| 创伤患者医院内感染耐甲氧西林金黄色葡萄球菌毒力基因分析 |
| 投稿时间：2015-04-10 修订日期：2015-04-23 点此下载全文 |
| 引用本文：黄支密,糜家睿,罗雪平,盛以泉,杨伟平,夏守慧,沈娟,周芸.创伤患者医院内感染耐甲氧西林金黄色葡萄球菌毒力基因分析[J].医学研究杂志,2016,45(2):108-112 |
| DOI：
10.11969/j.issn.1673-548X.2016.02.028 |
| 摘要点击次数: 2263 |
| 全文下载次数: 1307 |
|
|
| 中文摘要:目的 了解某医院临床分离的创伤患者医院内感染耐甲氧西林金黄色葡萄球菌(MRSA)毒力基因分布状况。方法 在2004年3月~2005年6月间从住院的创伤患者中分离48株MRSA,采用PCR法检测金黄色葡萄球菌看家基因spa进行菌株分子鉴定、检测甲氧西林耐药决定基因mecA确认为MRSA、检测SCCmec(Ⅰ、Ⅱ、Ⅲ、Ⅳa、Ⅳb、Ⅳc、Ⅳd、Ⅴ)进行菌株基因分型均为Ⅲ型。采用PCR及序列分析的方法分析7类共43种毒力基因即1种金黄色葡萄球菌蛋白A编码基因(spa)、2种荚膜抗原(血清型)编码基因(cap5、cap8)、4种调节基因(agr1、agr2、agr3、agr4)、16种黏附毒素编码基因(sasX、fnbA、clfA、clfB、icaA、cna、bbp、ebpS、sdrC、sdrD、sdrE、map、efb/fib、isdA、isdB、isdC)、10种细胞毒素编码基因(pvl、lukE、lukM、psm-mec、psm-α、hla、hlb、hld、hlg、hlg-2)、9种胞外酶编码基因(ssp、splB、edinA、edinB、edinC、sak、nuc、hysA、lip)和1种中毒性休克毒素编码基因(tst)。结果 在48株中,除了tst基因未检出外,其他6类基因均有检出,阳性率在75.0%~100.0%。共有28种毒力基因呈阳性,其中24种基因spa、cap8、agr1、fnbA、clfA、clfB、icaA、can、sdrC、sdrD、sdrE、efb/fib、isdA、isdB、isdC、lukE、hld、hlg-2、ssp、splB、sak、nuc、hysA和lip阳性率均为100%,4种基因sasX、pvl、psm-mec和hla阳性株数(阳性率)分别为47株(97.92%)、36株(75.00%)、46株(95.83%)、46株(95.83%);其余15种基因均阴性。毒力基因检测结果可分为5种阳性模式。结论 对创伤患者医院内感染MRSA同时检测43种毒力基因为国内首次报道。毒力基因在本组菌株中广泛存在,并且是产生致病性的重要原因。 |
| 中文关键词:创伤 患者 医院内感染 耐甲氧西林金黄色葡萄球菌 毒力基因 |
| |
|
|
|
| Abstract:Objective To investigate the prevalenece of virulence genes in methicillin-resistant Staphylococcus aureus(MRSA) isolated from the trauma patients under nosocomial infection in the study hospital. Methods Forty eight strains of MRSA causing wound infection were isolated from the inpatients of trauma between Mar 2004 and Jun 2005. By PCR, housekeeping gene spa of Staphylococcus aureus were detected for molecular identification, methicillin resistant gene mecA were recognized as MRSA, and typing of SCCmec(Ⅰ, Ⅱ, Ⅲ, Ⅳa, Ⅳb, Ⅳc, Ⅳd, Ⅴ) genes all reported SCCmecⅢ. 7 classes(43 kinds) of virulence genes were analyzed by PCR and verified by DNA sequencing:Staphylococal Protein A(spa), 2 kinds of capsular antigens(cap5, cap8), 4 of accessory gene regulator(agr1, agr2, agr3, agr4), 16 of adhesins(sasX, fnbA, clfA, clfB, icaA, can, bbp, ebpS, sdrC, sdrD, sdrE, map, efb/fib, isdA, isdB, isdC), 10 of cytotoxins(pvl, lukE, lukM, psm-mec, psm-α, hla, hlb, hld, hlg, hlg-2), 9 of proteases(ssp, splB, edinA, edinB, edinC, sak, nuc, hysA, lip) and 1 of toxic shock syndrome toxin(tst). Results In 48 strains, 6 classes of virulence genes, Staphylococal protein A, capsular antigens, accessory gene regulator, adhesins, cytotoxins and proteases were positive, and the positive rates were 75.0%-100.0%, while tst gene was not detected. 28 of 43 kinds of virulence genes were positive. For 24 kinds of genes(spa, cap8, agr1, fnbA, clfA, clfB, icaA, can, sdrC, sdrD, sdrE, efb/fib, isdA, isdB, isdC, lukE, hld, hlg-2, ssp, splB, sak, nuc, hysA and lip), the positive rates were all 100%. For sasX, pvl, psm-mec and hla, the positive rates were 97.92%(47/48), 75.00%(36/48), 95.83%(46/48) and 95.83%(46/48), respectively. The rest 15 kinds of genes were all negative.48 strains of MRSA virulence gene detecting results can be divided into 5 positive modes. Conclusion It's the first report in China that 43 kinds of virulence genes in MRSA isolated from the trauma patients under nosocomial infection were analyzed. Virulence genes are prevalent in this group of MRSA isolates, and played a key part in pathogenicity. |
| keywords:Trauma Patients Nosocomial infection Methicillin-resistant Staphylococcus aureus Virulence genes |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
