CAJ | 학술논문

目的：研究湖北省黄州区人民医院于2011—2013年分离的488株金黄色葡萄球菌的分子生物学特征及毒力基因分布情况。方法采用琼脂稀释法测定苯唑西林和头孢西丁对金黄色葡萄球菌的最小抑菌浓度（ minimum inhibitory concentration ，MIC）， PCR方法进行SCCmec分型（ staphy-lococcal cassette chromosome mec）和多位点序列分析（multilocus-sequence typing， MLST），多重PCR方法检测31个常见的毒力基因。结果488株金黄色葡萄球菌中共检出耐甲氧西林金黄色葡萄球菌（MRSA）227株，检出率为46．5％，227株MRSA 中 SCCmecⅢ型居多，占81．5％；其次为Ⅳ型，占10．1％。 MRSA菌株中，主要的克隆型为CC（clonal complex）8，占81．1％，其次为CC59和CC5，分别占4．8％和3．1％，261株甲氧西林敏感金黄色葡萄球菌（MSSA）中，主要克隆型为CC1，占34．1％，其次为CC398、CC121和CC59，分别占21．8％、14．9％和13．0％。109株MSSA（48．2％）同时携带≥15个毒力基因，明显高于MRSA菌株（28．2％，P＝0．002），肠毒素基因（sed、sej和ser）的分布与CC8和CC5密切相关，表皮剥脱素基因（ eta， etb）和lukED基因仅在CC1中检测到，与其他CCs相比，CC1和CC59克隆中pvl基因检出率更高（P＜0．05）。结论本地区MRSA的流行率为46．5％，与全国平均水平基本一致，MRSA菌株主要流行克隆为ST239-MRSA-SCCmecⅢ型，占79．3％，医疗卫生部门应采取有效措施控制MRSA的传播。 MSSA菌株毒力基因检出率明显高于MRSA，并且不同的CCs克隆呈现不同的毒力基因谱，表明毒力基因的携带与遗传背景有关。
목적：연구호북성황주구인민의원우2011—2013년분리적488주금황색포도구균적분자생물학특정급독력기인분포정황。방법채용경지희석법측정분서서림화두포서정대금황색포도구균적최소억균농도（ minimum inhibitory concentration ，MIC）， PCR방법진행SCCmec분형（ staphy-lococcal cassette chromosome mec）화다위점서렬분석（multilocus-sequence typing， MLST），다중PCR방법검측31개상견적독력기인。결과488주금황색포도구균중공검출내갑양서림금황색포도구균（MRSA）227주，검출솔위46．5％，227주MRSA 중 SCCmecⅢ형거다，점81．5％；기차위Ⅳ형，점10．1％。 MRSA균주중，주요적극륭형위CC（clonal complex）8，점81．1％，기차위CC59화CC5，분별점4．8％화3．1％，261주갑양서림민감금황색포도구균（MSSA）중，주요극륭형위CC1，점34．1％，기차위CC398、CC121화CC59，분별점21．8％、14．9％화13．0％。109주MSSA（48．2％）동시휴대≥15개독력기인，명현고우MRSA균주（28．2％，P＝0．002），장독소기인（sed、sej화ser）적분포여CC8화CC5밀절상관，표피박탈소기인（ eta， etb）화lukED기인부재CC1중검측도，여기타CCs상비，CC1화CC59극륭중pvl기인검출솔경고（P＜0．05）。결론본지구MRSA적류행솔위46．5％，여전국평균수평기본일치，MRSA균주주요류행극륭위ST239-MRSA-SCCmecⅢ형，점79．3％，의료위생부문응채취유효조시공제MRSA적전파。 MSSA균주독력기인검출솔명현고우MRSA，병차불동적CCs극륭정현불동적독력기인보，표명독력기인적휴대여유전배경유관。
Objective To investigate the molecular characteristics and virulence genes of 488 Staphylococcus aureus ( S.aureus) strains isolated from the People′s Hospital of Huangzhou District in Hubei Province during 2009 to 2013.Methods The minimum inhibitory concentrations (MICs) of Oxacillin and Cefoxitin to S.aureus were determined by agar dilution method .PCR analysis was used for the detection of staphylococcal cassette chromosome mec ( SCCmec ) and multilocus-sequence typing ( MLST ) .Multiplex PCR analysis was performed to detect the 31 common virulence genes .Results A total of 227 methicillin-resistant S.aureus ( MRSA) strains were identified from 488 S.aureus strains with a prevalence rate of 46.5%.The SCCmec Ⅲtype was the prevalent genotype accounting for 81.5% of the 227 MRSA strains, followed by Ⅳtype which accounted for 10.1%.The predominant clonal complex ( CC) of MRSA strains was CC8 accounting for 81.1%, followed by CC59 (4.8%) and CC5 (3.1%).CC1 was the predominant clonal complex of methicillin-sensitive S.aureus (MSSA) strains, accounting for 34.1% of the 261 MSSA strains, followed by CC398 (21.8%), CC121 (14.9%) and CC59 (13.0%).The number of MSSA iso-lates carrying no less than 15 test virulence genes was 109 ( 48 .2%) , which was significantly higher than that of MRSA isolates (28.2%) (P=0.002).A close relationship between the enterotoxins genes (sed, sej and ser) and the CCs of CC8 and CC5 was identified.Exfoliatin genes (eta and etb) and lukED gene were detected only in strains that belonged to CC 1.Strains that belonged to CC 1 and CC59 clones showed higher rates of pvl gene as compared with those belonging to other CCs (P<0.05).Conclusion The prevalence rate of MRSA strains was 46.5%in Huangzhou District, Hubei Province, which was consistent with the na-tional average rate .The predominant genotype of MRSA strains was ST 239-MRSA-SCCmecIII , accounting for 79.3%.Effective measures should be taken by Health sectors to control the spread of MRSA strains .The MSSA isolates carried more virulence genes than MRSA strains .The spectrums of virulence genes were var-ied in strains belong to different CCs clones , indicating the close relationship between virulence genes and genetic backgrounds .