临床甲氧西林敏感和耐药金黄色葡萄球菌菌株中纤连蛋白结合蛋白（FBP）和杀白细胞素（PVL）毒力因子的研究

Investigation of Fibronectin Binding Protein (FBP) and Panton Valentine Leukocidin (PVL) Viulance Factors in Clinical Methicillin Sensitive and Resistant Staphylococcus Aureus Strains.

作者信息

Cihanoglu Neslihan, Adaleti Riza, Nakipoglu Yasar

出版信息

Clin Lab. 2019 Jan 1;65(1). doi: 10.7754/Clin.Lab.2018.180625.

DOI:10.7754/Clin.Lab.2018.180625

PMID:30775902

Abstract

BACKGROUND

We aimed to investigate the frequency of fibronectin binding protein (FBP), which is part of the first step of adhesion, and Panton-Valentine leukocidin (PVL) toxin, which contributes to the destruction of host leukocytes and tissue necrosis, in clinical S. aureus strains.

METHODS

One hundred S. aureus strains were included in the study and distributed as follows; 33 from skinwound swabs and catheter tips (SWCT), 33 from body fluid and secretion specimens (BSFS) such as tracheal aspirate, sputum, and pleural effusion fluid, 18 from tissue biopsy specimens (TBS), 10 specimens from blood, and related specimens (BRS) such as bone marrow, and cerebral spinal fluid, and six specimens from mucosal membrane of pharynx, nose, and vagina (MMS). Methicillin resistance was tested by disk diffusion method. mecA (methicillin resistance coded gene), pvl and fnbA genes were investigated by using a PCR method.

RESULTS

Thirty-seven strains (37.0%) were identified as methicillin resistant S. aureus (MRSA) and 63 (63.0%) as methicillin susceptible S. aureus (MSSA) strains. fnbA was more frequent in S. aureus isolates of MMSs (100.0%); followed by BRSs (80.0%), SWCTs (78.8%), TBS (72.3%), and BSFs (66.7%), whereas pvl gene was more frequent in isolates of BRS (60.0%), followed by TBSs (50.0%), SWCTs (33.4%), BSFs (30.3%), and MMSs (16.7%). fnbA existed in 85.7% of MSSA and 56.8% of MRSA in contrast to pvl, which was more frequent in MRSA (70.3%) than those of MSSA strains (17.4%). These differences were statistically significant (p < 0.05).

CONCLUSIONS

Our different clinical specimens contained a high rate of fnbA (75.0%) and low-moderate frequency of pvl (37.0%). fnbA was most frequent in S. aureus of MMSs, followed by BRSs, and SWCTs, whereas pvl was ex-isted in high proportion in S. aureus of BRSs, followed by TBSs, and SWCTs. Presence of PVL in a high proportion in MRSA strains of superfical specimens such SWCT (24.4%) and deeper serious specimens such as BRS (16.3%) compared to MSSA strains from the same specimens, 3.2% and 0%, respectively, have shown that MRSA infections still threatens patients' lives and control of their spread is urgently needed.

摘要

背景

我们旨在调查临床金黄色葡萄球菌菌株中纤连蛋白结合蛋白（FBP，其是黏附第一步的一部分）以及杀白细胞素（PVL）毒素（其导致宿主白细胞破坏和组织坏死）的出现频率。

方法

本研究纳入了100株金黄色葡萄球菌菌株，分布如下：33株来自皮肤伤口拭子和导管尖端（SWCT），33株来自体液和分泌物标本（BSFS），如气管吸出物、痰液和胸腔积液，18株来自组织活检标本（TBS），10株来自血液及相关标本（BRS），如骨髓和脑脊液，6株来自咽、鼻和阴道黏膜（MMS）。采用纸片扩散法检测耐甲氧西林情况。通过聚合酶链反应（PCR）方法研究mecA（耐甲氧西林编码基因）、pvl和fnbA基因。

结果

37株（37.0%）被鉴定为耐甲氧西林金黄色葡萄球菌（MRSA），63株（63.0%）为甲氧西林敏感金黄色葡萄球菌（MSSA）菌株。fnbA在MMS的金黄色葡萄球菌分离株中出现频率更高（100.0%）；其次是BRS（80.0%）、SWCT（78.8%）、TBS（72.3%）和BSF（66.7%），而pvl基因在BRS分离株中出现频率更高（60.0%），其次是TBS（50.0%）、SWCT（33.4%）、BSF（30.3%）和MMS（16.7%）。与pvl相比，fnbA存在于85.7%的MSSA和56.8%的MRSA中，而pvl在MRSA（70.3%）中比在MSSA菌株（17.4%）中出现频率更高。这些差异具有统计学意义（p<0.05）。

结论

我们不同的临床标本中fnbA出现率较高（75.0%），pvl出现频率为低至中度（37.0%）。fnbA在MMS的金黄色葡萄球菌中出现频率最高，其次是BRS和SWCT，而pvl在BRS的金黄色葡萄球菌中占比高，其次是TBS和SWCT。与来自相同标本的MSSA菌株（分别为3.2%和0%）相比，浅表标本如SWCT（24.4%）和深部严重标本如BRS（16.3%）的MRSA菌株中PVL的高比例存在表明，MRSA感染仍然威胁着患者生命，迫切需要控制其传播。