慢性鼻-鼻窦炎患者鼻腔分泌物金黄色葡萄球菌分离株耐药性及毒力基因

Drug resistance and virulence genes in Staphylococcus aureus strains isolated from nasal secretions of patients with chronic rhinosinusitis

目的 探究慢性鼻-鼻窦炎(CRS)患者鼻腔分泌物分离金黄色葡萄球菌的耐药特点及毒力基因。方法 收集2020年8月-2021年8月上海市第六人民医院南院诊治的104例CRS患者鼻拭子分离的金黄色葡萄球菌55株,分析其对常用抗菌药物的耐药率,多位点序列分型(MLST)及其毒力基因。结果 55株金黄色葡萄球菌检出耐甲氧西林金黄色葡萄球菌(MRSA)16株占29.09%,检出甲氧西林敏感金黄色葡萄球菌(MSSA)39株占70.91%;MRSA菌株对红霉素、利福平、环丙沙星、庆大霉素、左氧氟沙星、四环素、莫西沙星的耐药率显著高于MSSA菌株(P<0.05);55株金黄色葡萄球菌有46株成功进行分型,其中MRSA检出8种ST型,以ST59为主,MSSA检出12种ST型,以ST6、ST72为主;MRSA菌株毒力基因seb、tsst-1、hlα、hlbβ、sdrC、sdrD、sdrE检出率显著高于MSSA菌株(P<0.05)。结论 CRS患者鼻腔分泌物分离金黄色葡萄球菌对利奈唑胺、呋喃妥因、替加环素、替考拉宁、万古霉素敏感,其中MRSA主要流行型别为ST59,hlα、fnbpA、clfA、sdrC、hlbβ毒力基因检出率较高,MSSA主要流行型别为ST6、ST72,fnbpA、clfA、fnbpB毒力基因检出率较高。

OBJECTIVE To explore the drug resistance and virulence genes in Staphylococcus aureus strains isolated from nasal secretions of patients with chronic rhinosinusitis(CRS). METHODS Totally 55 strains of S. aureus were isolated form nasal swab specimens of 104 CRS patients who were treated in South Hospital of Shanghai Sixth People′s Hospital from Aug 2020 to Aug 2021, the drug resistance rates to commonly used antibiotics were analyzed, and the virulence genes were observed by means of multilocus sequence typing(MLST). RESULTS Among the 55 strains of S. aureus, methicillin-resistant S. aureus(MRSA)(16 strains) accounted for 29. 09%, and methicillin-sensitive S. aureus(MSSA)(39 strains) accounted for 70.91%. The drug resistance rates of the MRSA strains to erythromycin, rifampicin, ciprofloxacin, gentamicin, levofloxacin, tetracycline and moxifloxacin were significantly higher than those of the MSSA strains(P<0.05). Totally 46 of 55 S. aureus strains were successfully typed, 8 ST types were detected among the MRSA strains, and ST59 was dominant;12 ST types were identified among the MSSA strains, ST6 and ST72 were dominant. The detection rates of virulence genes seb, tsst-1, hlα, hlbβ, sdrC, sdrD and sdrE of the MRSA strains were significantly higher than those of the MSSA strains(P<0.05). CONCLUSION The S. aureus strains isolated from nasal secretions of the CRS patients are sensitive to linezolid, nitrofurantoin, tigecycline, teicoplanin and vancomycin;ST59 is dominant among the MRSA strains, the detection rates of virulence genes hlα, fnbpA, clfA, sdrC and hlbβ are high;ST6 and ST72 are dominant among the MSSA strains, and the virulence genes fnbpA, clfA and fnbpB are high.