Hu Qiwen, Cheng Hang, Yuan Wenchang, Zeng Fangyin, Shang Weilong, Tang Dahai, Xue Wencheng, Fu Jianfeng, Zhou Renjie, Zhu Junmin, Yang Jie, Hu Zhen, Yuan Jizhen, Zhang Xia, Rao Qing, Li Shu, Chen Zhijin, Hu Xiaomei, Wu Xingan, Rao Xiancai
Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi, China.
J Clin Microbiol. 2015 Jan;53(1):67-72. doi: 10.1128/JCM.01722-14. Epub 2014 Oct 22.
The emergence of Panton-Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) is a public health concern worldwide. PVL is associated with community-associated MRSA and is linked to skin and soft tissue infections (SSTIs). However, PVL genes have also been detected in health care-associated (HA) MRSA isolates. The diseases associated with PVL-positive HA-MRSA isolates and the distributions of PVL-encoding bacteriophages in HA-MRSA have not been determined. In this study, a total of 259 HA-MRSA strains isolated between 2009 and 2012 in China from inpatients with SSTIs, pneumonia, and bacteremia were selected for molecular typing, including staphylococcal cassette chromosome mec typing, multilocus sequence typing, and staphylococcal protein A gene typing. The PVL genes and PVL bacteriophages in the MRSA isolates were characterized by PCR. Among the tested MRSA isolates, 28.6% (74/259) were PVL positive. The high prevalence of PVL-carrying HA-MRSA was observed to be associated with SSTIs but not with pneumonia or bacteremia. The PVL-positive HA-MRSA isolates were colonized mainly by infective PVL phages, namely, Φ7247PVL, ΦSLT, and ΦSa2958. The distribution of PVL-carrying bacteriophages differed geographically. Our study highlights the potential risk of the emergence of multidrug-resistant HA-MRSA strains with increased virulence.
潘顿-瓦伦丁杀白细胞素（PVL）阳性的耐甲氧西林金黄色葡萄球菌（MRSA）的出现是一个全球性的公共卫生问题。PVL与社区获得性MRSA相关，并与皮肤和软组织感染（SSTIs）有关。然而，在医疗保健相关（HA）的MRSA分离株中也检测到了PVL基因。与PVL阳性的HA-MRSA分离株相关的疾病以及PVL编码噬菌体在HA-MRSA中的分布尚未确定。在本研究中，选取了2009年至2012年间在中国从患有SSTIs、肺炎和菌血症的住院患者中分离出的259株HA-MRSA菌株进行分子分型，包括葡萄球菌盒式染色体mec分型、多位点序列分型和葡萄球菌蛋白A基因分型。通过PCR对MRSA分离株中的PVL基因和PVL噬菌体进行了鉴定。在检测的MRSA分离株中，28.6%（74/259）为PVL阳性。观察到携带PVL的HA-MRSA的高流行率与SSTIs相关，但与肺炎或菌血症无关。PVL阳性的HA-MRSA分离株主要由感染性PVL噬菌体定殖，即Φ7247PVL、ΦSLT和ΦSa2958。携带PVL的噬菌体的分布在地理上有所不同。我们的研究强调了出现具有增强毒力的多重耐药HA-MRSA菌株的潜在风险。
