耐甲氧西林金黄色葡萄球菌杀白细胞素基因检测与耐药性分析  

Detection of panton-valentine leukocidin gene and analysis of antibiotic resistance in methicillin-resistant Staphylococcus aureus

作　　者：叶晓涛[1] 卢月梅 马焕丽[1] 袁文斌[3] 张旭[1] 张丽玲[3] 黄衍锋[1] 刘雄伟[1] 罗丹[1] 

机构地区：[1]广东省深圳市龙岗中心医院检验科,广东深圳518116 [2]深圳市人民医院 [3]广东省深圳市龙岗中心医院内科,广东深圳518116

出　　处：《中国感染与化疗杂志》2013年第4期289-292,共4页Chinese Journal of Infection and Chemotherapy

基　　金：广东省深圳市科技计划项目(201203318);深圳市龙岗区科技计划医疗卫生资助项目(ys2012198)

摘　　要：目的采用实时荧光PCR检测耐甲氧西林金葡菌(MRSA)杀白细胞素(PVL)基因,并分析其对抗菌药物敏感性,指导临床合理用药。方法采用双重实时荧光PCR技术对血液和脓液分离的40株MRSA进行PVL基因检测,并对PVL基因阳性菌株感染患者的临床资料进行分析;VITEK2-compact全自动微生物测试仪进行药敏试验。结果 40株MRSA检出7株PVL基因阳性,阳性率17.5%,PVL基因阳性菌株所致的感染分别为坏死性皮肤软组织感染3例,血流感染3例和乳腺脓肿1例。MRSA携带或不携带PVL基因菌株的药敏试验结果有所不同,未检出对万古霉素不敏感菌株。结论 MRSA携带或不携带PVL基因对抗菌药物敏感性有差异,本地区MRSA-PVL基因阳性率较高,应加强监测。Objective We developed a real-time PCR assay for detection of panton-valentine leukocidin（PVL）gene of methicillin-resistant Staphylococcus aureus.The antimicrobial susceptibility was also tested for these pathogens for reasonable clinical prescription.Methods A total of 40 MRSA strains were isolated from blood and pus.The MRSA strains carrying Panton-Valentine leukocidin gene（PVL-MRSA）were identified by duplex real-time PCR.The patients carrying PVL-MRSA were surveyed.Antimicrobial susceptibility testing was tested with VITEK2-Compact system.Results A total of 7（17.5%）PVLMRSA strains were identified from the 40 MRSA stains.These PVL-positive isolates were responsible for necrotizing skin and soft tissue infection（3 cases）,blood stream infection（3 cases）and breast abscess（1 case）.The MRSA strains carrying or not carrying Panton-Valentine leukocidin gene showed different antibiotic resistant patterns.No vancomycin resistant strain was found.Conclusions MRSA strains have different antibiotic resistant patterns dependent on whether they carry Panton-Valentine leukocidin gene or not.The MRSA strains carrying PVL gene are relatively prevalent in this hospital.

关 键 词：耐甲氧西林金黄色葡萄球菌 社区获得性MRSA 杀白细胞毒素 耐药性 实时荧光PCR 

分 类 号：R446.5[医药卫生—诊断学]