新生儿金黄色葡萄球菌分离株的分子特征

中国小儿急救医学 Pub Date : 2019-11-20 DOI:10.3760/CMA.J.ISSN.1673-4912.2019.11.003

Chen Sun, Yajuan Wang, Xin Yang, Lijuan Wang, Y. Qi, F. Dong, Wenqi Song, Ying-chao Liu, K. Yao, S. Qian

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引用次数: 0

摘要

目的探讨金黄色葡萄球菌的临床及分子特征。北京儿童医院新生儿分离的金黄色葡萄球菌。方法收集2016年2月至2017年1月北京儿童医院新生儿金黄色葡萄球菌感染的临床资料。对金黄色葡萄球菌分离株的分子生物学特性进行了检测。采用头孢西丁圆盘法和mecA基因检测，对耐甲氧西林金黄色葡萄球菌(MRSA)和敏感金黄色葡萄球菌(MSSA)进行鉴定。对MRSA分离株进行多位点序列分型(MLST)和spa分型分析，并对葡萄球菌染色体盒型(SCCmec)进行分析。PCR还检测到11个粘附基因和3个毒力基因(pvl、psma、hlα)。药敏试验采用阿格拉稀释法或e -试验法。结果共收集新生儿金黄色葡萄球菌感染57例。临床诊断最多的是肺炎38例(66.7%)，皮肤感染综合征28例(49.1%)。MRSA感染31例(54.4%)，MSSA感染26例(45.6%)。MRSA组SSTI感染比例(64.5%)和2个位点以上感染比例(61.3%，19/31)显著高于MSSA组(30.8%，8/26和23.1%，6/31)。MLST类型16种，spa类型29种，最常见的分别为ST59(40.4%)和t437(33.33%)。MRSA和MSSA最常见的克隆分别为ST59-SCCmecIVa-t437(54.8%)和ST22-t309(11.5%)。MRSA的sdrE携带率高于MSSA, sdrD和cna携带率低于MSSA (P<0.05)。其他粘附率和毒力基因携带率在两株间无显著差异。所有菌株的多药耐药率为61.4%(35/57)。除内酰胺类抗生素外，MRSA和MSSA最常见的耐药表型为ERY-CLI，分别占74.2%和26.9%。结论我院新生儿金黄色葡萄球菌感染主要类型为肺炎和SSTI。SSTI和MRSA感染的多部位感染更为常见。MRSA和MSSA分离株具有克隆传播特征。最常见的无性系是ST59-SCCmecIVa-t43和ST22-t309，两者携带毒力因子的状态无显著差异。新生儿金黄色葡萄球菌多药耐药率较高。关键词:金黄色葡萄球菌;新生儿;分子特征;毒性;抗生素耐药性

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Molecular characteristics of Staphylococcus aureus isolated from neonates

Objective To study the clinical and molecular characteristics of Staphylococcus aureus(S.aureus ) isolated from neonates of Beijng Children′s Hospital. Methods The clinical information of S. aureus infection in newborns of Beijing Children′s Hospital from February 2016 to January 2017 was collected.The molecular biological characteristics of S. aureus isolates were detected.Methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus(MSSA)were identified, using the cefoxitin disc method and the detection of the mecA gene.Multilocus sequence typing(MLST)and spa typing were analyzed using the PCR, and the staphylococcal chromosomal cassette mec(SCCmec) type was analyzed for the MRSA isolates.Eleven adhesion gene and three virulence genes(pvl, psma, hlα )were also detected by PCR.Antimicrobial susceptibility testing was performed by agra dilution method or E-test method. Results The total of 57 cases of neonatal S. aureus infection were collected during the study.The most common clinical diagnosis was 38 cases (66.7%) of pneumonia and 28 cases (49.1%) of skin infection syndrome (SSTI). There were 31 cases (54.4%) with MRSA infection and 26 cases (45.6%) with MSSA infection.The proportion of SSTI in the MRSA group (64.5%) and the infection of more than 2 sites (61.3%, 19/31) were significantly higher than those in the MSSA group (30.8%, 8/26 and 23.1%, 6/31). There were 16 MLST types and 29 spa types, the most common ones were ST59 (40.4%) and t437 (33.33%), respectively.The most common popular clones of MRSA and MSSA were ST59-SCCmecIVa-t437 (54.8%) and ST22-t309, respectively(11.5%). The sdrE carrying rate of MRSA was higher than that of MSSA, while the sdrD and cna carrying rates were lower than those of MSSA (P<0.05). The other adhesion and virulence gene carrying rates were not significantly different between the two strains.The multi-drug resistance rate of all strains was 61.4%(35/57). Except for lactam antibiotics, the most common resistant phenotypes of MRSA and MSSA were ERY-CLI, accounting for 74.2% and 26.9%, respectively. Conclusion The main types of neonatal S. aureus infection in our hospital were pneumonia and SSTI.SSTI and multi-site infections of MRSA infection are more common.MRSA and MSSA isolates have clonal dissemination characteristics.The most common clones are ST59-SCCmecIVa-t43 and ST22-t309, which show no significant differences in the status of carrying virulence factors between them.The multi-drug resistance rate of neonatal S. aureus isolates is higher. Key words: Staphylococcus aureus; Neonate; Molecular characteristics; Virulence; Antibiotic resistance

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来源期刊

中国小儿急救医学

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6226

期刊介绍： Chinese Journal of Neurology was established in 1955, the predecessor of which is Chinese Journal of Neurology and Psychiatry. Chinese Journal of Neurology and Psychiatry has been indexed by MEDLINE until 1996, when it was divided into two journals, Chinese Journal of Neurology, and Chinese Journal of Psychiatry. Chinese Journal of Neurology is now indexed by EM, SCOPUS, AJ, WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 2.755 in 2017, ranking the first among all neurological and psychological journals in China and among all the 142 medical journals published by the Chinese Medical Association. The journal is available both in print and online.