携带杀白细胞素基因的金黄色葡萄球菌菌株引起感染的患病率及转归
Prevalence and Outcome of Infections Caused by Staphylococcus aureus Strains Harboring the Panton-Valentine Leukocidin Gene.
作者信息
Thakar Vrushali H, Kumar Mahadevan, Modak Meera, Mehrotra Neetu, Devhare Deepa, Babu Aishwarya, Dalal Bharati, Paul Sania, Yadav Lata, Sawant Shailaja
机构信息
Infectious Diseases, Clinical Microbiology, and Antimicrobial Stewardship Programs (AMSP), Bharati Vidyapeeth's Medical College, Pune, IND.
Infectious Diseases, Bharati Vidyapeeth's Medical College, Pune, IND.
出版信息
Cureus. 2025 Apr 4;17(4):e81687. doi: 10.7759/cureus.81687. eCollection 2025 Apr.
BACKGROUND
, especially Methicillin-resistant (MRSA), is responsible for various hospital-acquired (HA) and community-acquired (CA) infections. Mec A gene responsible for methicillin resistance is encoded in Staphylococcal cassette chromosome gene (SCC). CA-MRSA strains often carry SCC mec IV / SCC mec V and Panton-Valentine leukocidin (PVL) genes. PVL-producing MRSA can cause severe skin or soft tissue infections.
AIM
This study estimates the prevalence and outcome of infections caused by PVL-producing strains in outdoor and indoor patients of a tertiary care hospital in Western Maharashtra, India.
METHOD
This cross-sectional study included 274 strains isolated from various clinical samples during the study period. Detection of Methicillin resistance was done by the cefoxitin disk method and by automated antimicrobial susceptibility (Vitek 2) method. Multiplex PCR was done for the detection of MecA, SCC type IV, Nuc, and PVL gene using appropriate primers.
RESULTS
Out of 274 strains, 151 (55%) were methicillin resistant. The PVL gene was detected in 187 (70.8%) strains and SCC IV in 116 (43.9%) strains. Mec A was detected in all MRSA strains. Both PVL-producing MRSA (83.4%) and MSSA (78.78) strains were isolated commonly from pus samples. Patients with PVL-producing infections required more surgical interventions (18.1%) as compared to those with PVL-negative infections (5.19%) (p-value = 0.006). The PVL gene was associated with SCC IV in 84 (58.7%) strains, while 35 (24.4%) PVL-positive strains were not associated with SCC IV. Few SCC IV and PVL-positive strains (17 strains) have produced HA infections.
CONCLUSION
The prevalence of the PVL gene is 70.8% in . PVL and SCC IV genes are markers of CA infection. MRSA strains harbouring PVL and SCC IV gene producing HA infections is a cause of concern. This suggests infiltration of SCC IV gene producing strains in hospital settings. Proper antibiotic stewardship practices, strict aseptic techniques, identification, and treatment of carriers are needed to control the spread of CA-MRSA in hospitals and in the community.
背景
金黄色葡萄球菌，尤其是耐甲氧西林金黄色葡萄球菌（MRSA），可导致各种医院获得性（HA）和社区获得性（CA）感染。负责甲氧西林耐药性的Mec A基因编码于葡萄球菌盒式染色体基因（SCC）中。CA-MRSA菌株通常携带SCC mec IV / SCC mec V和杀白细胞素（PVL）基因。产PVL的MRSA可引起严重的皮肤或软组织感染。
目的
本研究评估印度马哈拉施特拉邦西部一家三级护理医院的室外和室内患者中产PVL金黄色葡萄球菌菌株引起的感染的患病率和结局。
方法
这项横断面研究纳入了研究期间从各种临床样本中分离出的274株金黄色葡萄球菌。通过头孢西丁纸片法和自动药敏试验（Vitek 2）法检测甲氧西林耐药性。使用适当的引物进行多重PCR检测MecA、IV型SCC、Nuc和PVL基因。
结果
在274株金黄色葡萄球菌中，151株（55%）对甲氧西林耐药。在187株（70.8%）菌株中检测到PVL基因，在116株（43.9%）菌株中检测到SCC IV。在所有MRSA菌株中均检测到Mec A。产PVL的MRSA菌株（83.4%）和甲氧西林敏感金黄色葡萄球菌（MSSA）菌株（78.78%）通常从脓液样本中分离得到。与PVL阴性感染患者（5.19%）相比，产PVL金黄色葡萄球菌感染患者需要更多的手术干预（18.1%）（p值 = 0.006）。84株（58.7%）菌株中的PVL基因与SCC IV相关，而35株（24.4%）PVL阳性菌株与SCC IV不相关。少数IV型SCC和PVL阳性金黄色葡萄球菌菌株（17株）引起了医院获得性感染。
结论
金黄色葡萄球菌中PVL基因的患病率为70.8%。PVL和SCC IV基因是CA感染的标志物。携带PVL和SCC IV基因的MRSA菌株引起医院获得性感染令人担忧。这表明产SCC IV基因的金黄色葡萄球菌菌株已渗透到医院环境中。需要采取适当的抗生素管理措施、严格的无菌技术、识别和治疗携带者，以控制CA-MRSA在医院和社区中的传播。
Zotero 插件