金黄色葡萄球菌毒力因子与儿童金黄色葡萄球菌软组织感染、肺炎的相关性  

Correlation between virulent factors of Staphylococcus aureus and soft tissue infection,pneumonia in children

作　　者：麻明彪 黄海林[1] 许彬[1] 李小娟[1] 李珏 世淑兰 王海平 杜廷义[1,2] MA Mingbiao;HUANG Hailin;XU Bin;LI Xiaojuan;LI Jue;SHI Shulan;WANG Haiping;DU Tingyi(Department of Clinical Laboratory,Kunming Children's Hospital,Kunming,Yunnan 650228,China;Yunnan Key Laboratory of Children's Major Disease Research,Kunming,Yunnan 650228,China)

机构地区：[1]云南省昆明市儿童医院检验科,云南昆明650228 [2]云南省儿童重大疾病研究重点实验室,云南昆明650228

出　　处：《检验医学与临床》2021年第11期1516-1520,共5页Laboratory Medicine and Clinic

基　　金：云南省教育厅科学研究项目(2020J0229、2020J0224);昆明市科学技术局项目(2015-1-S-00564);昆明市卫生科技人才培养项目[2016-sw-20、2020-SW(后备)-109];昆明市卫生健康委员会科研项目(2019-06-01-014)。

摘　　要：目的探讨金黄色葡萄球菌(SA)杀白细胞毒素基因(pvl)、中毒性休克综合征毒素1基因(tst-1)和α-溶血素基因(hl-α)在儿童SA软组织感染、肺炎中的检出情况及临床意义。方法以2018年10月至2019年3月诊断为SA软组织感染和SA肺炎患儿为研究对象,分离、收集其病原菌,并记录患儿相关资料和临床指征。革兰染色镜检和VITEK-2 Compact全自动微生物分析仪鉴定菌株;聚合酶链式反应(PCR)检测SA菌株pvl、tst-1以及hl-α。结果共纳入75例患儿,其中34例为SA软组织感染,30例为SA轻症肺炎以及11例为SA重症肺炎。在软组织感染组中pvl检出率(52.94%)最高,其次为重症肺炎组(36.36%),轻症肺炎组中检出率(20%)最低,差异有统计学意义(P<0.05)。pvl+SA肺炎患儿的体温、呼吸频率和心率均高于pvl-SA肺炎患儿,舒张压也比其低,差异有统计学意义(P<0.05)。tst-1在重症肺炎组中检出率(72.72%)最高,其次为软组织感染组(29.41%),轻症肺炎组中未检测到,差异有统计学意义(P<0.05)。tst-1+SA肺炎患儿的体温和呼吸频率均高于tst-1-SA肺炎患儿,差异有统计学意义(P<0.05),但心率和血压差异无统计学意义(P>0.05)。hl-α在软组织感染,轻、重症肺炎组中均检出,检出率比较差异无统计学意义(P>0.05)。结论pvl主要常见于儿童SA软组织感染,且可导致SA肺炎患儿病情加重;tst-1与儿童SA重症肺炎的发生密切相关,tst-1的检测对儿童SA重症肺炎的诊断和病情预判有潜在价值;hl-α在儿童SA软组织感染及肺炎中均有较高检出率,无明显特异性。Objective To investigate the distribution of pvl,tst-1 and hl-αof Staphylococcus aureus(SA)in children with soft tissue infection or pneumonia,and their correlation with clinical symptoms.Methods The hospitalized children who diagnosed with soft tissue infection or pneumonia caused by Staphylococcus aureus in Kunming children's Hospital from October 2018 to March 2019 were enrolled.The pathogenic bacteria were isolated and collected.Relevant data and clinical indications of children were recorded,and children with Staphylococcus aureus pneumonia were classified into mild pneumonia and severe pneumonia.Bacterial strains were indentified by Gram stain and the automatic bacterial identification system(VITEK2-Compact),and pvl,tst-1 and hl-αwere detected by PCR.Results A total of 75 children were enrolled in the study,including 34 children with soft tissue infection,30 children with mild pneumonia and 11 children with severe pneumonia.The highest detection rate(52.94%)of pvl gene was in the soft tissue infection group,followed by the severe pneumonia group(36.36%)and the lowest detection rate was in the mild pneumonia group(20%).The difference was statistically significant between the three groups(P<0.05).The temperature,respiratory rate and heart rate of children with pvl+SA pneumonia were significantly higher than those with pvl-SA pneumo-nia,and the diastolic blood pressure was also lower.The difference was significant(P<0.05).Tst-1 gene had the highest detection rate(72.72%)in the severe pneumonia group,followed by the soft tissue infection group(29.41%),and was not detected in the mild pneumonia group.The difference was statistically signifi-cant(P<0.05).The temperature and respiratory rate of children with tst-1+SA pneumonia were significantly higher than those with tst-1-SA pneumonia,and difference was statistically significant(P<0.05).But no statistically significant difference in heart rate and blood pressure was found(P>0.05).Hl-αwas detected in all three groups,but the difference was not statistically si

关 键 词：金黄色葡萄球菌 肺炎 PVL tst-1 hl-α 

分 类 号：R372[医药卫生—病原生物学]