外科感染PVL阳性金黄色葡萄球菌患者粒淋比相关性研究  

Surgical patients infect PVL-positive Staphylococcus aureus correlation study of neutrophils and lymphocytes

作　　者：张乐 王月玲 白媛媛 宋真 鹿星伦 吴玉龙[1] ZHANG Le;WANG Yue-ling;BAI Yuan-yuan;SONG Zhen;LU Xing-lun;WU Yu-long(School of Basic Medical Sciences,Binzhou Medical University,Yantai,Shandong 264003,China;Department of Clinical Laboratory,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan,Shandong 250014,China)

机构地区：[1]滨州医学院,山东烟台264003 [2]山东第一医科大学附属省立医院,山东济南250014

出　　处：《岭南现代临床外科》2024年第5期314-319,共6页Lingnan Modern Clinics in Surgery

基　　金：山东省自然基金项目(ZR2020MH306)。

摘　　要：目的了解2023年山东第一医科大学附属省立医院外科患者携带杀白细胞素(PVL基因的金黄色葡萄球菌的流行情况和耐药情况,研究了白细胞(WBC)、C反应蛋白(CRP)、中性粒细胞-淋巴细胞比值(NLR)在感染PVL基因阳性金黄色葡萄球菌患者诊断中的临床应用价值。方法从患者中分离出100株金黄色葡萄球菌。采用PCR方法检测mecA基因和PVL基因,并分析分离株的耐药性。各组根据mecA和PVL基因检测结果进行分组,同时选取100名接受健康体检的受试者作为对照组。收集各组WBC、CRP、NLR水平,并分析各项指标对于PVL基因阳性金黄色葡萄球菌感染的临床应用价值。结果100株金黄色葡萄球菌中,耐甲氧西林金黄色葡萄球菌(MRSA)47株。其中49株金黄色葡萄球菌中检测到PVL基因,大部分为甲氧西林敏感金黄色葡萄球菌(MSSA)。在金黄色葡萄球菌感染期间患者WBC、CRP、NLR水平显著升高,PVL阳性组NLR水平显著高于PVL阴性组(Z=-2.26,P=0.02)。PVL阳性组和PVL阴性组之间的WBC和CRP水平差异不具有统计学意义(P>0.05)。结论与WBC和CRP相比,NLR对感染PVL基因阳性金黄色葡萄球菌具有较高的临床应用价值,NLR可作为PVL基因阳性金黄色葡萄球菌感染的预测指标。Objective To understand the prevalence and resistance of Staphylococcus aureus(S.aureus)carrying the Panton-Valentine leukocidin(PVL)gene in surgical patients at the Shandong Provincial Hospital Affiliated to Shandong First Medical University in 2023.The clinical application values of white blood cell(WBC),C-reactive protein(CRP),and neutrophil-to-lymphocyte ratio(NLR)in the diagno-sis of PVL-positive S.aureus infection were investigated.Methods 100 strains of S.aureus were iso-lated.The presence of the mecA gene and genes encoding PVL were ditermined using PCR,and the drug resistance of the isolates were analyzed.Groups were grouped according to the mecA and PVL gene test results.Contemporaneous 100 subjects undergoing healthy physical examination were selected as the control group.The levels of WBC,CRP,and NLR of each group were collected,and the clinical application values of WBC,CRP,and NLR for PVL-positive S.aureus infection were compared.Results Among the 100 strains of S.aureus,47 isolates were Methicillin-resistant Staphylococcus aureus(MRSA).Of the 49 S.aureus strains tested,the PVL gene was detected in most of them,which were mainly methicillin-sensitive Staphylococcus aureus(MSSA).The levels of WBC,CRP,and NLR increased significantly during S.aureus infection,and the level of NLR in the PVL-positive group was significantly higher than that in the PVL-negative group(Z=-2.26,P=0.02).Still,the levels of WBC,and CRP were rarely differ-ent between the PVL-positive group and PVL-negative group.Conclusion Compared with WBC and CRP,NLR had a higher clinical application value for PVL-positive S.aureus,and NLR can be used as a predictor of PVL-positive S.aureus infection.

关 键 词：金黄色葡萄球菌 Panton-Valentine杀白细胞素 耐甲氧西林金黄色葡萄球菌 C反应蛋白 中性粒细胞与淋巴细胞比值 

分 类 号：R63[医药卫生—外科学]