金黄色葡萄球菌毒力基因psm-mec与手足部软组织损伤创面感染程度的相关性  

Association between virulence gene psm-mec in Staphylococcus aureus and severity of wound infection in soft tissue damage of hands and feet

作　　者：陆道军 陶金莲 胡春良 王波 张国良 LU Dao-jun;TAO Jin-lian;HU Chun-liang;WANG Bo;ZHANG Guo-liang(Huishan District People's Hospital,Wuri,Jiangsu 214187,China)

机构地区：[1]无锡市惠山区人民医院手足外科,江苏无锡214187

出　　处：《中华医院感染学杂志》2022年第13期2001-2004,共4页Chinese Journal of Nosocomiology

基　　金：江苏省科研基金资助项目(DF101420)。

摘　　要：目的分析金黄色葡萄球菌毒力基因酚溶调制肽-mec(psm-mec)与手足部软组织损伤创面感染程度的相关性。方法选取2019年2月-2021年1月在惠山区人民医院确诊的手足部外伤软组织损伤合并金黄色葡萄球菌感染患者92例为观察对象。根据损伤创面感染程度分为轻度组52例和重度组40例,观察并记录两组患者临床表现(创口疼痛、创口红肿、体温升高和精神萎靡),检测两组白细胞计数、红细胞沉淀率和超敏C-反应蛋白。采用聚合酶链式反应(PCR)检测sasX、psm-mec和pvl基因。结果92例患者共检出92株金黄色葡萄球菌,其中轻度组检出51(55.43%)株,重度组检出41(44.57%)株。两组患者出现创口疼痛及精神萎靡症状比较,无统计学差异;轻度组出现创口脓肿和发热的症状少于重度组(P<0.05)。两组感染患者红细胞沉降率、超敏C-反应蛋白、中性粒细胞、血小板和降钙素原比较,无统计学差异;轻度组感染患者白细胞计数高于重度组(P<0.05)。重度组金黄色葡萄球菌毒力基因psm-mec检出情况多于轻度组(P<0.05)。结论金黄色葡萄球菌毒力基因psm-mec与手足部软组织损伤创面感染程度有关。OBJECTIVE To observe the association between the virulence gene phenol-soluble modulin peptide-mec(psm-mec)in Staphylococcus aureus and the severity of wound infection in soft tissue damage of hands and feet.METHODS A total of 92 patients who were diagnosed with soft tissue injury of hands and feet complicated with S.aureus infection and treated in Huuishan District People’s Hospital from Feb 2019 to Jan 2021 were recruited as the study subjects and divided into the mild group with 52 cases and the severe group with 40 cases according to the severity of wound infection in soft and tissue damage.The clinical manifestation(wound pain,wound swelling,fever,listlessness)of the two groups of patients were observed and recorded,the white blood cell counts,erythrocyte sedimentation rate and high-sensitivity C-reactive protein were detected,and the sasX,psm-mec and pvl genes were detected by polymerase chain reaction(PCR).RESULTS Totally 92 strains of S.aureus were isolated from 92 patients,51(55.43%)of which were isolated from the mild group,and 41(44.57%)were isolated from the severe group.There were no significant differences in the symptoms of wound pain and listlessness between the two groups of patients;the incidence rates of wound abscess and fever were significantly lower in the mild group than in the severe group(P<0.05).There were no significant differences in the erythrocyte sedimentation rate,high-sensitivity C-reactive protein,neutrophils,platelets and procalcitonin between the two groups of patients.The white blood cell level of the mild group was significantly higher than that of the severe group(P<0.05).The detection rate of virulence gene psm-mec in S.aureus was higher in the severe group than in the mild group(P<0.05).CONCLUSION The virulence gene psm-mec in S.aureus is associated with the severity of wound infection in soft tissue damage of hands and feet.

关 键 词：金黄色葡萄球菌 创面感染 相关性 毒力基因 酚溶调制肽-mec 软组织 手足部 

分 类 号：R658[医药卫生—外科学]