耐甲氧西林金黄色葡萄球菌SCCmec基因分型及PVL基因研究  

Staphylococcal Cassette Chromosome mec Genotype and PVL Gene in Meticillin-resistant Staphylococcus aureus

作　　者：潘军[1] 刘文恩[1] 张运丽[1] 梁湘辉[1] 邹明祥[1] 陈振华[1] 简子娟[1] 

机构地区：[1]中南大学湘雅医院检验科,湖南长沙410008

出　　处：《中华医院感染学杂志》2010年第17期2541-2544,共4页Chinese Journal of Nosocomiology

基　　金：湖南省科技厅资助(05SK3118)

摘　　要：目的了解耐甲氧西林金黄色葡萄球菌(MRSA)SCCmec基因型的分布特征并检测杀白细胞毒素(PVL)基因。方法收集2007年10月-2008年5月临床标本中,分离的非重复金黄色葡萄球菌110株,用头孢西丁纸片扩散法对MRSA进行初筛;用多重聚合酶链反应(PCR)对MRSA进行SCCmec基因分型及PVL基因检测;用琼脂稀释法对MRSA菌株进行抗菌药物最低抑菌浓度(MIC)检测。结果 64株MRSA中,63株医院获得性(HA)-MRSA,1株社区获得性(CA)-MRSA,其中SCCmecⅢ型57株(89.0%),Ⅱ型1株(1.6%),SCCmecⅣ型1株(1.6%),未分型5株(7.8%);未发现SCCmecⅠ、Ⅴ型菌株;SCCm ecⅡ型、SCCm ecⅢ型的菌株均为多药耐药株,SCCmecⅣ型的菌株除对β-内酰胺类抗菌药物耐药外,对其他类抗菌药物较敏感。结论 HA-MRSA主要以SCCmecⅢ型为主,CA-MRSA菌株为SCCmecⅣ型,携带PVL毒力基因,HA-MRSA对抗菌药物呈多药耐药性,CA-MRSA菌株耐药谱比HA-MRSA菌株耐药谱窄,加强对MRSA的监测,对指导临床合理使用抗菌药物具有重要意义。OBJECTIVE To investigate the distribution characteristics of staphylococcal cassette chromosome（SCC） mec genotype in meticillin-resistant Staphylococcus aureus（MRSA） and detect Panton-Valentine leukocidin（PVL） gene.METHODS Totally 110 non-repetitive clinical strains of S.aureus isolates were collected from Oct 2007 to May 2008.The phenotype of MRSA was screened by cefoxitin disk diffusion test.The genotypes of SCCmec were determined by multiplex PCR and the PVL gene was detected by PCR.The drug MIC of MRSA strains was studied by using agar dilution method.RESULTS Among 64 isolates of MRSA,SCCmec Ⅲ,SCCmecⅡ,SCCmecⅣ and nontypeable isolates accounted for 89.0%（57/64）,1.6%（1/64）,1.6%（1/64）,and 7.8%（5/64）,respectively.SCCmec typeⅠ and Ⅴ strains were not discovered in our study.SCCmec type Ⅱ and Ⅲstrains were multi-drug resistant.SCCmec type Ⅳ strains were susceptible to other kinds of antibiotics except the β-lactam antibiotics.CONCLUSION The dominant epidemic strain of hospital-acquired（HA）-MRSA is SCCmec type Ⅲ.Community-acquired（CA）-MRSA is SCCmec type Ⅳ carrying the PVL virulence gene in the region.SCCmec type Ⅲ MRSA strains are multi-drug resistant.The drug resistance spectrum of CA-MRSA is narrower than that of HA-MRSA.It is of important significance monitoring of MRSA strains to guide the clinical use of antibiotics appropriately.

关 键 词：耐甲氧西林金黄色葡萄球菌 葡萄球菌染色体mec 杀白细胞毒素 

分 类 号：R378[医药卫生—病原生物学]