Carriage of Community-Associated Methicillin-Resistant Staphylococcus aureus in a Cohort of Infants in Southern Israel: Risk Factors and Molecular Features
Carriage of Community-Associated Methicillin-Resistant Staphylococcus aureus in a Cohort of Infants in Southern Israel: Risk Factors and Molecular Features
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DOI：
10.1128/jcm.02290-08
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发表时间：
2010-02-01
影响因子：
9.4
通讯作者：
Dagan, Ron
中科院分区：
文献类型：
--
作者：
Adler, Amos;Givon-Lavi, Noga;Dagan, Ron
关于以色列儿童社区相关耐甲氧西林金黄色葡萄球菌（CA-MRSA）的流行病学数据很少。本研究旨在确定健康婴儿中CA-MRSA定植的风险因素，表征定植微生物的分子特征，并确定它们是否与卫生保健相关（HA）感染有关。在2至12个月的5次访视时，从一组健康婴儿中收集鼻培养和人口统计学详细信息。还研究了儿科MRSA血流感染（2001年至2006年）和6个月以上收集的伤口培养物的临床特征。通过多位点序列分型评价克隆结构。研究了分离株的葡萄球菌盒式染色体mec（SCCmec）类型和Panton-Valentine杀白细胞素（PVL）基因的存在。659名婴儿中有45名（346名犹太婴儿和313名贝都因婴儿）至少培养了一次MRSA。45个分离株中有40个（89%）来自贝都因婴儿。45个中的29个（64.4%）属于一个新的克隆复合体，命名为CC 913，携带SCCmec IV，但不携带PVL基因。CC 913还从9/14的血培养物和7/8的伤口中分离。所有CC 913感染均发生在贝都因儿童中，除两人外，其余均为HA。总之，贝都因血统是携带CA-MRSA的主要风险因素。CC 913在健康携带者和儿科HA-MRSA血流感染中均占主导地位。
There are few data about the epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among children in Israel. This study was intended to identify risk factors for CA-MRSA colonization in healthy infants, to characterize the molecular features of colonizing organisms, and to determine whether they are responsible for health care-associated (HA) infections. Nasal cultures and demographic details were collected from a cohort of healthy infants at 5 visits between the ages of 2 and 12 months. Clinical characteristics of pediatric MRSA blood stream infections (2001 to 2006) and wound cultures collected over 6 months were also studied. Clonal structure was evaluated by multilocus sequence typing. Isolates were studied for the staphylococcal cassette chromosome mec (SCCmec) type and for the presence of Panton-Valentine leukocidin (PVL) genes. MRSA was cultured at least once from 45 of 659 infants (346 Jewish and 313 Bedouin infants). Forty of 45 (89%) isolates were from Bedouin infants. Twenty-nine of 45 (64.4%) belonged to a new clonal complex, designated CC913, that carries SCCmec IV but not the PVL genes. CC913 was also isolated from 9/14 blood cultures and 7/8 wounds. All CC913 infections occurred in Bedouin children, and all but two were HA. In conclusion, Bedouin origin was the main risk factor for carriage of CA-MRSA. CC913 was dominant both in healthy carriers and as a cause of pediatric HA-MRSA bloodstream infections.