CAJ | 학술논문

目的研究我国异质性万古霉素中介的金黄色葡萄球菌(hVISA)的分子特征,比较hVISA和万古霉素敏感的金黄色葡萄球菌(VSSA)在分子特征方面的差别.方法收集2007年来自全国14个城市分离的非重复甲氧西林耐药金黄色葡萄球菌(MRSA)315株,采用PAP-AUC(菌群谱型分析-曲线下面积法)确定hVISA.通过多重PCR对315株MRSA进行SCCmec分型及agr (accessory gene regulator)分型,对PCR产物进行测序确定spa分型,同时检测pvl基因.结果在315株MRSA中共检测出30株hVISA,发生率为9.5%.315株MRSA以SCCmec Ⅲ为主,占74.3%,其次为SCCmec Ⅱ,占17.8%.在hVISA中SCCmec Ⅱ的比例明显高于VSSA组(46.7%比14.7%,X~2=18.93,P＜0.001).所有MRSA的agr分型以agr 1为主,占73.6%,其次为agr 2,占18.7%,agr3和agr 4型MRSA在临床分离株中少见.agr分型在hVISA和VSSA之间有明显的不同,hVISA中agr 2的比例显著高于VSSA(53.4%比15.1%,X~2=26.08,P＜0.001).30株hVISA中有4种spa克隆型,包括t002(13株)、t037(9株)、t030(6株)和1548(2株).315株MRSA中pvl基因的携带率非常低,占1.6%.结论 hVISA的发生率较高.与VSSA相比,hVISA主要以agr 2型为主,与VSSA明显不同.通过spa分型发现hVISA呈多克隆型.
목적 연구아국이질성만고매소중개적금황색포도구균(hVISA)적분자특정,비교hVISA화만고매소민감적금황색포도구균(VSSA)재분자특정방면적차별.방법 수집2007년래자전국14개성시분리적비중복갑양서림내약금황색포도구균(MRSA)315주,채용PAP-AUC(균군보형분석-곡선하면적법)학정hVISA.통과다중PCR대315주MRSA진행SCCmec분형급agr (accessory gene regulator)분형,대PCR산물진행측서학정spa분형,동시검측pvl기인.결과 재315주MRSA중공검측출30주hVISA,발생솔위9.5%.315주MRSA이SCCmec Ⅲ위주,점74.3%,기차위SCCmec Ⅱ,점17.8%.재hVISA중SCCmec Ⅱ적비례명현고우VSSA조(46.7%비14.7%,X~2=18.93,P＜0.001).소유MRSA적agr분형이agr 1위주,점73.6%,기차위agr 2,점18.7%,agr3화agr 4형MRSA재림상분리주중소견.agr분형재hVISA화VSSA지간유명현적불동,hVISA중agr 2적비례현저고우VSSA(53.4%비15.1%,X~2=26.08,P＜0.001).30주hVISA중유4충spa극륭형,포괄t002(13주)、t037(9주)、t030(6주)화1548(2주).315주MRSA중pvl기인적휴대솔비상저,점1.6%.결론 hVISA적발생솔교고.여VSSA상비,hVISA주요이agr 2형위주,여VSSA명현불동.통과spa분형발현hVISA정다극륭형.
Obiective To investigate the molecular characteristics of heteroresistant vancomycinintermediate Staphylococcus aureus(hVISA)in China and analyze the differences of the molecular characteristics between hVISA and VSSA(vancomycin-susceptible Staphylococcus aureus)isolates.Methods A total of 3 15 non-repetitive MBSA were collected from the national surveillance program in China in 2007.The isolates of hVISA were confirmed by modified population analysis profile-area under the curve(PAP-AUC).The genotypes of agr and SCCmec were determined by multiplex PCR,and spa typing was performed bv PCR and DNA sequencing.The pvl gene was detected bv PCR Results The prevalence of hVISA was 9.5%(30/315).Among 315 MRSA,SCCmec Ⅲ was the most popular type,which was found in 234 isolates(234/315,74.3%),followed by SCCmec Ⅱ,which was identified in 56 isolates (56/315,17.8%).The rate of SCCmec Ⅱ in hVISA(46.7%)was significantly hisher than in VSSA (14.7%,X~2=18.93,P＜0.001).The most prevalent agr type among 315 MRSA was agr 1 accounting for 73.6%(232/315).The agr 2 accounted for 18.7%(59/315),and agr 3 and agr 4 were very rare in clinical isolates.It was different in agr types between the two groups.The rate of agr 2 in hVISA(53.4%)was higher than in VSSA(15.1%).X~2 value was 26.08 and P value was less than 0.001 through X~2 test.There was a statistical significance in the result.There were 4 spa types in hVISA isolates,including t002 (13 isolates),t037(9 isolates),t030(6 isolates),and 1548(2 isolates).The pvl positive MRSA isolates were very low,accounting for 1.6%(5/315).Conclusions The prevalence of hVISA was relatively higher in China.Compared to VSSA,the majority(53.4%)of the hVISA strains were agr 2,which was obviously different from VSSA.hVISA isolates were more diverse by spa typing,