鄂西北地区金黄色葡萄球菌临床分离株耐药及毒力基因分析

Analysis of drug resistance and virulence genes of clinical isolates of Staphylococcus aureus in Northwest Hubei Province

目的了解鄂西北地区医院临床标本中分离的金黄色葡萄球菌的耐药及毒力基因的携带情况。方法收集2019-2021年十堰市5家医院临床分离的金黄色葡萄球菌142株,采用微量肉汤稀释法检测耐药性,采用PCR法检测sea等9种肠毒素基因及mecA、杀白细胞素(PVL)毒力基因。结果142株金黄色葡萄球菌中检出44株耐甲氧西林金黄色葡萄球菌(MRSA),检出率为30.99%(44/142)。MRSA对红霉素、克林霉素、左氧氟沙星、四环素、庆大霉素的耐药率均高于甲氧西林敏感金黄色葡萄球菌(MSSA),差异均有统计学意义(P<0.05)。肠毒素基因检出率为70.42%(100/142),其中经典肠毒素基因(sea~see)和新型肠毒素基因(seg~sej)检出率分别为47.18%(67/142)、42.25%(60/142);PVL毒力基因检出率为13.38%(19/142),其中MSSA和MRSA的检出率分别为9.18%(9/98)和22.73%(10/44),差异有统计学意义(P<0.05)。结论临床分离的金黄色葡萄球菌肠毒素及PVL基因检出率较高,在临床诊疗中应做好医院感染控制,及时采取有效的隔离措施并适时加强对PVL基因的监测。

Objective To investigate the drug resistance and virulence genes of Staphylococcus aureus isolated from clinical specimens of hospitals in northwest Hubei province.Methods A total of 142 clinical isolates of Staphylococcus aureus were collected from 5 hospitals in Shiyan City from 2019 to 2021.Broth microdilution method was used to detect drug resistance,and PCR method was used to detect 9 enterotoxin genes such as sea,mecA and Panton-Valentine leukocidein(PVL)virulence genes.Results A total of 44 methicillinresistant Staphylococcus aureus(MRSA)strains were detected in 142 strains of Staphylococcus aureus,and the detection rate was 30.99%(44/142).The resistance rates of MRSA to erythromycin,clindamycin,levofloxacin,tetracycline and gentamicin were higher than those of methicillin-sensitive Staphylococcus aureus(MSSA),and the differences were statistically significant(P<0.05).The detection rate of enterotoxin genes was 70.42%(100/142),among which the detection rates of classic enterotoxin genes(sea-see)and new enterotoxin genes(seg-sej)were 47.18%(67/142)and 42.25%(60/142),respectively.The detection rate of PVL virulence genes was 13.38%(19/142),among which the detection rates of MSSA and MRSA were 9.18%(9/98)and 22.73%(10/44),respectively,and the difference was statistically significant(P<0.05).Conclusion The detection rate of enterotoxin and PVL gene of Staphylococcus aureus isolated from clinical isolates is high.In clinical diagnosis and treatment,it is necessary to control hospital infection,take effective isolation measures in time and strengthen the monitoring of PVL gene.