致皮肤软组织感染社区获得性金黄色葡萄球菌的分子生物特征分析
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Biological characteristics of community-acquired staphylococcus aureus in patients with skin soft-tissue infections
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    摘要:

    目的 了解解放军总医院第一附属医院致皮肤软组织感染社区获得性金黄色葡萄球菌(CA-SA)的流行情况、耐药特点、毒力和致病因素信息。方法 收集2009年1月至2010年8月皮肤科、门诊、急诊55例患者化脓性皮肤软组织感染检测标本,进行细菌鉴定和药敏试验,采用多位点序列分型(MLST)、金黄色葡萄球菌A蛋白(SPA)分型和毒素基因检测筛查。结果 55例中分离到社区获得性甲氧西林敏感的金黄色葡萄球菌(CA-MSSA)12株;药敏结果显示CA-MSSA除对红霉素、克林霉素、四环素、庆大霉素和左氧氟沙星耐药性较高(8.3%~50.0%),对其他抗菌药物均敏感。毒素基因检测显示杀白细胞素(pvl)、肠毒素C(sec)和毒性休克综合征毒素-1(tsst-1)在CA-MSSA中的阳性率分别为33.3%,25.0%和8.3%,未检测到葡萄球菌肠毒素H(seh)和葡萄球菌表皮剥脱毒素(et);结合MLST和SPA分型,发现CA-MSSA中的克隆有ST5-t002(2株)、ST22-t309(2株)及ST398-t034、ST15-t5864、ST7-t091、ST25-t078、ST30-t318、ST121-t1425、ST800-t1425、ST630-t377各1株。结论 我院致皮肤软组织感染CA-MSSA菌株对抗菌药物的敏感性较高,分子分型具有多样性,携带多种毒素。

    Abstract:

    Objective To investigate the prevalence, antibiotic resistance, virulence and pathogenicity of community-acquired Staphylococcus aureus (CA-SA) in the patients with skin soft-tissue infections. Methods Clinical specimen of the 55 patients with skin soft-tissue infections admitted in Department of Dermatology, Outpatient Department and Emergency Department in our hospital between January 2009 and August 2010 were collected. The isolates of SA strains were collected from the patients for bacterial identification and antibiotic susceptibility. Multilocus-sequence typing (MLST), staphylococcal protein A (SPA) typing and toxin gene screening were also performed. ResultsOf the 55 isolates, 12 strains of community-acquired methicillin-sensitive SA (CA-MSSA) were isolated. The CA-MSSA strains had comparatively high resistance rates (8.3%-50.0%) to erythromycin, tetracycline, clindamycin, gentamicin and levofloxacin, but were sensitive to other antibiotics. Their toxin positive rates were 33.3%, 25.0% and 8.3%, respectively to Panton-Valentine leukocidin (pvl), staphylococcal entotoxin C (sec) and toxic shock syndrome toxin-1 (tsst-1), but were none to staphylococcal entotoxin H (seh) and staphylococcal exfoliative toxin (et). The MLST and SPA typing results showed that there were 2 isolates of ST5-t002, 2 isolates of ST22-t309, and 1 isolate respectively of ST398-t034, ST15-t5864, ST7-t091, ST25-t078, ST30-t318, ST121-t1425, ST800-t1425 and ST630-t377. Conclusion The CA-MSSA isolates derived from the patients with skin soft-tissue infections of our hospital have high antibiotic sensitive rates, diversity of molecular types and multiple toxins.

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蒋 伟*,张 康,李少增.致皮肤软组织感染社区获得性金黄色葡萄球菌的分子生物特征分析[J].中华老年多器官疾病杂志,2016,15(09):669~673

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  • 收稿日期:2016-05-20
  • 最后修改日期:2016-06-13
  • 录用日期:2016-06-13
  • 在线发布日期: 2016-09-28
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