金黄色葡萄球菌pvl基因检测与分布研究

Detection and distribution of pvl gene in Staphylococcus aureus

  • 摘要: 目的 探讨临床分离的金黄色葡萄球菌杀白细胞毒素(PVL)基因携带及各种类型菌株的分布情况,为医院感染管理及监测提供病原学依据。方法 对2017年1月-2017年12月汉川市人民医院的193株金黄色葡萄球菌临床标本进行头孢西丁纸片法、聚合酶链式反应(PCR)扩增法mecApvl基因检测。依照美国临床与实验室标准协会(CLSI)2017版的推荐标准进行结果判读。结果 193株金黄色葡萄球菌菌株中分离出耐甲氧西林金黄色葡萄球菌(MRSA)62株,占32.1%;pvl基因检测阳性菌株29株,占15.0%,其中MSSA 21株占16.0%,MRSA 8株占12.9%,检验结果显示差异无统计学意义(χ2=0.332,P=0.570);pvl阳性MRSA中CA-MRSA 6株,HA-MRSA 2株,分别占37.5%、4.3%,检验结果显示差异有统计学意义(χ2=11.609,P=0.001)。结论 金黄色葡萄球菌pvl基因检测对于临床治疗及预后判断有积极的作用,对携带pvl基因菌株数量及分布情况的监测是针对金黄色葡萄球菌实施精准化感控的必要手段。

     

    Abstract: OBJECTIVE To investigate the distribution of leucocytic toxin gene(PVL) in various strains of Staphylococcus aureus isolated from clinical specimens, so as to provide the etiological basis for nosocomial infection management and monitoring. METHODS The cefoxitin disk method and polymerase chain reaction(PCR) method were used to detect mecA and pvl genes in the 193 strains of S aureus from clinical specimens in Hanchuan People's Hospital from Jan. 2017 to Dec. 2017.The results were interpreted according to the recommended criteria of CLSI (2017 version). RESULTS From the 193 strains of S aureus, 62 strains of methicillin-resistant S aureus (MRSA) were isolated, accounting for 32.1%. There were 29 pvl-positive strains, accounting for 15%, of which 21 were MSSA, accounting for 16% (21/131) of all MSSA strains, and the other 8 strains were MRSA, accounting for 12.9% (8/62) of all MRSA strains. The chi square test results showed that the difference was not significant (χ2=0.332,P=0.570). There were 6 strains of CA-MRSA and 2 strains of HA-MRSA in pvl-positive MRSA, accounting for 37.5% and 4.3%, and the difference was significant (χ2=11.609,P=0.001). CONCLUSION The detection of pvl gene in S aureus has a positive effect on clinical treatment and prognosis. The monitoring of the number and distribution of pvl gene is a necessary means for precise control of S aureus.

     

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