携带Panton-Valentine杀白细胞素基因金黄色葡萄球菌致新生儿软组织化脓性感染三例

Soft-tissue pyogenic infection in neonates caused by Staphylococcus aureus carrying Panton-Valentine leukocidin genes

目的研究引起新生儿软组织化脓性感染的病原菌。方法常规方法分离细菌，全自动微生物分析仪进行菌种鉴定和药物敏感试验，多重PCR检测Panton—Valentine杀白细胞素基因，用另一种多重PCR检测SCCmec基因型，采用多位点测序技术检测基因序列型。结果2例从软组织化脓性感染的新生儿从其脓液中分离出2株金黄色葡萄球菌，另1例从其血液和脓液中分别分离出2株金黄色葡萄球菌。4株金黄色葡萄球菌都为携带PVL基因的耐甲氧西林金黄色葡萄球菌，SCCmec基因型都为SCCmecⅢA型，序列型为ST88，4株MRSA除红霉素外，其余耐药谱相同。结论3例新生儿的软组织化脓性感染是由携带PVL杀白细胞素的MRSA同一克隆株引起，该克隆株为ST88-SCCmecⅢA—MRSA。

Objective To investigate the pathogen causing soft-tissue pyogenic infection in neonate. Methods The isolates of Staphylococcus aureus were obtained from liquor puris and blood by routine method. The Automated Microbiology Analyzer was used for identification and antimicrobial susceptibility test of the isolates. Panton-Valentine leukocidin （PVL） genes were determined by multiplex PCR in the isolates of Staphylococcus aureus. Multilocus sequence typing （MLST） was used to determine the sequence types （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 In 3 cases of neonate with softtissue pyogenic infection, 2 strains of Staphylococcus aureus isolated from liquor puris in 2 cases. 2 strains of Staphylococcus aureus were isolated from liquor puris and blood from another case. All 4 isolates were methicillin-resistant Staphylococcus aureus （MRSA） strains carrying PVL genes. Their SCCmec types were SCCmec Ⅲ A. The STs of 4 isolates were ST88. The antimicrobial-resistance profile of the isolates were the same except erythromycin. Conclusion Soft-tissue pyogenic infection in the 3 neonates was caused by the same clone of MRSA carrying PVL genes.