海安地区引起皮肤软组织感染的金黄色葡萄球菌的分子特征及其耐药性分析

摘要

目的：对南通大学附属海安医院2014年引起皮肤软组织感染（SSTI）的金黄色葡萄球菌的分子特征及耐药性进行分析。方法收集2014年从南通大学附属海安医院SSTI患者病灶中分离的金黄色葡萄球菌26株，采用生化表型试验鉴定菌种，纸片扩散法检测临床分离菌株对抗菌药物的敏感性，聚合酶链反应（PCR）检测Panton-Valentine杀白细胞素基因（pvl），多重PCR进行葡萄球菌染色体mec基因盒（SCCmec）分型，PCR及序列分析进行金黄色葡萄球菌A蛋白基因（spa）检测和多位点序列分型（MLST）。结果在26株金黄色葡萄球菌中有5株为甲氧西林耐药金黄色葡萄球菌（MRSA），其中ST630-t4549-SCCmec-Ⅴ型3株、ST59-t437-SCCmec-Ⅰ型1株、ST5-t311-SCCmec-Ⅰ型1株。无万古霉素、替考拉宁、复方磺胺甲噁唑、利福平、利奈唑胺和夫西地酸耐药菌株。未检测到pvl阳性菌株。结论江苏省海安地区引起SSTI的菌株以甲氧西林敏感金黄色葡萄球菌（MSSA）为主，在SSTI患者中发现了社区相关MRSA克隆。%Objective To study the molecular characteristics and drug resistance ofStaphylococcus aureus isolated from patients with skin and soft tissue infections(SSTI) at Nantong University Haian Hospital in 2014. Methods A total of 26 isolates ofStaphylococcus aureus were collected from patients with SSTI at Nantong University Haian Hospital,and the isolates were identified by phenotypic tests. Drug susceptibility test was performed by disk diffusion method. Panton-Valentine leukocidin(pvl) gene was determined by polymerase chain reaction(PCR). Staphylococcal cassette chromosomemec(SCCmec) typing was performed by multi-PCR, andStaphylococcus protein A(spa) gene typing and multi-locus sequence typing(MLST) were performed by PCR and sequencing.ResultsA total of 5 isolates of methicillin-resistantStaphylococcus aureus(MRSA) were determined. Among them,3 isolates were ST630-t4549-SCCmec-Ⅴ,1 isolate was ST59-t437-SCCmec-Ⅰ,and 1 isolate was ST5-t311-SCCmec-Ⅰ. There was no resistant isolate to vancomycin,teicoplanin,sulfamethoxazole, rifampicin,linezolid and fusidic acid,and there was nopvl-positive isolate as well.Conclusions The main pathogen is methicillin-sensitiveStaphylococcus aureus(MSSA)in patients with SSTI in Haian area of Jiangsu province. Community-acquired MRSA clone is found in SSTI patients.