金黄色葡萄球菌所致肺部感染的耐药特点及其Panton-Valentine杀白细胞素基因的携带状况分析

Study on drug-resistance of lung infection caused by Staphylococcus aureus and its carrying Panton-Valentine leukocidin genes

目的分析金黄色葡萄球菌所致肺部感染的耐药性特点及其Panton-Valentine杀白细胞素基因的携带状况。方法回顾性调查了温州医学院第一附属医院2005年1月至2006年1月医院感染的金黄色葡萄球菌所致肺部感染患者132例,对其体外药敏试验进行分析;并利用多重PCR检测其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基因分型采用多重聚合酶链反应。结果致肺部感染的132株金黄色葡萄球菌的耐药现象较为严重,仅对万古霉素、呋喃妥因及复方新诺明等药物的敏感率较高;其中经多重PCR筛选出10株携带PVL基因的金葡菌,全部为MRSA菌株,3株为ST239-SCCⅢ,2株为ST398-SCCmecⅢ,2株为ST398-SCCmecⅣ,ST25-SCCmecⅢ、ST59-SCCmecⅠ和ST88-SCCmecⅢ各1株。结论肺部感染的金黄色葡萄球菌对多种抗生素耐药,呈多重耐药性;其携带PVL基因占一定比例。

Objective To analyze the drug-resistance of lung infection caused by Staphylococcus aureus and its carrying Panton-Valentine leukocidin genes. Methods The drug sensitivity results of 132 cases with lung infection by Staphylococcus aureus from January 2005 to January 2006 were investigated retrospective in local hospital. 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 The drug-resistance of 132 strains Staphylococcus aureus was serious. The antibiotic drugs which had higher susceptibility ratio were vancomycin, nitmfurantoin and trimeth-sulfa et al. 10 strains Staphylococcus aureus carrying Panton-Valentine leukocidin genes were all methicillin-resistant Staphylococcus aureus （MRSA） , 3 isolates of ST239-SCC Ⅲ, 2 isolates of ST398-SCCmec Ⅲ, 2 isolates of ST398-SCC- mecⅣ, 1 isolate of ST25-SCCmecⅢ, 1 isolate of ST59-SCCmec Ⅰ and 1 isolate of ST88-SCCmec. Conclusion Staphylococcus aureus causing lung infections were multi-drug resistant to many kinds of antibiotics and its carrying Panton-Valentine leukocidin genes had certain ratio.