广州社区人群金黄色葡萄球菌鼻腔携带调查和分子流行特征  

Molecular and epidemiological characteristics of nasal carriage of Staphylococcus aureus among the general population in Guangzhou

作　　者：陈百计 姚泽宇 王彤[2,4] 代鑫露 伍锡泉 CHEN Bai-ji;YAO Ze-yu;WANG Tong;DAI Xin-lu;WU Xi-quan(Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou , Guangdong 510120;Summer Team, Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou , Guangdong 510120;The Affiliated High School of South China Normal University, Guangzhou, Guangdong 510630;Kingmed Diagnostics College, Guangzhou Medical University, Guangzhou, Guangdong 510182, China)

机构地区：[1]中山大学孙逸仙纪念医院检验科,广东广州510120 [2]中山大学孙逸仙纪念医院检验科学生暑期科研小组,广东广州510120 [3]华南师范大学附属中学,广东广州510630 [4]广州医科大学金域检验学院,广东广州510182

出　　处：《热带医学杂志》2017年第12期1583-1588,共6页Journal of Tropical Medicine

基　　金：广东省科技社会发展项目(2014A050503029);逸仙科研启航项目(YXQH201701)

摘　　要：目的调查社区健康人群鼻腔中金黄色葡萄球菌(Sau)携带情况、耐药性及分子生物学特征。方法通过调查问卷采集流行病学信息,用一次性采样拭子从受访者鼻前庭采取标本,常规方法培养分离菌株,VITEK~?2全自动细菌鉴定分析系统鉴定细菌。采用KB法结合E-test法检测药物敏感性,PCR法检测mecA基因、SCCmec基因岛、杀白细胞毒素(pvl)基因、肠毒素A(sea)和肠毒素B(seb)等毒力基因,多位点序列(MLST)和脉冲场凝胶电泳(PFGE)检测细菌分子分型。结果社区人群中鼻腔金黄色葡萄球菌携带率为24.7%(73/295),耐甲氧西林金黄色葡萄球菌(MRSA)携带率为0.3%(1/295);73株Sau中,71株成功进行PFGE分型,共分成13个基因簇,A簇(50.7%,36/71)与L簇(18.3%,13/71)为主要流行基因簇。耐药谱相似的23株Sau ST型分为以ST59(17.4%,4/23)、ST188(13.0%,3/23)与ST1(13.0%,3/23)为主的12个不同型,1株MRSA为ST8-SCCmecⅢ;56.5%Sau同时检出sea和seb基因,未检出pvl基因;Sau对青霉素耐药率高达83.6%,所有菌株对替考拉宁、万古霉素、奎奴普订/达福普汀敏感;社区人群携带Sau的危险因素主要与男性、30岁以下年龄以及鼻腔清洁习惯有关。结论本地区社区健康20～30岁人群鼻腔Sau携带率高于其他年龄段,Sau分子生物学特点呈多样性。Objective To determine the molecular and epidemiological characteristics of nasal carriage of S. aureus in the general population in Guangzhou, China. Methods A total of 297 volunteers were recruited. Each subject completed a questionnaire, and specimens were obtained from the anterior nares for S. aureus screening. Genotype analysis included pulsed-field gel electrophoresis （PFGE） , multilocus sequence typing （MLST） , staphylococcal cassette chromosome mec （SCCmec） typing, and virulence gene detection were performed. Results A total of 73 S. aureus isolates were recovered from different subjects （24.7%, 73/295 ）, with one methicillin-resistant S. aureus （MRSA） isolate （0.3%, 1/295）. Among the 73 isolates, 71 isolates were successfully grouped into 13 pulsotypes by PFGE analysis, with profiles A and L were the most prevalent; 12 sequence types （STs） were found among the 23 isolates which had similar drug resistant spectrum. ST59, ST188 and ST1 were the most prevalent types, accounting for 17.4%, 13.0% and 13.0% of all isolates, respectively. The MRSA isolate presented ST8-SCCmec III. 56.5% of isolates carried both the staphylococcal enterotoxin A （sea） and enterotoxin B （seb） genes. The resistance rate of penicillin was highest, up to 83.6%. All isolates were susceptible to Teicoplanin, Vancomycin and Quinupristin/dalfopristin. The most common risk factors for S. aureus carriage were being male, age ~〈30 years, and nasal cavity cleaning habits. Conclusions Colonization by S. aureus was greater occurred among male and young age （20N30 years ） students and those with irregularity nasal cleaning. The S. aureus isolates selectedwere revealed into various sequence types and pulso-types , indicating molecular heterogeneity among S. aureus isolates from the populations in the general population in Guangzhou.

关 键 词：社区健康人群 金黄色葡萄球菌 多位点序列分析 脉冲场凝胶电泳 

分 类 号：R378.11[医药卫生—病原生物学]