携带Panton-Valentine杀白细胞素基因金黄色葡萄球菌所致感染类型研究

Study on infections caused by Staphylococcus aureus carrying Panton-Valentine leukocidin genes

目的研究携带 Panton-Valentine 杀白细胞素(Panton-Valentine leukocidin,PVL)基因金黄色葡萄球菌所致感染类型。方法利用多重 PCR 检测金黄色葡萄球菌临床分离株的 PVL 基因,应用多位点基因序列分型(multilocus sequence typing,MLST)技术对 PVL 基因阳性的菌株进行序列分型,耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)的 SCCmec 基因分型采用多重 PCR。结果 26株携带 PVL 基因的金黄色葡萄球菌有13株为 ST88,5株为 ST239,5株为 ST398,ST25、ST30和 ST59各1株。20株为医院获得株,主要引起肺部感染和术后伤口化脓性感染;6株为社区感染株,主要引起软组织化脓性感染。7株 MSSA全部为 ST88,主要引起化脓性感染。而19株 MRSA分布在6种 ST 型中,主要有 ST88-SCCmecⅢA、ST239-SCCmecⅢ、ST398-SCCmecⅣ和ST398-SCCmecⅢ。26株菌株分布于14个病区,在产科发生过携带 PVL 基因的 ST88-SCCmecⅢA-MRSA 克隆株的播散。结论本院分离的携带 PVL 基因的金黄色葡萄球菌的序列型主要为 ST88、ST239 和 ST398,既可造成医院感染也可造成社区感染且可能引起克隆株的播散。

Objective To investigate the infections caused by Staphylococcus aureus carrying Panton-Valentine leukocidin （PVL） genes. Methods 26 isolates of Staphylococcus aureus carrying Panton- Valentine leukocidin （PVL）genes were determined by multiplex PCR. Multilocus sequence typing （MLST） was used to determine the STs of the isolates. The genotypes of SCCmec were also determined by another multiplex PCR in the isolates of methicillin-resistant Staphylococcus aureus （MRSA）. Results Among 26 isolates, there were 6 isolates of ST88 MRSA ,7 isolates of ST88 methicillin-susceptible Staphylococcus aureus （MSSA） ,5 isolates of ST239 MRSA,5 isolates of ST398 MRSA, 1 isolate of ST25 MRSA, 1 isolate of ST30 MRSA and 1 isolate of ST59 MRSA. 20 isolates were hospital-acquired（HA） which mainly caused pulmonary infection and post-operative pyogenic infection . 6 isolates were community-acquirod （ CA ） which mainly caused soft tissue necrosis. Among 19 isolates of MRSA, ST88-SCCmec Ⅲ A, ST239-SCCmec Ⅲ, ST398-SCCmecⅣ and ST398-SCCmecⅢ were main types. 26 isolates were isolated from 14 wards. ST88-SCCmec Ⅲ A-MRSA caused clone spread in maternity department in our hospital. Conclusion ST88, ST239 and ST 398 are main STs in Staphylococcus aureus carrying PVL in our hospital. The isolates not only cause nosocomial infections but also cause community infection.