摘要
目的研究剖宫产术后切口耐甲氧西林金黄色葡萄球菌感染毒力因子,指导临床感染预防及治疗。方法选取51例行剖宫产术后患者并发切口感染临床资料。采用全自动微生物鉴定系统对菌种进行鉴定。采用KB纸片法筛选耐甲氧西林金黄色葡萄球菌并检测耐药性,PCR扩增检测毒力因子分布情况。结果培养出病原菌51株,其中,革兰阳性菌36株,革兰阴性菌13株,真菌2株。22株金黄色葡萄球菌中共有甲氧西林耐药菌株12株,敏感菌株10株。耐甲氧西林金黄色葡萄球菌对苯唑西林、头孢唑啉、庆大霉素、红霉素、四环素、环丙沙星、万古霉素的耐药率分别为100.00%、100.00%、66.67%、100.00%、91.67%、58.33%、8.33%和0.00%。临床分离株中pvl、fnbA、clfA、sec、tst毒力因子的阳性检出率分别为33.33%、16.67%、25.00%、16.67%和33.33%。4例切口感染耐甲氧西林金黄色葡萄球菌患者携带tst毒力因子,其中住院时间13~22 d,平均18.3 d;未携带tst毒力因子8例患者住院时间8~16 d,平均13.6 d。结论切口感染是剖宫产术后感染的主要类型,临床治疗切口感染耐甲氧西林金黄色葡萄球菌时可合理选用万古霉素,tst毒力因子可能会延长病程。
Objective To study the virulence factors of methicillin-resistant S.aureus causing a surgical site infection after a cesarean section to guide clinical prevention and treatment of infections.Methods Clinical data on 51 patients with surgical site infection after a cesarean section were collected.The strains were identified by an automated microbial identification system,Methicillin-resistant S.aureus was screened,and drug resistance was detected using the KB disc method.Virulence factor distribution was determined via amplification with PCR.Results Fifty-one strains of pathogens were cultured from 51 secretion samples.Of those strains,36 were strains of Gram-positive bacteria,13 were strains of Gram-negative bacteria,and 2 were strains of fungi.Of 22 strains of S.aureus,12 were methicillin-resistant and 10 were sensitive.The resistance of methicillin-resistant S.aureus to oxacillin was 100.00%,its resistance to cefazolin was 100.00%,its resistance to gentamicin was 66.67%,its resistance to erythromycin was 100.00%,its resistance to tetracycline was 91.67%,its resistance to ciprofloxacin was 58.33%,its resistance to rifampicin was 8.33%,and its resistance to vancomycin was 0.00%.The virulence factor pvl was detected in clinical isolates at a rate of 33.33%,fnbA was detected at a rate of 16.67%,clfA was detected at a rate of 25.00%,sec was detected at a rate of 16.67%,and tst was detected at a rate of 33.33%.Methicillin-resistant S.aureus with the virulence factor tst was detected in 4 patients who were hospitalized for 13-22 d(average:18.3 d).Methicillin-resistant S.aureus without the virulence factor tst was detected in 8 patients who were hospitalized for 8-16 d(average:13.6 d).Conclusion A surgical site infection was the main type of infection found in patients after a cesarean section.Vancomycin is a rational choice for clinical treatment of a surgical site infection with MRSA.The virulence factor tst may prolong the course of disease.
作者
沈晔
周洁琼
郭君红
SHEN Ye;ZHOU Jie-qiong;GUO Jun-hong(Wuhan Children’s Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan,430015)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第11期1335-1338,共4页
Journal of Pathogen Biology
关键词
切口感染
耐甲氧西林金黄色葡萄球菌
毒力因子
Surgical site infection
methicillin-resistant Staphylococcus aureus
virulence factors
