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[医院内耐甲氧西林金黄色葡萄球菌菌株的克隆性及杀白细胞素毒素研究]

[Investigation of the clonality and Panton-Valentine leukocidin toxin among nosocomial methicillin-resistant Staphylococcus aureus strains].

作者信息

Kirdar Sevin, Arslan Uğur, Tuncer Inci, Findik Duygu, Bozdoğan Bülent

机构信息

Adnan Menderes Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Aydin.

出版信息

Mikrobiyol Bul. 2009 Oct;43(4):529-33.

Abstract

Methicillin-resistant Stapyhlococcus aureus (MRSA) is one of the major causes of morbidity and mortality in hospitalized patients. This study was aimed to investigate the clonality of the MRSA strains isolated from patients with nosocomial infection and also to determine the presence of Panton-Valentine leukocidin (PVL) toxin in these isolates. A total of 37 samples (31 isolated from surgical wound samples, 2 them from abscess and 4 from drainage samples) obtained from patients hospitalized at surgery, internal medicine and intensive care units, were included to the study. The clonality among MRSA strains was demonstrated by pulsed-field gel electrophoresis (PFGE) and the presence of PVL by polymerase chain reaction using luk-PV-1 and luk-PV-2 primers. PFGE revealed that 31 of 37 strains were A pulsotype and subtypes, 3 strains were B pulsotype and the last 3 were C pulsotype. Pulsotype A has been isolated especially from cardiovascular surgery and other surgery departments and intensive care units, pulsotype B from orthopedic and pulsotype C from neurology and neurosurgery wards. PVL gene was not identified in any of the isolates. These results indicated the presence of a dominant clone among MRSA strains in our hospital, however, different pulsotypes may also be present in different surgery units. Continuous molecular epidemiological surveillance of nosocomial MRSA strains and their PVL positivity supply valuable clinical and epidemiological data for infection control and patient follow-up.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)是住院患者发病和死亡的主要原因之一。本研究旨在调查从医院感染患者中分离出的MRSA菌株的克隆性,并确定这些分离株中是否存在杀白细胞素(PVL)毒素。本研究纳入了从外科、内科和重症监护病房住院患者中获得的37份样本(31份来自手术伤口样本,2份来自脓肿样本,4份来自引流样本)。通过脉冲场凝胶电泳(PFGE)证明MRSA菌株之间的克隆性,并使用luk-PV-1和luk-PV-2引物通过聚合酶链反应检测PVL的存在。PFGE显示,37株菌株中31株为A脉冲型及亚型,3株为B脉冲型,最后3株为C脉冲型。A脉冲型尤其从心血管外科和其他外科科室以及重症监护病房分离得到,B脉冲型从骨科分离得到,C脉冲型从神经科和神经外科病房分离得到。在任何分离株中均未鉴定出PVL基因。这些结果表明我院MRSA菌株中存在优势克隆,然而,不同的脉冲型也可能存在于不同的外科科室。对医院获得性MRSA菌株及其PVL阳性情况进行持续的分子流行病学监测,可为感染控制和患者随访提供有价值的临床和流行病学数据。

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