患者皮肤感染中分离的甲氧西林敏感金黄色葡萄球菌耐药性研究
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摘要
目的探究从皮肤感染患者中分离的甲氧西林敏感金黄色葡萄球菌的耐药性、基因分型及毒力基因分布特征。方法选取2015年12月-2016年6月于医院就诊的皮肤软组织感染患者96例,收集患者分离出的78株甲氧西林敏感金黄色葡萄球菌(MSSA),进行耐药性检验、脉冲场凝胶电泳(PFGE)基因分型,并对不同型别的菌株进行毒力基因检测,分析其耐药性、基因分型及其毒力基因分布特征。结果耐药性检测显示,所有MSSA菌株中耐药率最高的2种抗菌药物是红霉素(87.18%,68/78)、青霉素(92.31%,72/78),MSSA菌株对其他药物耐药率低于以上两种药物(P<0.05)。基因分型结果显示,78株MSSA中分15型,其中I型占28.21%(22/78)、H型占32.05%(25/78)为优势型别。78株菌株中杀白细胞毒素(Panton-Valentine leukocidin,PVL)阳性率为75.64%(59/78),优势型别的毒力基因总携带率高于非优势型别(P<0.05)。结论甲氧西林敏感金黄色葡萄球菌对红霉素类和β-内酰胺类抗菌药物有较强的耐药性,其基因型多样,I型和H型为优势型别,且优势型别的毒力基因携带率高于非优势型别。
OBJECTIVE To explore the drug resistance,genotyping and virulence gene distribution characteristics of methicillin-sensitive Staphylococcus aureus isolated from patients with skin soft tissue infection.METHODS 96 patients with skin and soft tissue infections who were admitted to the hospital from Dec.2015 to Jun.2016 were selected.78 strains of methicillin-sensitive Staphylococcus aureus(MSSA)isolated from the patients were collected for drug resistance test and pulse field gel electrophoresis(PFGE)genotyping,and virulence gene detection of different types of strains was conducted to analyze the drug resistance,genotyping and virulence gene distribution characteristics.RESULTS The drug resistance test showed that the two antibiotics with the highest resistance rate among all MSSA strains were erythromycin(87.17%,68/78)and penicillin(92.31%,72/78),and the resistance rates of MSSA strains to other drugs were all significantly lower than these two antibiotics(P<0.05).The genotyping results showed that 78 strains of MSSA were classified into 15 types,of which type I accounted for 28.21%(22/78)and type H accounted for 32.05%(25/78).The positive rate of Panto-Valentine leukocidin(PVL)was74.36%(59/78),and the total virulence gene of dominant types was significantly higher than that of non-dominant types(P<0.05).CONCLUSION Methicillin-sensitive S aureus has strong resistance to erythromycin and beta-lactam antibiotics.Its genotypes are diverse.Type I and H are dominant genotypes,and the virulence gene carrying rate of dominant genotypes is higher than that of non-dominant genotypes.
OBJECTIVE To explore the drug resistance,genotyping and virulence gene distribution characteristics of methicillin-sensitive Staphylococcus aureus isolated from patients with skin soft tissue infection.METHODS 96 patients with skin and soft tissue infections who were admitted to the hospital from Dec.2015 to Jun.2016 were selected.78 strains of methicillin-sensitive Staphylococcus aureus(MSSA)isolated from the patients were collected for drug resistance test and pulse field gel electrophoresis(PFGE)genotyping,and virulence gene detection of different types of strains was conducted to analyze the drug resistance,genotyping and virulence gene distribution characteristics.RESULTS The drug resistance test showed that the two antibiotics with the highest resistance rate among all MSSA strains were erythromycin(87.17%,68/78)and penicillin(92.31%,72/78),and the resistance rates of MSSA strains to other drugs were all significantly lower than these two antibiotics(P<0.05).The genotyping results showed that 78 strains of MSSA were classified into 15 types,of which type I accounted for 28.21%(22/78)and type H accounted for 32.05%(25/78).The positive rate of Panto-Valentine leukocidin(PVL)was74.36%(59/78),and the total virulence gene of dominant types was significantly higher than that of non-dominant types(P<0.05).CONCLUSION Methicillin-sensitive S aureus has strong resistance to erythromycin and beta-lactam antibiotics.Its genotypes are diverse.Type I and H are dominant genotypes,and the virulence gene carrying rate of dominant genotypes is higher than that of non-dominant genotypes.
引文
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[10] Masclaux FG,Sakwinska O,Charriere N,et al.Concentration of airborne Staphylococcus aureus(MRSA and MSSA),total bacteria,and endotoxins in pig farms[J].Ann Occup Hyg.2013,57(5):550-557.
[11]李艳萌,赵瑞珂,黄宝丽,等.医院获得性耐甲氧西林金黄色葡萄球菌Spa和SCCmec分型研究[J].重庆医学,2015,44(34):4821-4824.
[12] Bar-Gal GK,Blum SE,Hadas L,et al.Host-specificity of Staphylococcus aureus causing intramammary infections in dairy animals assessed by genotyping and virulence genes[J].Vet Microbiol,2015,176(1-2):143-154.
[13] Cosandey A,Boss R,Luini M,et al.Staphylococcus aureus genotype B and other genotypes isolated from cow milk in European countries[J].J Dairy Sci,2016,99(1):529-540.
[14]杨延成,程航,胡珍,等.乌鲁木齐地区金黄色葡萄球菌分离株的分子分型与耐药性分析[J].第三军医大学学报,2016,38(9):1035-1042.
[2]郝崇华,万艳红,裴世静,等.耐甲氧西林金黄色葡萄球菌的耐药基因与毒力基因分析[J].中国药物与临床,2015,15(12):1712-1713.
[3] Sinlapasorn S,Lulitanond A,Angkititrakul S,et al.SCCmec IX in meticillin-resistant Staphylococcusaureusand meticillin-resistant coagulase-negative Staphylococci from pigs and workers at pig farms in Khon Kaen,Thailand[J].J Med Microbiol,2015,64(9):1087-1093.
[4]时文艳,冯宪敏,于圣,等.吉林市区耐甲氧西林金黄色葡萄球菌SCCmec基因分型与耐药性研究[J].中国医师进修杂志,2016,39(12):1080-1083.
[5]李小鹏,王治国.美国临床实验室标准化委员会标准与指南[J].中华检验医学杂志,2001,24(4):251-252.
[6] Cremonesi P,Pozzi F,Raschetti M,et al.Genomic characteristics of Staphylococcus aureus strains associated with high within-herd prevalence of intramammary infections in dairy cows.[J].J Dairy Sci,2015,98(10):6828-6838.
[7] Gandra S,Braykov N,Laxminarayan R,et al.Is methicillinsusceptible Staphylococcus aureus(MSSA)sequence type398confined to northern manhattan?Rising prevalence of erythromycin-and clindamycin-resistant MSSA clinical isolates in the United States[J].Clin Infect Dis,2014,58(2):306-307.
[8]聂志妍,陈旭,周红,等.上海地区859名青少年鼻腔金黄色葡萄球菌携带及耐药状况调查[J].检验医学,2015,30(2):156-159.
[9] Lulitanond A,Kanyota R,Engchanil C,et al.Virulence genes and genotypes of Staphylococcus aureus from blood of Thai patients[J].Scienceasia,2015,41(3):162.
[10] Masclaux FG,Sakwinska O,Charriere N,et al.Concentration of airborne Staphylococcus aureus(MRSA and MSSA),total bacteria,and endotoxins in pig farms[J].Ann Occup Hyg.2013,57(5):550-557.
[11]李艳萌,赵瑞珂,黄宝丽,等.医院获得性耐甲氧西林金黄色葡萄球菌Spa和SCCmec分型研究[J].重庆医学,2015,44(34):4821-4824.
[12] Bar-Gal GK,Blum SE,Hadas L,et al.Host-specificity of Staphylococcus aureus causing intramammary infections in dairy animals assessed by genotyping and virulence genes[J].Vet Microbiol,2015,176(1-2):143-154.
[13] Cosandey A,Boss R,Luini M,et al.Staphylococcus aureus genotype B and other genotypes isolated from cow milk in European countries[J].J Dairy Sci,2016,99(1):529-540.
[14]杨延成,程航,胡珍,等.乌鲁木齐地区金黄色葡萄球菌分离株的分子分型与耐药性分析[J].第三军医大学学报,2016,38(9):1035-1042.