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从血液系统恶性肿瘤患者血培养中分离出的凝固酶阴性葡萄球菌的表型和基因型特征

Phenotypic and genotypic characterization of coagulase-negative staphylococci isolated in blood cultures from patients with haematological malignancies.

作者信息

Persson L, Strid H, Tidefelt U, Söderquist B

机构信息

Department of Infectious Diseases, Orebro University Hospital, 701 85, Orebro, Sweden.

出版信息

Eur J Clin Microbiol Infect Dis. 2006 May;25(5):299-309. doi: 10.1007/s10096-006-0129-8.

Abstract

Coagulase-negative staphylococci are the predominant aetiological agents in bacteraemic patients hospitalized for haematological malignancies. The aim of this study was to determine whether differences exist in the prevalence of icaAB genes and in the phenotypic and/or genotypic pattern between blood isolates of coagulase-negative staphylococci, interpreted as representing true bacteraemia, and contaminant isolates from patients with haematological malignancies. Eighty-two isolates representing true bacteraemia and 47 contaminant isolates were found among 76 patients. The most prevalent species in both groups of patients was Staphylococcus epidermidis (n=103; 80%). Biochemical typing using the Phene Plate system and genotyping using pulsed-field gel electrophoresis showed a tendency towards a more homogeneous pattern among isolates causing true bacteraemia compared with contaminant isolates. Two major genotypic groups of S. epidermidis were found in both the true bacteraemia group and the contaminant group, with concordant pulsotypes found as well. These groups may comprise isolates carrying specific virulence factors, but the prevalence of the icaAB genes did not differ between the true bacteraemia group and the contaminant group. No significant difference was seen between the two study groups regarding clinical symptoms or complications, use of central venous catheter, and levels of absolute neutrophil count or C-reactive protein.

摘要

凝固酶阴性葡萄球菌是因血液系统恶性肿瘤住院的菌血症患者的主要病原体。本研究的目的是确定在凝固酶阴性葡萄球菌的血液分离株(被视为代表真正的菌血症)与血液系统恶性肿瘤患者的污染分离株之间,icaAB基因的流行率以及表型和/或基因型模式是否存在差异。在76例患者中发现了82株代表真正菌血症的分离株和47株污染分离株。两组患者中最常见的菌种是表皮葡萄球菌(n = 103;80%)。使用Phene Plate系统进行生化分型以及使用脉冲场凝胶电泳进行基因分型显示,与污染分离株相比,导致真正菌血症的分离株之间的模式更趋于一致。在真正菌血症组和污染组中均发现了两个主要的表皮葡萄球菌基因型组,并且也发现了一致的脉冲型。这些组可能包含携带特定毒力因子的分离株,但真正菌血症组和污染组之间icaAB基因的流行率没有差异。在临床症状或并发症、中心静脉导管的使用以及绝对中性粒细胞计数或C反应蛋白水平方面,两个研究组之间没有观察到显著差异。

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