耐甲氧西林金黄色葡萄球菌杀白细胞素基因检测  

Gene detection of Panton-Valentine leukocidin in methicillin-resistant Staphylococcus aureus

作　　者：赖奋强 郭庆昕 杨滨[3] 郑韵芳 LAI Fen-qing;GUO Qing-xin;YANG Bin;ZHENG Yun-fang(Hospital of Fuzhou University,Fuzhou 350002,China;Quanzhou Orthopedic Hospital,Quanzhou 362000,China;The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Fujian Health College, Fuzhou 350101,China)

机构地区：[1]福州大学医院,福州350002 [2]泉州市正骨医院,泉州362000 [3]福建医科大学附属第一医院检验科,福州350005 [4]福建卫生职业技术学院,福州350101

出　　处：《中国人兽共患病学报》2019年第8期726-731,共6页Chinese Journal of Zoonoses

摘　　要：目的调查临床分离的耐甲氧西林金黄色葡萄球菌(MRSA)杀白细胞毒素基因携带率。方法收集非重复MRSA菌株83株,按照美国疾病预防控制中心的CA-MRSA 定义分为HA-MRSA和CA-MRSA两组。采用多重PCR法进行SCCmec分型,普通PCR+测序法进行spa分型,普通PCR检测杀白细胞素(PVL)基因。结果83株MRSA中HA-MRSA、CA-MRSA分别占47.0%、53.0%,SCCmec分型中SCCmecⅠ、Ⅱ、Ⅲ、Ⅳa型和未分型各占1.2%、3.6%、65.1%、28.9%、1.2%,spa分型中83株MRSA共检出15个型,主要分型为t437,t062,t015分别占39.8%, 21.7%,10.8%;PVL阳性的MRSA中HA-MRSA和CA-MRSA分别10.3%、36.4%,两者差异有显著性(P=0.006);33株spa t437中有18株携带PVL基因,阳性率54.5%,50株其他spa分型中仅2株携带PVL基因,阳性率4.0%,两者差异有显著性(P=0.000)。PVL基因阳性的MRSA特征CA-MRSA-Ⅳa-t437 9株,HA-MRSA-Ⅲ-t437 4株,HA-MRSA-Ⅳa-t437 3株;20株PVL基因阳性的MRSA中10株分离自皮肤软组织感染病例,6株分离于耳鼻喉科感染病例,3株分离于呼吸道感染病例,1株分离于败血症病例。结论CA-MRSA菌株较HA-MRSA菌株的 PVL基因阳性率更高,同时也发现携带有更高毒力的CA-MRSA的克隆已经播散到医院的环境中,引起医院获得性相关感染。This study investigated the carrier rate of Panton-Valentine leukocidin gene in clinically isolated methicillin-resistant Staphylococcus aureus (MRSA).The 83 strains non repetitive MRSA were classified into HA-MRSA and CA-MRSA according to the US Centers for Disease Control and Prevention (CDC). Multiple PCR was used for SCCmec typing, and spa typing was conducted by means of PCR+DNA sequencing. Panton-valentine leukocidin (PVL) detected by conventional PCR. Results showed that in total of 83 strains were identified and HA-MRSA accounts for 47% while CA-MRSA accounts for 53%, of which the SCCmec type I,Ⅱ,Ⅲ,Ⅳa and unclassified type accounted for 1.2%, 3.6%, 65.1%, 28.9%, 1.2% respectively. There were 15 types of spa, t437, t062, t015 occupied 39.8%, 21.7%, 10.8% respectively. In PVL positive MRSA, HA-MRSA and CA-MRSA were 10.3% and 36.4%, respectively, with significant difference ( P =0.006). Among 33 strains of spa t437, 18 strains carried PVL gene, the positive rate was 54.5%, only 2 strains of other spa types carried PVL gene, the positive rate was 4.0%, the difference was significant ( P =0.000). The positive MRSA characteristics of PVL gene were 9 strains of CA-MRSA-IVa-t437, 4 strains of HA-MRSA-III-t437, and 3 strains of HA-MRSA-IVa-t437. Ten of 20 PVL positive MRSA isolates were isolated from the cases of skin soft tissue infection, 6 were isolated from the infection cases in the Department of ENT, 3 were isolated from the respiratory tract infection cases, and 1 were isolated from the septicemia cases. The CA-MRSA had a higher positive rate of the PVL gene than the HA-MRSA. At the same time, it was also found that the CA-MRSA clone carrying stronger virulence spread to the hospital environment, causing hospital acquired infection.

关 键 词：耐甲氧西林金黄色葡萄球菌 杀白细胞毒素 基因分型 

分 类 号：R378.1[医药卫生—病原生物学]