{"title":"血液培养中异种万古霉素中间体金黄色葡萄球菌的分布及特点","authors":"Cai-lin Liu, Xiaogai Li","doi":"10.3760/CMA.J.CN112309-20190823-00271","DOIUrl":null,"url":null,"abstract":"Objective \nTo investigate the epidemiological and molecular biological characteristics of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) in blood culture. \n \n \nMethods \nhVISA was detected using Mueller-Hinton agar containing 5 μg/ml of teicoplanin (MHA5T) and Populats profiles/area under the curve (PAP/AUC). Staphylococcal cassette chromosome mec (SCCmec), Staphylococcus aureus protein A (spa) and accessory gene regulator (agr) typing and multilocus-sequence typing (MLST) were analyzed using PCR. Difference in autolysis between hVISA and vancomycin-sensitive Staphylococcus aureus (VSSA) isolates were evaluated with Triton X-100-inducd autolysis. Expression of vraR, mgrA, icaA, icaR, pbp4 and agr genes in hVISA and VSSA strains were detected by real-time PCR. \n \n \nResults \nThe positive detection rate of methicillin-resistant Staphylococcus aureus (MRSA) in blood culture was 39.5% (136/344) in our hospital. Among the MRSA strains, there were 31 strains of hVISA (22.8%). The minimum inhibitory concentrations (MIC) of vancomycin were mainly 1.5 μg/ml (54.8%) and 2 μg/ml(25.8%)against hVISA isolates, and 0.5 μg/ml (46.7%) and 0.75 μg/ml (39.0%) against VSSA isolates. The predominant clone of hVISA was ST239-SCCmecⅢ-t030-agrⅠ accounting for 71.0% (22/31). The autolysis of hVISA isolates decreased significantly as compared with that of VSSA isolates (χ2=13.583, P=0.032). Compared with VSSA strains, the expression of vraR, mgrA and icaA genes in hVISA strains increased by 1.58, 1.53 and 1.06 times (P<0.01), while the expression of icaR, agr and pbp4 genes decreased by 0.85, 0.61 and 1.03 times (P<0.05). \n \n \nConclusions \nThe prevalence rate of hVISA in our hospital reached 22.8% and the main epidemic clone was ST239-SCCmecⅢ-t030-agrⅠ, which should be paid great attention to clinically. Rational use of antibiotics, strengthening the prevention and control of nosocomial infection, and avoiding the spread of hVISA strains and the emergence of VISA and VRSA (vancomycin-resistance Staphylococcus aureus) were also necessary. \n \n \nKey words: \nStaphylococcus aureus; hVISA; Autolysis; MLST","PeriodicalId":10089,"journal":{"name":"中华微生物学和免疫学杂志","volume":"40 1","pages":"85-90"},"PeriodicalIF":0.0000,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Distribution and characteristics of heterogeneous vancomycin-intermediate Staphylococcus aureus in blood culture\",\"authors\":\"Cai-lin Liu, Xiaogai Li\",\"doi\":\"10.3760/CMA.J.CN112309-20190823-00271\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo investigate the epidemiological and molecular biological characteristics of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) in blood culture. \\n \\n \\nMethods \\nhVISA was detected using Mueller-Hinton agar containing 5 μg/ml of teicoplanin (MHA5T) and Populats profiles/area under the curve (PAP/AUC). Staphylococcal cassette chromosome mec (SCCmec), Staphylococcus aureus protein A (spa) and accessory gene regulator (agr) typing and multilocus-sequence typing (MLST) were analyzed using PCR. Difference in autolysis between hVISA and vancomycin-sensitive Staphylococcus aureus (VSSA) isolates were evaluated with Triton X-100-inducd autolysis. Expression of vraR, mgrA, icaA, icaR, pbp4 and agr genes in hVISA and VSSA strains were detected by real-time PCR. \\n \\n \\nResults \\nThe positive detection rate of methicillin-resistant Staphylococcus aureus (MRSA) in blood culture was 39.5% (136/344) in our hospital. Among the MRSA strains, there were 31 strains of hVISA (22.8%). The minimum inhibitory concentrations (MIC) of vancomycin were mainly 1.5 μg/ml (54.8%) and 2 μg/ml(25.8%)against hVISA isolates, and 0.5 μg/ml (46.7%) and 0.75 μg/ml (39.0%) against VSSA isolates. The predominant clone of hVISA was ST239-SCCmecⅢ-t030-agrⅠ accounting for 71.0% (22/31). The autolysis of hVISA isolates decreased significantly as compared with that of VSSA isolates (χ2=13.583, P=0.032). Compared with VSSA strains, the expression of vraR, mgrA and icaA genes in hVISA strains increased by 1.58, 1.53 and 1.06 times (P<0.01), while the expression of icaR, agr and pbp4 genes decreased by 0.85, 0.61 and 1.03 times (P<0.05). \\n \\n \\nConclusions \\nThe prevalence rate of hVISA in our hospital reached 22.8% and the main epidemic clone was ST239-SCCmecⅢ-t030-agrⅠ, which should be paid great attention to clinically. Rational use of antibiotics, strengthening the prevention and control of nosocomial infection, and avoiding the spread of hVISA strains and the emergence of VISA and VRSA (vancomycin-resistance Staphylococcus aureus) were also necessary. \\n \\n \\nKey words: \\nStaphylococcus aureus; hVISA; Autolysis; MLST\",\"PeriodicalId\":10089,\"journal\":{\"name\":\"中华微生物学和免疫学杂志\",\"volume\":\"40 1\",\"pages\":\"85-90\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-02-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华微生物学和免疫学杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.CN112309-20190823-00271\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Immunology and Microbiology\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华微生物学和免疫学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.CN112309-20190823-00271","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Immunology and Microbiology","Score":null,"Total":0}
Distribution and characteristics of heterogeneous vancomycin-intermediate Staphylococcus aureus in blood culture
Objective
To investigate the epidemiological and molecular biological characteristics of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) in blood culture.
Methods
hVISA was detected using Mueller-Hinton agar containing 5 μg/ml of teicoplanin (MHA5T) and Populats profiles/area under the curve (PAP/AUC). Staphylococcal cassette chromosome mec (SCCmec), Staphylococcus aureus protein A (spa) and accessory gene regulator (agr) typing and multilocus-sequence typing (MLST) were analyzed using PCR. Difference in autolysis between hVISA and vancomycin-sensitive Staphylococcus aureus (VSSA) isolates were evaluated with Triton X-100-inducd autolysis. Expression of vraR, mgrA, icaA, icaR, pbp4 and agr genes in hVISA and VSSA strains were detected by real-time PCR.
Results
The positive detection rate of methicillin-resistant Staphylococcus aureus (MRSA) in blood culture was 39.5% (136/344) in our hospital. Among the MRSA strains, there were 31 strains of hVISA (22.8%). The minimum inhibitory concentrations (MIC) of vancomycin were mainly 1.5 μg/ml (54.8%) and 2 μg/ml(25.8%)against hVISA isolates, and 0.5 μg/ml (46.7%) and 0.75 μg/ml (39.0%) against VSSA isolates. The predominant clone of hVISA was ST239-SCCmecⅢ-t030-agrⅠ accounting for 71.0% (22/31). The autolysis of hVISA isolates decreased significantly as compared with that of VSSA isolates (χ2=13.583, P=0.032). Compared with VSSA strains, the expression of vraR, mgrA and icaA genes in hVISA strains increased by 1.58, 1.53 and 1.06 times (P<0.01), while the expression of icaR, agr and pbp4 genes decreased by 0.85, 0.61 and 1.03 times (P<0.05).
Conclusions
The prevalence rate of hVISA in our hospital reached 22.8% and the main epidemic clone was ST239-SCCmecⅢ-t030-agrⅠ, which should be paid great attention to clinically. Rational use of antibiotics, strengthening the prevention and control of nosocomial infection, and avoiding the spread of hVISA strains and the emergence of VISA and VRSA (vancomycin-resistance Staphylococcus aureus) were also necessary.
Key words:
Staphylococcus aureus; hVISA; Autolysis; MLST
期刊介绍：
Chinese Journal of Microbiology and Immunology established in 1981. It is one of the series of journal sponsored by Chinese Medical Association. The aim of this journal is to spread and exchange the scientific achievements and practical experience in order to promote the development of medical microbiology and immunology. Its main contents comprise academic thesis, brief reports, reviews, summaries, news of meetings, book reviews and trends of home and abroad in this field. The distinguishing feature of the journal is to give the priority to the reports on the research of basic theory, and take account of the reports on clinical and practical skills.
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