耐甲氧西林金黄色葡萄球菌pvl及tst基因分布与感染类型研究  

Distribution of pvl and tst genes in methicillin-resistant Staphylococcusaureus isolates and types of infections

作　　者：沈利蒙[1] 张易进 孔江英 董华丽[1] 张传领[1] 

机构地区：[1]浙江萧山医院检验科,浙江杭州311201

出　　处：《中华医院感染学杂志》2016年第10期2186-2189,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2012KYB171)

摘　　要：目的了解耐甲氧西林金黄色葡萄球菌(MRSA)临床菌株携带杀白细胞毒素(PVL)编码基因pvl和中毒休克综合征毒素-1(TSST-1)编码基因tst情况、流行特征及感染类型,为该类感染的临床治疗提供依据。方法收集2012年1-12月临床分离的MRSA 96株,采用PCR检测96株MRSA中pvl和tst基因,采用全自动微生物分析仪检测11种临床常用抗菌药物的敏感性,采用多重PCR对携带pvl基因(pvl+)或tst基因(tst+)的MRSA进行mec分型(SCCmec),了解与分析pvl+或tst+MRSA感染类型。结果 96株MRSA中20株检出pvl基因占20.8%,13株检出tst基因占13.5%,未发现同时携带pvl和tst基因的菌株;除左氧氟沙星和莫西沙星外,pvl+/tst+MRSA对其他抗菌药物耐药率与pvl-/tst-菌株相似;20株pvl+MRSA中7株社区获得性感染菌株、13株医院获得性感染菌株,其中17株分离自皮肤和软组织感染患者脓液,13株tst+MRSA均为医院获得感染菌株,其中8株分离自肺部感染患者痰液;20株pvl+MRSA中,SCCmecⅢ型11株、SCCmecⅣa型5株、SCCmecII型2株,2株未能分型;13株tst+MRSA均为SCCmecⅢ型。结论 pvl+MRSA在社区和医院内均有流行,主要引起皮肤和软组织感染;tst+MRSA仅在医院内流行,主要引起肺部感染;pvl+和tst+MRSA均以SCCmecⅢ型为主。OBJECTIVE To investigate the distribution,epidemiological features and infection types of Panton-Valentine leukocidin-encoding gene（pvl）and toxic shock syndrome toxin-1-encoding gene（tst）in methicillin-resistant Staphylococcus aureus（MRSA）isolates for the guidance of clinical treatment.METHODS A total of 96 clinical MRSA isolates were collected from Jan 2012 to Dec 2012,the pvl and tst genes in the 96 MRSA isolates were detected by PCR.The susceptibilities of the isolates to 11 commonly used antibiotics were determined by using automatic microorganism analyzer.The mec genotyping（SCCmec）was carried out for the MRSA strains harboring the pvl gene（pvl＋）or tst gene（tst＋）by means of multiple PCR,and the types of infections caused by the MRSA harboring the pvl＋or tst＋were observed.RESULTS Of the 96 MRSA isolates,20（20.8%）were detected positive for pvl gene,13（13.5%）were detected positive for tst gene,and no isolate was detected positive for both pvl and tst gene.The drug resistance rate of the pvl＋/tst＋MRSA to all the antibiotics except for levofloxacin and moxifloxacin was similar to that of the pvl-/tst-strains.Among the 20 pvl＋MRSA isolates,7were communityacquired infectious strains,and 13 were hospital-acquired infectious strains;totally 17 strains were isolated from the pus specimens of the patients with skin and soft tissue infections,13 tst＋MRSA isolates were hospital-acquired infectious strains,of which 8were isolated from sputum specimens of the patients with pulmonary infections.Of the 20 pvl＋MRSA isolates,11 were identified as SCCmecⅢ,5identified as SCCmecⅣa,2identified as SCCmecII,and 2could not be determined.All of the 13 tst＋MRSA isolates were identified as SCCmecⅢ.CONCLUSION The pvl＋MRSA is prevalent in both community and hospital and mainly results in the skin and soft tissue infection.The tst＋MRSA is only prevalent in hospital and mainly leads to the pulmonary infection.The SCCmecⅢis the predominant type in both pvl＋and tst＋MRSA strain

关 键 词：耐甲氧西林金黄色葡萄球菌 杀白细胞毒素 中毒休克综合征毒素-1 SCCmec分型 

分 类 号：R378.11[医药卫生—病原生物学]