绍兴地区皮肤软组织感染耐甲氧西林金黄色葡萄球菌的分子流行病学和毒力基因分析。
Molecular Epidemiology and Virulence Gene Analysis of Methicillin-Resistant Staphylococcus aureus Associated with Skin and Soft Tissue Infections in the Shaoxing Region.
出版信息
Altern Ther Health Med. 2023 Nov;29(8):776-781.
OBJECTIVE
This study aimed to investigate the prevalence, molecular types, and virulence genes of methicillin-resistant Staphylococcus aureus (MRSA) causing skin and soft tissue infections (SSTIs) in the Shaoxing region.
METHODS
MRSA strains were collected from patients with SSTIs in Shaoxing People's Hospital from January 2019 to December 2019. We conducted SCCmec typing, Staphylococcus protein A (SPA) typing, multilocus sequence typing (MLST), and virulence gene analysis using whole-genome sequencing on all MRSA strains.
RESULTS
The detection rate of community-acquired MRSA (CA-MRSA) isolated from SSTI patients in our hospital was 33.3% (6/18). The primary SCCmec types of CA-MRSA strains were IV and V, with IVg(2B) and V(5C2&5) accounting for 16.7% each. Hospital-acquired MRSA (HA-MRSA) strains primarily exhibited SCCmec types IVa(2B) (25.0%), followed by II(2A) (16.7%), V(5C2) (16.7%), and V(5C2&5) (8.3%). SPA typing indicated that CA-MRSA strains causing SSTIs were predominantly t437 (14.3%), t034 (14.3%), t309 (14.3%), t4549 (14.3%), and t7637 (14.3%). The primary SPA type of HA-MRSA strains was t311 (16.7%). MLST typing revealed that the main sequence types (STs) of CA-MRSA strains causing SSTIs were ST22 (33.3%), followed by ST398, ST59, ST88, and ST630, each accounting for 16.7%. The principal STs of HA-MRSA strains were ST398 (16.7%), ST59 (16.7%), ST88 (16.7%), and ST5 (16.7%), followed by ST22, ST630, ST6, and ST188, each at 8.3%. The primary clones of CA-MRSA strains causing SSTIs were ST59-t437-IVg(2B) (16.7%) and ST630-t4549-V(5C2&5) (16.7%), while the primary clones of HA-MRSA strains were ST59-t437-IVa(2B), ST630-t4549-V(5C2&5), ST6-t304-IVa(2B), ST5-t311-II(2A), ST59-t172-IVa(2B), ST398-t571-V(5C2), ST398-t034-V(5C2), and ST5-t311-II(2A), each accounting for 8.3%. The detection rate of the lukSF-PV virulence gene was higher in CA-MRSA strains (50.0%) than in HA-MRSA strains (16.7%).
CONCLUSIONS
The isolation rate of CA-MRSA strains causing SSTIs was high in Shaoxing People's Hospital, with ST59-t437-IVg(2B) and ST630-t4549-V(5C2&5) being the predominant clones. MRSA strains exhibited multiple virulence genes, with the lukSF-PV gene having a higher detection rate in CA-MRSA strains, signifying its importance as a virulence factor in CA-MRSA.
目的
本研究旨在调查绍兴地区引起皮肤软组织感染（SSTI）的耐甲氧西林金黄色葡萄球菌（MRSA）的流行率、分子类型和毒力基因。
方法
从绍兴市人民医院 2019 年 1 月至 2019 年 12 月期间 SSTI 患者中收集 MRSA 菌株。我们对所有 MRSA 菌株进行 SCCmec 分型、葡萄球菌蛋白 A（SPA）分型、多位点序列分型（MLST）和毒力基因分析，采用全基因组测序。
结果
我院分离的社区获得性 MRSA（CA-MRSA）检出率为 33.3%（6/18）。CA-MRSA 菌株的主要 SCCmec 型为 IV 和 V，其中 IVg（2B）和 V（5C2&5）各占 16.7%。医院获得性 MRSA（HA-MRSA）菌株主要表现为 SCCmec 型 IVa（2B）（25.0%），其次是 II（2A）（16.7%）、V（5C2）（16.7%）和 V（5C2&5）（8.3%）。SPA 分型表明引起 SSTI 的 CA-MRSA 菌株主要为 t437（14.3%）、t034（14.3%）、t309（14.3%）、t4549（14.3%）和 t7637（14.3%）。HA-MRSA 菌株的主要 SPA 型为 t311（16.7%）。MLST 分型显示引起 SSTI 的 CA-MRSA 菌株的主要序列型（ST）为 ST22（33.3%），其次是 ST398、ST59、ST88 和 ST630，各占 16.7%。HA-MRSA 菌株的主要 ST 为 ST398（16.7%）、ST59（16.7%）、ST88（16.7%）和 ST5（16.7%），其次是 ST22、ST630、ST6 和 ST188，各占 8.3%。引起 SSTI 的 CA-MRSA 菌株的主要克隆为 ST59-t437-IVg（2B）（16.7%）和 ST630-t4549-V（5C2&5）（16.7%），而 HA-MRSA 菌株的主要克隆为 ST59-t437-IVa（2B）、ST630-t4549-V（5C2&5）、ST6-t304-IVa（2B）、ST5-t311-II（2A）、ST59-t172-IVa（2B）、ST398-t571-V（5C2）、ST398-t034-V（5C2）和 ST5-t311-II（2A），各占 8.3%。CA-MRSA 菌株 lukSF-PV 毒力基因的检出率高于 HA-MRSA 菌株（50.0%）。
结论
绍兴市人民医院引起 SSTI 的 CA-MRSA 菌株分离率较高，主要克隆为 ST59-t437-IVg（2B）和 ST630-t4549-V（5C2&5）。MRSA 菌株表现出多种毒力基因，其中 lukSF-PV 基因在 CA-MRSA 菌株中的检出率较高，表明其在 CA-MRSA 中作为毒力因子的重要性。
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