Mohd-Zain Z, Mohd-Nawi S F A, Adnan A, Kumar S
Universiti Teknologi MARA, Faculty of Medicine, Core of Health and Wellbeing, Sungai Buloh, 47000 Selangor, Malaysia.
Malays J Pathol. 2017 Aug;39(2):115-122.
HIV-infected patients pose a high risk of contracting skin and soft tissue infections caused by Staphylococcus aureus. Those who are colonized with methicillin-resistant S. aureus (MRSA) that carry Panton-Valentine leukocidin (PVL) are predisposed to severe infections that could lead to necrotic skin infections. However the association of S. aureus specifically methicillin sensitive S. aureus carrying PVL gene in HIV patients has not been widely reported. Here, we study the prevalence and the molecular epidemiology of PVL-producing S. aureus in HIV-infected patients.
Swabs from four body sites of 129 HIV-infected patients were cultured for S. aureus and identified by standard microbiological procedures. The isolates were subjected to antimicrobial susceptibility testing by disk diffusion against penicillin, erythromycin, clindamycin, and cotrimoxazole. PCR was used to detect the PVL gene and genetic relationship between the isolates was determined by using pulse field gel electrophoresis.
A total of 51 isolates of S. aureus were obtained from 40 (31%) of the patients. The majority (43.1%) of the isolates were obtained from the anterior nares. Thirteen (25.5%) of all the isolates were resistant to more than one category of antibiotics, with one isolate identified as MRSA. Thirty-eight (74.5%) isolates (including the MRSA isolate) carried PVL gene where the majority (44.7%) of these isolates were from the anterior nares. A dendogram revealed that the isolates were genetically diverse with 37 distinct pulsotypes clustered in 11 groups.
S. aureus obtained from multiple sites of the HIV patients were genetically diverse without any clonality observed.
感染HIV的患者感染由金黄色葡萄球菌引起的皮肤和软组织感染的风险很高。那些被携带杀白细胞素（PVL）的耐甲氧西林金黄色葡萄球菌（MRSA）定植的患者易发生严重感染，可能导致坏死性皮肤感染。然而，金黄色葡萄球菌，特别是携带PVL基因的甲氧西林敏感金黄色葡萄球菌在HIV患者中的关联尚未得到广泛报道。在此，我们研究了HIV感染患者中产PVL金黄色葡萄球菌的流行情况和分子流行病学。
对129例HIV感染患者四个身体部位的拭子进行金黄色葡萄球菌培养，并通过标准微生物学程序进行鉴定。采用纸片扩散法对分离株进行青霉素、红霉素、克林霉素和复方新诺明的药敏试验。采用PCR检测PVL基因，并通过脉冲场凝胶电泳确定分离株之间的遗传关系。
共从40例（31%）患者中获得51株金黄色葡萄球菌分离株。大多数（43.1%）分离株来自前鼻孔。所有分离株中有13株（25.5%）对不止一类抗生素耐药，其中1株鉴定为MRSA。38株（74.5%）分离株（包括MRSA分离株）携带PVL基因，其中大多数（44.7%）分离株来自前鼻孔。树形图显示分离株在基因上具有多样性，37种不同的脉冲型聚集在11个组中。
从HIV患者多个部位分离得到的金黄色葡萄球菌在基因上具有多样性，未观察到任何克隆性。
