社区与医院获得性感染金黄色葡萄球菌毒力因子对比分析

Comparative analysis of virulence factor of Staphylococcus aureus in community-and hospital-acquired infection

目的了解社区与医院获得性感染金黄色葡萄球菌的毒力因子PVL和TSST-1的携带情况。方法收集社区和医院获得性感染金黄色葡萄球菌菌株184株和262株,PCR检测毒力因子基因pvl和tst,统计分析检出率的差异。结果pvl在社区感染菌株中的检出率(11.96%)高于医院感染(0.76%),在MSSA中的检出率(7.50%)高于MRSA(2.91%);与pvl相反,tst在社区感染菌株的检出率(6.52%)低于医院感染(17.56%),在MSSA中的检出率(5.83%)低于MRSA(21.36%)。对不同感染部位菌株pvl和tst检出率进行两两比较后发现,社区皮肤/软组织感染菌株pvl的检出率最高,而医院感染菌血症菌株中tst的检出率最高。结论 PVL和TSST-1作为金黄色葡萄球菌的2种重要毒素,与感染部位、社区/医院获得性、细菌耐药性、疾病的严重性及转归都可能存在密切关系。

Objective To study the virulence factor of Staphylococcus aureus,PVL and TSST-1,in community-and hospital-acquired infection. Methods 184 community-acquired and 262 hospital-acquired Staphylococcus aureus isolates were collected. The virulence genes,pvl and tst genes were tested by PCR,and the positive rates were analyzed by statistics. Results For pvl,the positive rate of community-acquired isolates（ 11. 96%） was much higher than that of hospital-acquired isolates（0. 76%）. And the pvl positive rate of MSSA isolates（7. 50%） was higher than that of MRSA isolates（2. 91%）. In contrast,for tst,the positive rate of community-acquired isolates（ 6. 52%） was lower than that of hospital-acquired isolates（17. 56%）. And the tst positive rate of MSSA isolates（5. 83%） was lower than that of MRSA isolates（21. 36%）. The positive rates from different infection sites were compared by statistics. The results showed that the pvl positive rate of iolates from skin / soft tissues was highest. And for tst,the positive rate of hospital-acquired bacteremia isolates was highest. Conclusion PVL and TSST-1,as the main two virulence factors of Staphylococcus aureus,might be closely relative with infection sites,community-or hospital-acquired,bacterial resistance,disease severity and outcome.