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目的了解菌血症患者血液,医护工作者、非感染性疾病入院患者以及社区健康人群前鼻腔内的金黄色葡萄球菌超抗原基因分子特征。方法用PCR和multiplex-PCR方法对277株菌的毒性休克综合征毒素-1(toxicshock syndrome toxin-1,TSST-1)和肠毒素(staphylococcal enterotoxin,SE)编码基因进行了扩增。结果 277株分离的金黄色葡萄球菌中共有142株(51%)肠毒素基因检测结果为阳性。从医院内各人群组(包括医院菌血症患者组、医护人员组和非感染性疾病入院患者组)分离菌株的阳性率在50%~59%,要比社区健康人群组阳性率(36%)高(χ2=10.86,P<0.05)。医院内各人群组分离株的SE基因主要以A型为主,而社区健康人群组的分离菌株则以D型为优势型别。另外,菌血症患者血液的金黄色葡萄球菌携带基因tsst-1的阳性率要高于其他人群组(χ2=21.91,P<0.01)。结论本研究表明不同人群分离得到的金黄色葡萄球菌超抗原分子特点具有特异性,对临床金黄色葡萄球菌的诊断治疗和流行病学研究具有一定的指导意义。
Objective To understand the molecular characteristics of Staphylococcus aureus superantigen genes in the blood of patients with bacteremia, health care workers, patients admitted to non-infectious diseases and the anterior nasal cavity of healthy people in community. Methods 277 strains of toxicshock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxin (SE) were amplified by PCR and multiplex-PCR. Results A total of 142 (51%) enterotoxin genes were positive in 277 Staphylococcus aureus isolates. The positive rate of isolates from 50% to 59% of isolates from hospital groups (including hospital bacteremia patients, health care workers and non-infectious patients admitted to hospital) was higher than that in healthy community groups ( 36%) (χ2 = 10.86, P <0.05). The SE gene of each isolate in the hospital is mainly type A, while the isolates of healthy population in community take type D as the predominant type. In addition, the positive rate of tsst-1 gene in the blood of patients with bacteremia was higher than that in other groups (χ2 = 21.91, P <0.01). Conclusion This study shows that the molecular characteristics of Staphylococcus aureus isolated from different populations are specific and have some guiding significance for the diagnosis, treatment and epidemiology of clinical Staphylococcus aureus.