60株金黄色葡萄球菌分泌表皮剥脱毒素A、B情况及与疾病的相关性研究

Study on Correlation between the Serotype of Exfoliative Toxins and Dermatosis in 60 Strains of Staphylococcal Aureus

目的探讨脓疱疮和金葡菌烫伤样皮肤综合征(SSSS)两者病原菌分泌表皮剥脱毒素(ET)的情况及与疾病的相关性。方法分离脓疱疮和SSSS患者的病原菌并保存,应用反向乳胶凝集法测定金黄色葡萄球菌(SA)产生ET的型别。结果60株SA中,51株(85%)检测到有ET产生,其中表皮剥脱毒素A(ETA)阳性3株(5%),表皮剥脱毒素B(ETB)阳性8株(13%),ETA和ETB均阳性40株(67%)。30株来源于SSSS的SA,29株(97%)有ET产生;单纯ETB阳性者8株(27%);ETA和ETB均阳性21株(70%)。来源于脓疱疮的30株SA中,22株(73%)有ET产生;单纯ETA阳性3株(10%);ETA和ETB均阳性19株(63%)。其中来源于非大疱型脓疱疮的SA共15株,10株(67%)有ET产生。单纯ETA 1株(7%);ETA和ETB均阳性9株(60%)。来源于大疱型脓疱疮的SA共15株,12株(80%)有ET产生;单纯ETA 2株(13%);ETA和ETB均阳性10株(67%)。结论北京及其周边地区来自儿童脓疱疮和SSSS的SA以产ET菌为主,其中大部分可同时产生ETA和ETB。

Objective To study the correlation between dermatosis and the serotype of exfoliative toxins （ET）, and identify the correlativity of the serotype to impetigo or staphylococcal scalded-skin syndrome（SSSS）. Methods Sixty strains of Staphylococcal aureus （SA） isolated from patients were studied. Among them, 15 strains were isolated from patients with bullous impetigo patients, 15 strains from patients with nonbullous impetigo, and 30 patients with strains from SSSS. The reversed passive latex agglutination has been used to detect exfoliative toxin A and B. Results There were 51 exfoliative toxin producers detected by the EXT-RPLA, including 3 serotype A producers and 8 serotype B producers, and 40 double producers. Of the 15 isolates from the skin of patients with bullous impetigo, 12 isolates were positive in terms of exfoliative toxin production, including 2 serotype A producers and 10 double producers, with no serotype B producer. Of the 15 isolates from the skin of patients with nonbullous impetigo, 10 isolates were positive in terms of exfoliative toxin production, including 1 serotype A producer and 9 double producers, with no serotype B producer. On the other hand, of the thirty SA isolates from patients with SSSS, 29 exfoliative toxin producers were detected with the EXT-RPLA, including 8 serotype B producers, 21 double producers and with no serotype A producer. Conclusion ETA is correlated with impetigo and ETB is associated with generalized SSSS. ET-producing SA is the most common pathogenic bacteria in these two diseases.