哺乳期乳腺炎的金黄色葡萄球菌毒力基因和药敏分析

Analysis of virulence geneand drug susceptibility of Staphylococcus aureus causing lactation mastitis

目的:探讨致哺乳期乳腺炎的金黄色葡萄球菌的毒力基因(杀白细胞素P V L基因)在耐甲氧西林金黄色葡萄球菌(M R S A)和甲氧西林敏感性金黄色葡萄球菌(MSSA)中的分布及其药敏结果。方法:选取2022年1月—6月江津区妇幼保健院乳腺科收治的哺乳期乳腺炎患者73例,采集脓液或者乳汁样本进行细菌培养和鉴定,并对其中分离鉴定出的金黄色葡萄球菌进行P V L基因检测和抗生素药物敏感性试验。结果:73例哺乳期乳腺炎患者中,56例患者检出致病病原体,病原体检出率为76.71%。在检出的病原体中,占比例最高的是金黄色葡萄球菌,占75.00%,其中:MRS A和MSSA分别占69.05%和30.95%,是导致哺乳期乳腺炎的最主要病原体。检出的MRSA菌株对青霉素、克林霉素、红霉素和苯唑西林的耐药性远高于MSSA,两者比较,差异有统计学意义(P<0.05);且MRSA的多重耐药率高于MSSA,差异有统计学意义(P<0.05)。从42株金黄色葡萄球菌菌株中检出24株菌株携带PVL基因,PVL基因携带率为57.14%,其中:20例属于MRSA(83.33%),4例属于MSSA(16.67%)。MRSA菌株的PVL基因携带率高于MSSA菌株,两者比较,差异有统计学意义(P<0.05)。结论:金黄色葡萄球菌是导致哺乳期乳腺炎的重要病原体,MRSA的多重耐药情况较MSSA严重,PVL基因在MRSA菌株中的携带率较高。

Objective To investigate the distribution of virulence genes(Panton-Valentine Leukocidin)of staphylococcus aureus causing lactation mastitis in methicillin-resistant staphylococcus aureus(MRSA)and methicillin-sensitive staphylococcus aureus(MSSA)and antibiotic drug susceptibility results.Methods From January 2022 to June 2022,73 patients diagnosed with lactation mastitis in the Breast Department of Maternal and Child Health Hospital of Jiangjin District were enrolled as object.Pus or milk samples were collected for bacterial culture and identification,the isolates of staphylococcus aureuswas tested for PVL gene and antibiotic susceptibility.Results Among 73 patients with lactation mastitis,56 patients were dected pathogens,the detection rate was76.71%,of which staphylococcus aureus was the most detectable pathogen,accounting for 75.00%,MRSA and MSSA accounted for 69.05%and 30.95%,respectively,which were the major pathogens of lactation mastitis.The resistance rates to penicillin,clindamycin,erythromycin and oxacillin in MRSA isolates were much higher than that in MSSA,the difference was statistically significant(P<0.05).The multi drug resistance rate of MRSA was higher than that of MSSA(P<0.05).Among 42 staphylococcus aureus isolates,24 isolates were found to carry PVL genes,the carriage of PVL gene in staphylococcus aureus was 57.14%,of which 20 cases belonged to MRSA(83.33%)and 4 cases belonged to MSSA(16.67%).MRSA carried significantly higher PVL genes than MSSA isolates,the difference was statistically significant(P<0.05).Conclusions Staphylococcus aureus is an important pathogen which can cause lactation mastitis.The multi drug resistance of MRSA is more serious than that of MSSA,MRSA carried higher PVL genes than MSSA isolates.