某院ICU医院获得性肺炎患者痰分离MRSA耐药基因和pvl基因携带情况

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英文篇名：Carrying status of resistances genes and pvl gene in MRSA isolated from sputum of patients with healthcare-associated pneumonia in ICU of a hospital 作者：夏雯 ; 吴亮 ; 阴晴 ; 戴晓玥 ; 邹治情 ; 吴瑶 ; 周亚玲 ; 何蕾 英文作者：XIA Wen;WU Liang;YIN Qing;DAI Xiao-yue;ZOU Zhi-qing;WU Yao;ZHOU Ya-ling;HE Lei;School of Medicine,Jiangsu University;Department of Clinical Laboratory,Affiliated Hospital of Jiangsu University; 关键词：金黄色葡萄球菌 ; 耐药基因 ; 医院获得性肺炎 ; pvl基因 ; SCCmec分型 英文关键词：Staphylococcus aureus;;drug resistance gene;;healthcare-associated pneumonia;;pvl;;SCCmec typing 中文刊名：GRKZ 英文刊名：Chinese Journal of Infection Control 机构：江苏大学医学院;江苏大学附属医院检验科; 出版日期：2019-06-26 出版单位：中国感染控制杂志 年：2019 期：v.18 基金：镇江市2017年度科技创新资金(重点研发计划—社会发展项目)(SH2017024);; 江苏省2018年度预防医学科研课题(Y2018108) 语种：中文; 页：GRKZ201906010 页数：6 CN：06 ISSN：43-1390/R 分类号：71-76

摘要

目的了解医院获得性肺炎患者痰中耐甲氧西林金黄色葡萄球菌(MRSA)耐药基因和毒力因子pvl基因携带情况。方法对来源于某院重症监护病房(ICU)医院获得性肺炎患者痰中的46株MRSA,采用聚合酶链反应(PCR)检测细菌耐药基因(mecA、aacA-D、tetK、tet M、msrA、msrB、ermA、ermC、vatA、vatB、vatC、femB和linA)和毒力因子pvl基因,并以PCR法分析MRSA菌株SCCmec型别。结果 46株MRSA中,耐药基因mecA、aacA-D、tetK、msrA、ermA、ermC、femB和linA的检出率分别为100%、54.35%、36.96%、13.04%、36.96%、52.17%、71.74%和10.87%,所有菌株均未检出tet M、msrB、vatA、vatB和vatC基因;毒力基因pvl携带率为65.22%。46株MRSA共检出4种SCCmec基因型,其中SCCmecⅡ型、Ⅲ型、IVc型、V型分别为26.09%、52.17%、2.17%和2.17%。结论医院获得性肺炎患者痰中MRSA携带多种耐药基因,且毒力基因pvl携带率较高,SCCmec基因型以Ⅲ型为主,临床医务人员对此情况应高度重视。
        Objective To investigate the carrying status of methicillin-resistant Staphylococcus aureus(MRSA resistance genes and virulence factor pvl gene in sputum of patients with healthcare-associated pneumonia(HAP).Methods Forty-six strains of MRSA from sputum of patients with HAP in an intensive care unit(ICU)of a hospital were detected resistance genes(mecA,aacA-D,tetK,tet M,msrA,msrB,ermA,ermC,vatA,vatB,vatC,femB and linA)and virulence factor pvl gene by polymerase chain reaction(PCR),SCCmec genotypes of MRSA strains were analyzed by PCR.Results Among 46 MRSA strains,detection rates of resistance genes mecA,aacA-D,tetK,msrA,ermA,ermC,femB,and linA were 100%,54.35%,36.96%,13.04%,36.96%,52.17%,71.74%,and 10.87%respectively.None of strains were detected tet M,msrB,vatA,vatB,and vatC genes;virulence factor pvl gene carrying rate was 65.22%.Four genotypes of SCCmec were detected among 46 MRSA strains,26.09%,52.17%,2.17%,and 2.17% of which were SCCmecⅡ,Ⅲ,IVc,and V respectively.Conclusion MRSA carries multiple drug resistance genes in sputum of patients with HAP,virulence gene pvl is high,SCCmec genotype is mainly typeⅢ,health care workers should pay highly attention.

引文

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