异质性万古霉素中介金黄色葡萄球菌的分子分型和同源性分析  

Molecular typing and homology analysis of heterogeneous vancomycin-intermediate Staphylococcus aureus

作　　者：胡远芳 付明霞[2] 王凤霞[1] 李娜[1] 梁进 王月玲 纪冰[1] Hu Yuan-fang;Fu Ming-xia;Wang Feng-xia;Li Na;Liang Jin;Wang Yue-ling;Ji Bing(Department of Clinical Laboratory,Bingzhou Medical University Hospital,Binzhou 256600;Department of Pathology,Binzhou people’s hospital,Binzhou 256600;Department of Clinical Laboratory,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Ji'nan 250021)

机构地区：[1]滨州医学院附属医院检验科,滨州256600 [2]滨州市人民医院病理科,滨州256600 [3]山东第一医科大学附属省立医院临床医学检验部,济南250021

出　　处：《中国抗生素杂志》2023年第2期222-227,共6页Chinese Journal of Antibiotics

基　　金：山东省自然科学基金资助项目(No.ZR2020MH306和No.ZR2020MH309);山东省医药卫生科技发展计划基金资助项目(No.2017WS372)。

摘　　要：目的了解滨州医学院附属医院异质性万古霉素中介金黄色葡萄球菌(hVISA)的分子流行病学现状,为有效预防hVISA的传播提供依据。方法采用万古霉素琼脂平皿筛选法对263株金黄色葡萄球菌进行初筛,菌群分析-曲线下面积(PAPAUC)法对初筛阳性的hVISA可疑株进行确认。采用多位点序列分型(MLST)、葡萄球菌A蛋白基因(spa)分型和脉冲场凝胶电泳(PFGE)分型方法对hVISA菌株进行分子分型和同源性分析。结果本院初筛出113株hVISA可疑株,最终确认为hVISA的菌株共22株。MLST分型以ST72型(5株)为主,其次为ST59和ST25型(各4株);spa分型主要为t002、t437以及t2431(各3株)。PFGE聚类分析共得到12种PFGE型别,命名为H1-H12型,相似值处于62.6%~100%之间,其中最主要的是H3型(共6株),其次为H1型(共4株)。结论hVISA在本院为散发,22株hVISA菌株共检出10种ST型,14种spa型和12种PFGE型。本院hVISA菌株的主要流行克隆为ST72-t2431-H3型,且均来源于儿科,儿科可能存在ST72-t2431-H3型hVISA的流行。Objective To investigate the molecular epidemiological status of heterogeneous vancomycinintermediate Staphylococcus aureus(hVISA)in Bingzhou Medical University Hospital,and to provide evidence for effective prevention of hVISA transmission.Methods 263 strains of Staphylococcus aureus(S.aureu)were screened for hVISA by vancomycin brain heart infusion agar plate,and hVISA strains were validated by the modified population analyzed profile-area under the curve(PAP/AUC)method.The molecular typing and homology of hVISA strains were analyzed by multilocus sequence typing(MLST),staphylococcal protein A(spa)typing and pulsed field gel electrophoresis(PFGE)typing.Results There were 113 screening positive strains in 263 strains of S.aureus,and 22 strains were confirmed to be hVISA positive by PAP/AUC.The MLST typing results showed that the strain types were mainly the ST72 type(5 strains),followed by the ST59 type(4 strains),and the ST25 type(4 strains).The main types of spa were t002,t437,and t2431(3 strains each).PFGE cluster analysis revealed a total of 12 PFGE types,named H1-H12,with similarity ranging from 62.6%to 100%.Among them,H3 type was the most important(6 strains),followed by H1 type(4 strains).Conclusion hVISA was sporadic in our hospital,and a total of 10 ST types,14 spa types,and 12 PFGE types were detected in 22 hVISA strains.The main epidemic clone of hVISA strain in our hospital was ST72-T2431-H3,and they were all from pediatrics.There may be an epidemic of ST72-T2431-H3hVISA in pediatrics.

关 键 词：异质性万古霉素中介金黄色葡萄球菌 多位点序列分型 葡萄球菌A蛋白基因分型 脉冲场凝胶电泳分型 

分 类 号：R378.11[医药卫生—病原生物学]