皮肤软组织感染患者分离的金黄色葡萄球菌毒力基因分布研究  

Distribution of virulence genes in Staphylococcus aureus strains isolated from patients with skin soft tissue infections

作　　者：汪英俊[1] 白永凤[2] 程颖[2] 邱玉萍 杨云飞 陆军[2] 

机构地区：[1]衢州市人民医院皮肤科,浙江衢州324000 [2]衢州市人民医院检验科,浙江衢州324000

出　　处：《中华医院感染学杂志》2018年第2期169-172,176,共5页Chinese Journal of Nosocomiology

摘　　要：目的了解分离自皮肤软组织感染的金黄色葡萄球菌毒力基因的分布情况,揭示其分子流行特征,为防控医院感染及金黄色葡萄球菌传播提供指导。方法收集2014-2016年期间衢州市人民医院皮肤软组织感染患者病变部位分离的112株金黄色葡萄球菌;采用头孢西丁K-B法及mecA基因PCR扩增法筛选、鉴定耐甲氧西林金黄色葡萄球菌(MRSA);进一步通过PCR法检测所有菌株携带的杀白细胞素基因(PVL)、凝集因子基因(clfA、clfB)、纤黏蛋白基因(fnbA、fnbB)、溶血素基因(hla、hlb)和肠毒素基因(sec、seh)等9种毒力基因。结果 112株金黄色葡萄球菌中,共筛选鉴定出28株MRSA,检出率25.00%;除1株MSSA菌株不携带任何毒力基因外,9种毒力基因在其余菌株中均有检出,多数菌株携带一种以上的毒力基因,其中clfB(96.43%)与hla(95.54%)的检出率较高,而肠毒素sec(7.14%)、seh(8.04%)检出率较低,其他毒力基因的检出率为30.35%~73.21%;各毒力基因携带率在MRSA与MSSA菌株间的分布差异无统计学意义。结论本院金黄色葡萄球菌引起皮肤软组织感染患者中,MRSA比例较高,且携带多种毒力基因,应加强对该类菌株的监测。OBJECTIVE To understand the distribution of virulence genes in Staphylococcus aureus strains isolated from patients with skin soft tissue infections and explore the molecular epidemiological characteristics so as to provide guidance for prevention and control of nosocomial infections as well as the spread of S.aureus strains.METHODS A total of 112 strains of S.aureus were collected from lesion sites of the patients with skin soft tissue infections who were treated in the hospital from 2014 to 2016.The methicillin-resistant Staphylococcus aureus（MRSA）strains were screened and identified by using cefoxitin K-B method and mecA gene PCR amplification method.The 9 types of virulence genes,including leukocidin gene（PVL）,agglutination factor genes（clfA,clfB）,fibronectin genes（fnbA,fnbB）,hemolysin genes（hla,hlb）and enterotoxin genes（sec,seh）,were detected by means of PCR.RESULTS Totally 28 strains of MRSA were screened out among the 112 strains of S.aureus,with the isolation rate 25.00%.All of the MRSA strains were detected to carry with the 9 types of virulence genes except that 1 strain of MRSA did not carry with any virulence gene,most of the strains carried with more than one type of virulence genes,the detection rates of clfBand hla were 96.43%and 95.54%,respectively,the detection rates of enterotoxin genes sec and seh were 7.14% and 8.04%,respectively,the detection rates of the rest of virulence genes ranged between 30.35% and 73.21%.There were no significant differences in the carrying rates of virulence genes between the MRSA strains and MSSA strains.CONCLUSION The MRSA strains are dominant among the S.aureus strains causing the skin soft tissue infections and carry with multiple virulence genes,the surveillance of which needs be strengthened.

关 键 词：金黄色葡萄球菌 皮肤软组织感染 毒力基因 

分 类 号：R378.11[医药卫生—病原生物学]