金黄色葡萄球菌临床菌株杀白细胞素基因携带率和耐药特点  

The carrying rate and drug resistance of panton-valentine leukocidin genes in Staphylococcus aureus strains

作　　者：寿何庆 赵瑛 杨甜 梅丰翌 王家学[2] SHOU He-qing;ZHAO Ying;YANG Tian;MEI Feng-yi;WANG Jia-xue(Clinical Laboratory,Keqiao District Hospital of Traditional Chinese Medicine,Shaoxing,Zhejiang 312030,China;不详)

机构地区：[1]绍兴市柯桥区中医医院检验科,浙江绍兴312030 [2]杭州医学院检验学院,浙江杭州310053

出　　处：《中国卫生检验杂志》2020年第19期2333-2335,共3页Chinese Journal of Health Laboratory Technology

基　　金：浙江省自然科学基金项目(LY16H190006);杭州医学院校级大学生创新创业训练计划项目([2019]109)。

摘　　要：目的了解临床分离的金黄色葡萄球菌杀白细胞素(PVL)编码基因pvl携带情况和耐药特点。方法PCR扩增临床菌株pvl基因,头孢西丁法检测耐甲氧西林金黄色葡萄球菌(MRSA),K-B法检测临床菌株对抗菌药物的敏感性。结果277株临床菌株中,43株(15.5%)携带pvl基因(pvl+),pvl检出率MRSA菌株为24.7%,明显高于MSSA菌株的11.5%(P<0.05)。脓液标本分离菌株pvl基因检出率最高,为22.3%;pvl+-MRSA菌株主要来源为烧伤、软组织挫伤后感染部位的脓液和肺炎患者的痰液。临床菌株对青霉素耐药率高达91.0%,左氧氟沙星、庆大霉素、复方磺胺甲恶唑和利福平耐药率较低,均低于20%,未发现喹奴普汀/达福普汀、替考拉宁和万古霉素耐药菌株。pvl+和pvl-的金黄色葡萄球菌或MRSA菌株对所有抗菌药物耐药率比较差异均无统计学意义(P>0.05)。结论pvl+与金黄色葡萄球菌或MRSA耐药率升高没有明显的相关性,但pvl+与金黄色葡萄球菌感染的严重程度相关。Objective To investigate the prevailing feature and drug resistance of panton-valentine leucocidin(pvl)encoding gene in S.aureus.Methods The pvl genes were detected by PCR.The strain susceptibility was tested by K-B,and cefoxitin was used to detect methicillin resistant S.aureus(MRSA).Results Of the 43 isolates(15.5%)carrying pvl gene(pvl+),Thedetection rate of pvl+in MRSA strain was 24.7%,which was significantly higher than the that of MSSA strain(11.5%),and the difference was statistically significant(P<0.05).The detection rate of pvl+in different strains from different samples was different,among which the detection rate of pvl+in pus samples was the highest(22.3%).Most of pvl+-MRSA strains were isolated from the purulent fluid at the infected site after burn and soft tissue contusion and sputum of patients with pneumonia.The highest resistance rate to penicillin was 91.0%,the drug resistance rate to levofloxacin,gentamicin,compound sulfamethoxazole and rifampin was lower than 20%,and strains resistant to quinoputin/dafoputin,teicolanin and vancomycin were not found.Conclusion pvl+was not significantly associated with increased drug resistance of Staphylococcus aureus or MRSA,but pvl+was associated with the severity of Staphylococcus aureus infection.

关 键 词：金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 杀白细胞素基因 耐药 

分 类 号：R446.5[医药卫生—诊断学]