金黄色葡萄球菌感染的临床特征及毒力基因分布
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包头医学院第一附属医院检验科, 内蒙古 包头 014010

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通讯作者:

胡同平  E-mail: hutongping1976@126.com

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基金项目:

内蒙古自治区自然科学基金[2016MS(LH)0824];包头市医药卫生科技计划项目(wsjj2013080);包头医学院科学研究基金项目-扬帆计划(BYJJ-YF-201691)


Clinical characteristics and distribution of virulence genes of Staphyloco-ccus aureus infection
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Department of Laboratory Medicine, The First Affiliated Hospital of Baotou Medical College, Baotou 014010, China

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    摘要:

    目的 研究不同感染类型的金黄色葡萄球菌(SA)临床特征及毒力基因分布情况。 方法 收集2018年1月-2020年12月包头市参加全国细菌耐药监测网11所成员医院临床分离的SA。回顾性分析纳入菌株的患者病历资料, 分析其感染临床特征及耐药性。将菌株进行分层抽样, 从中抽取样本作为试验菌株进行毒力基因检测。采用WHONET 5.6及SPSS 22.0软件进行数据分析。 结果 共收集SA 2 452株。其中外科感染932例, 呼吸道感染504例, 血流感染172例, 其他类型感染844例。SA感染患者以男性为主(68.23%)。不同性别、年龄SA感染患者的感染类型分布情况比较, 差异均有统计学意义(均P < 0.001)。外科感染、呼吸道感染、血流感染主要以 < 60岁患者为主。外科感染患者住院时间>2周的比率较高, 占39.21%。呼吸道感染SA患者的病死率较高, 为76.39%。不同感染类型患者的白细胞数、中性粒细胞、中性粒细胞百分比、血小板计数、凝血酶原时间水平比较, 差异均有统计学意义(均P < 0.05)。不同感染类型患者的C反应蛋白、降钙素原、白细胞介素-6、D-二聚体、纤维蛋白原降解产物水平比较, 差异均有统计学意义(均P < 0.05)。不同感染类型MRSA对环丙沙星、庆大霉素、左氧氟沙星、莫西沙星的耐药率比较, 差异均有统计学意义(均P < 0.05)。clfaclfbscncoanuchlahld基因在不同感染类型中均具有较高的携带率(>94%), LukED在外科感染中所占比率高于其他3种感染类型, 差异有统计学意义(P < 0.05)。 结论 临床分离的SA携带较多毒力基因, 毒性较强, 且不同感染类型SA耐药性存在差异。

    Abstract:

    Objective To study the clinical characteristics and virulence gene distribution of Staphylococcus aureus (SA) of different infection types. Methods SA isolated from 11 member hospitals in Baotou which participates the national bacterial resistance monitoring network from January 2018 to December 2020 were collected. Medical records of patients with included strains were analyzed retrospectively, clinical characteristics of infection and antimicrobial resistance were analyzed. The strains were conducted stratified sampling, samples were taken as the tested strains for virulence gene detection. WHONET 5.6 and SPSS 22.0 software were used for data analysis. Results A total of 2 452 SA strains were collected. There were 932 cases of surgical infection, 504 cases of respiratory tract infection, 172 cases of blood stream infection and 844 cases of other types of infection. Patients with SA infection were mainly females (68.23%). There were significant differences in the distribution of infection types among SA infected patients of different gender and age (all P < 0.001). Surgical infection, respiratory tract infection and blood stream infection mainly occurred in patients < 60 years old. Patients with surgical infection had a higher proportion of hospitalization time >2 weeks, accounting for 39.21%. The mortality of patients with SA respiratory tract infection was 76.39%. The levels of white blood cell count, neutrophil count, percentage of neutrophils, platelet count, and prothrombin time in patients with different types of infection were all significantly different (all P < 0.05). There were significant differences in the levels of C-reactive protein, procalcitonin, interleukin-6, D-dimer, and fibrinogen degradation products of patients with different infection types (all P < 0.05). Antimicrobial resis-tance rates of MRSA causing different types of infection to ciprofloxacin, gentamicin, levofloxacin and moxifloxacin were significant (all P < 0.05). Carrying rate of clfa, clfb, scn, coa, nuc, hla, hld were all high in different types of infection (>94), proportion of LukED in surgical infection was higher than that of the other three types of infection, difference was significant (P < 0.05). Conclusion Clinically isolated SA carries more virulence genes and has high toxicity, and there are differences in antimicrobial resistance among different types of SA infection.

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李静,胡同平,张文兰,等.金黄色葡萄球菌感染的临床特征及毒力基因分布[J]. 中国感染控制杂志,2022,(3):224-231. DOI:10.12138/j. issn.1671-9638.20222067.
Jing LI, Tong-ping HU, Wen-lan ZHANG, et al. Clinical characteristics and distribution of virulence genes of Staphyloco-ccus aureus infection[J]. Chin J Infect Control, 2022,(3):224-231. DOI:10.12138/j. issn.1671-9638.20222067.

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  • 收稿日期:2021-12-01
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  • 在线发布日期: 2024-04-28
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