引起皮肤软组织感染的杀白细胞素阳性社区获得性耐甲氧西林金黄色葡萄球菌分子特征研究  

Molecular characteristics of Panton-Valentine leukocidin-positive community-acquired methicillin-resistant Staphylococcus aureus isolates causing skin and soft tissue infections

作　　者：应晓波 张传领 YING Xiao-bo;ZHANG Chuan-ling(Affiliated Xiaoshan Hospital,Hangzhou Normal University,Hangzhou 311201,China)

机构地区：[1]杭州师范大学附属萧山医院,杭州311201

出　　处：《中国人兽共患病学报》2022年第9期778-783,共6页Chinese Journal of Zoonoses

基　　金：浙江省医药卫生科技计划项目(No.2019RC256)。

摘　　要：目的了解分离自临床皮肤和软组织感染(SSTIs)患者携带杀白细胞素基因(pvl)社区获得性耐甲氧西林金黄色葡萄球菌(pvl^(+)-CA-MRSA)的分子特征。方法从SSTIs患者中分离出92株CA-MRSA。采用聚合酶链反应(PCR)和测序检测pvl基因及其突变。pvl^(+)-CA-MRSA菌株进行序列类型(STs)与克隆复合物(CCs)、葡萄球菌盒式染色体mec(SCC mec)、葡萄球菌蛋白基因(spa)多态性、辅助基因调控子(agr)位点、脉冲场凝胶电泳(PFGE)分型和多位点序列分型(MLST)。采用VITEK-2 Compact全自动微生物鉴定系统进行CA-MRSA药物敏感试验。结果92株CA-MRSA中,24株(26.1%)为pvl^(+)-CA-MRSA,其中91.7%(22/24)为pvl的H亚型,68株(73.9%)为未携带pvl基因CA-MRSA(pvl--CA-MRSA)。24株pvl^(+)-CA-MRSA中,共有8种STs和7种CCs,其中以ST59(62.5%,15/24)和CC59(70.8%,17/24)为主。pvl^(+)-CA-MRSA菌株中,SCC mec III和IVa型分别为54.2%和33.3%,agr I(87.5%,21/24)为最常见的agr等位基因,其余为agr III;检出8种spa型,其中以t437型最为常见(66.7%,16/24)。pvl^(+)-CA-MRSA菌株对红霉素、克林霉素、四环素耐药率较高(均>50%),对复方新诺明、环丙沙星、庆大霉素的耐药率较低(8.3%~16.7%),未发现万古霉素、利福平、莫西沙星和利奈唑啶耐药菌株。与pvl^(+)-CA-MRSA相比,pvl--CA-MRSA对四环素耐药率较低(P<0.05),对其它抗菌药物耐药率差异无统计学意义(P>0.05)。结论引起SSTIs的CA-MRSA中有较高的pvl基因阳性率,pvl H2、ST59/CC59、SCC mec III/IVa、agr I和t437是引起SSTIs CA-MRSA的优势克隆。The aim of this study was to determine the molecular characteristics of Panton-Valentine leukocidin-positive(pvl^(+))community-acquired methicillin-resistant Staphylococcus aureus(CA-MRSA)isolates from patients with skin and soft tissue infections(SSTIs).A total of 92 CA-MRSA strains were isolated from patients with SSTIs.In all isolates,the presence of pvl genes was detected,and mutation of pvl gene sequences was analyzed with polymerase chain reaction and sequencing.The pvl^(+)-CA-MRSA isolates were analyzed to determine sequence types(STs),clone complexes(CCs),staphylococcal cassette chromosome mec(SCC mec)type,staphylococcal protein A(spa)gene polymorphism type,pulsed-field gel electrophoresis type,accessory gene regulator(agr)locus type and multi locus sequence type.A VITEK-2 Compact auto-microorganism identification system was used for drug susceptibility tests of all CA-MRSA isolates.Of the 92 CA-MRSA isolates,24(26.1%)were pvl^(+);91.7%of the pvl^(+)isolates(22/24)belonged to the H variant of pvl(pvl H).Among the 24 pvl^(+)-CA-MRSA isolates,eight STs and seven CCs had predominance of ST59(62.5%,15/24)and CC59(70.8%,17/24).In the pvl^(+)-CA-MRSA isolates,SCC mec III and IVa accounted for 54.2%and 33.3%,respectively;agr I(87.5%,21/24)was the most common agr allele,and the remainder were agr III.Eight spa types were detected in the pvl^(+)-CA-MRSA isolates;the most common spa type was t437(66.7%,16/24).The pvl^(+)-CA-MRSA isolates showed higher resistance rates to erythromycin,clindamycin and tetracycline(>50%),but lower resistance rates to sulfamethoxazole/trimethoprim,ciprofloxacin and gentamicin(8.3%-16.7%),No vancomycin,rifampicin,moxifloxacin and linezolid resistant pvl^(+)-CA-MRSA isolates were found.Except for a lower resistance rate to tetracycline(P<0.05),no significant differences were observed in resistance rates to the other tested antibiotics between pvl--CA-MRSA and pvl^(+)-CA-MRSA.All results indicated that the CA-MRSA isolates causing SSTIs had a high positivity rate of pvl-encoding genes,and

关 键 词：社区相关性金黄色葡萄球菌 皮肤软组织感染 杀白细胞毒素 分子特征 

分 类 号：R378.1[医药卫生—病原生物学]