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目的探讨mecA基因与耐甲氧西林金黄色葡萄球菌(MRSA)临床感染的关系,为临床合理使用抗生素提供依据。方法收集2013年-2015年本院患者感染分离的MRSA 83株,分为血流感染组(39株)和非血流感染组(44株)。2组菌株分别进行mecA、PVL基因检测,mecA基因阳性菌株进行荧光定量PCR测定mecA基因RNA相对表达量。结果83株MRSA mecA阳性77株,阳性率为92.8%,血流感染组mecA基因阳性率为100.0%,非血流感染组86.4%,两者差异有统计学意义(χ2=3.880,P<0.05)。两组mecA基因RNA相对表达量差异无统计学意义(P>0.05)。利福平耐药菌株的mecA基因mRNA相对表达量高于敏感菌株的相对表达量,差异有统计学意义(P<0.05)。PVL基因阳性率为12.0%,其中血流感染组PVL基因阳性率为7.7%,非血流感染组为15.9%,两者差异无统计学意义(χ2=0.656,P>0.05)。结论 mecA基因在血流感染的MRSA中分布较高,其RNA相对表达量与利福平的耐药性密切有关。因此,检测mecA基因,对治疗及控制MRSA感染具有一定的临床指导作用。
Objective To investigate the relationship between mecA gene and clinical infection with methicillin-resistant Staphylococcus aureus (MRSA), and to provide a basis for clinical rational use of antibiotics. Methods 83 strains of MRSA isolated from our hospital from 2013 to 2015 were divided into three groups: bloodstream infection group (39 strains) and non-bloodstream infection group (44 strains). Two groups of strains were mecA, PVL gene detection, mecA gene positive strains for quantitative PCR mecA gene RNA relative expression. Results The positive rate of mecA in 83 MRSA strains was 77.8%, the positive rate of mecA gene was 100.0% in bloodstream infection group and 86.4% in non-bloodstream infection group, the difference was statistically significant (χ2 = 3.880, P <0.05 ). There was no significant difference in the relative expression of mecA mRNA between the two groups (P> 0.05). The relative expression level of mecA mRNA in rifampicin-resistant strains was higher than that in the sensitive strains, the difference was statistically significant (P <0.05). The positive rate of PVL gene was 12.0%. The positive rate of PVL gene was 7.7% in bloodstream infection group and 15.9% in non-bloodstream infection group. There was no significant difference between the two groups (χ2 = 0.656, P> 0.05). Conclusion The mecA gene is highly distributed in MRSA with bloodstream infection, and its relative RNA expression is closely related to the drug resistance of rifampicin. Therefore, detection of mecA gene has certain clinical significance in the treatment and control of MRSA infection.