上海市医院血流感染耐甲氧西林金黄色葡萄球菌分子流行病学特征研究  

Molecular epidemiological characteristics of methicillin-resistant Staphylococcus aureus in bloodstream infection in hospitals of Shanghai

作　　者：陈泰尧[1] 陈雯杰 田靓[1] 葛忆琳[1] 魏腾 毕菁 刘倩[1] 张曦[1] 张红芝[1] CHEN Tai-yao;CHEN Wen-jie;TIAN Liang;GE Yi-lin;WEI Teng;BI Jing;LIU Qian;ZHANG Xi;ZHANG Hong-zhi(Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海市疾病预防控制中心,上海200336

出　　处：《中国消毒学杂志》2022年第3期206-210,共5页Chinese Journal of Disinfection

基　　金：上海市公共卫生体系建设三年行动计划(GWV-2)。

摘　　要：目的分析上海市医院血流感染耐甲氧西林金黄色葡萄球菌(MRSA)分子流行病学特征。方法使用二代测序平台Illumina Hiseaxten PE150对29株MRSA进行全基因组测序,利用拼接序列进行多位点序列分型(MLST)、葡萄球菌染色体mec基因盒(SCCmec)、金黄色葡萄球菌A蛋白(spa)、毒力基因、耐药基因及耐药表型、核心基因组多位点序列分型(cgMLST)聚类分析。结果本研究中ST764-SCCmec-Ⅱ-t002为优势型别(34.5%),其次为ST5;SCCmecⅡ为主要的耐药基因盒(44.8%);MRSA对红霉素、四环素和庆大霉素的耐药率较高。MRSA均携带超级抗原、细胞毒素和黏附因子相关毒力基因。cgMLST聚类结果显示,在同一医院不同科室、不同医院分离的血流感染MRSA存在较高的同源性。结论上海市医院分离血流感染MRSA对常用抗菌药物耐药性较强,携带毒力相关基因,且存在优势型别的克隆传播,应加强血流感染MRSA的监测。Objective To investigate the molecular epidemiological characteristics of methicillin-resistant Staphylococcus aureus(MRSA)in bloodstream infections from different hospitals in Shanghai.Methods Using the second-generation sequencing platform Illumina Hiseaxten PE150,the whole genomes of 29 strains of MRSA were sequenced.The assemblied whole genome sequence was used to conduct multi-locus sequence typing(MLST),staphylococcal chromosome mec gene cassette(SCCmec),Staphylococcus aureus protein A(spa),toxic genes,drug resistance genes and drug resistance phenotypes,core genome multi-locus sequence typing(cgMLST)cluster analysis.Results ST764-SCCmec-Ⅱ-t002 was predominant clone(34.5%)in this study,followed by ST5.SCCmecII was the main drug resistance gene cassette(44.8%).The resistance rates to erythromycin,tetracycline and gentamicin were higher.MRSA all carried superantigens,cytotoxic and adhesion factor-related toxic genes.The cgMLST clustering results showed that MRSA isolated from different departments in the same hospital or from different hospitals had high homology.Conclusion MRSA isolated from bloodstream infection in hospitals of Shanghai is highly resistant to commonly used antibiotics.MRSA carries toxic genes,and has clonal transmission of predominant clone.Monitoring of MRSA in bloodstream infection should be strengthened.

关 键 词：耐甲氧西林金黄色葡萄球菌 血流感染 全基因组测序 MLST cgMLST 

分 类 号：R117[医药卫生—公共卫生与预防医学]