并检测其杀白细胞毒素基因。结果病例资料显示127株MRSA中3株为社区获得性MRSA(CA-MRSA),其余均为医院获得性MRSA(HA-MRSA)。进行分型研究的10株MRSA中,7株HA-MRSA为SCCmec Ⅲ-ST239-PVL(-),呈现高度的克隆一致性,spa分型进一步显示4株为t030,另外3株为t037;CA-MRSAs19165分型为ST8-t008,与USA300属同一克隆,并且携带SCCmecⅣa和PVL基因,符合USA300一般基因特征。另外2株CA-MRSAs35301、s29635均为SCCmecⅣa-ST59-t437,与我国其他地区的报道不同。结论该院分离的MRSA仍以医院获得性为主(124/127),HA-MRSA呈现高度的克隆一致性,并与我国的主要流行株为同一克隆;分离到与美国主要CA-MRSA流行株USA300相同克隆的菌株,另外分离到的CA-MRSAST59-t437克隆株在我国其他地区未有报道。MLST和spa分型技术是金黄色葡萄球菌分子流行病学研究的更为简便快速的方法。[Objective] Investigating the source and genetic background of MRSA so that the epidemic data of our region can be obtained. [Method] Reviewing 127 case files of patients with MRSA infection in west china hospital last year and 10 MRSA clinical isolates out of them were typed by SCCmec multi-PCR, spa typing and multilocus sequence typing method and their Panton-Valentine leucocidin （PVL） gene were also detected. [Result] Case records show that only 3 isolates out of 127 were community-acquired. The 7 HA-MRSA isolates in our study were typed as SCCmecⅢ-ST239 without carrying PVL genes. The spa typing further showed three of them belong to t037 and the other four belong to t030. The CA-MRSA s19165 belongs to SCCmeeⅣa-ST8-t008 clone, which is the same as USA300 clone. The other tow （s35301, s29635） belong to SCCmeelVa-ST59-t437 clone, which is different from reports of other regions in China. [Conclusion] The MRSA isolates in our hospital were mainly hospital-acquired. HA-MRSA isolates in our study belong to the same clone. The USA300, which is the major CA-MRSA clone prevalent in American has been isolated in west china hospital; another tow isolates belong to ST59-t437, which has not been reported in other parts of China. MLST and spa typing are more simple methods for molecular epidemic study of staphylococcus aureus.

关 键 词：耐甲氧西林金黄色葡萄球菌 多住点测序分型 葡萄球菌A蛋白 

分 类 号：R515[医药卫生—内科学]