Staphylococcus aureus strains isolated from bloodstream infections changed significantly in 2006
Staphylococcus aureus strains isolated from bloodstream infections changed significantly in 2006
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DOI：
10.1128/jcm.02178-06
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发表时间：
2007-03-01
影响因子：
9.4
通讯作者：
Quentin, Roland
中科院分区：
文献类型：
--
作者：
van der Mee-Marquet, Nathalie;Epinette, Christophe;Quentin, Roland
我们研究了2004年至2006年期间在32家医疗机构（110家）住院2，007，681天的流行病学研究中观察到的358株从血流感染（BSI）中分离的金黄色葡萄球菌菌株。测试菌株的抗生素敏感性并进行遗传表征。S.金黄色葡萄球菌BSI在2004年和2005年定期下降，然后在2006年显著增加（+80%）。这在很大程度上是由于涉及甲氧西林敏感的S.金黄色葡萄球菌（MSSA）菌株和非多重耐药的耐甲氧西林S.金黄色葡萄球菌（NORSA）菌株。96%的NORSA菌株仅对甲氧西林和氟喹诺酮类耐药。大多数MSSA菌株属于少数脉冲场凝胶电泳（PFGE）部门，并与HCIs的流行现象。NORSA菌株也聚集成有限数量的PFGE部门，但不能与任何地方爆发的HCI。2006年，与tst基因阳性MSSA菌株相关的BSI发生率显著增加（+275%），并且观察到前三例与tst基因阳性MRSA相关的BSI。PFGE数据显示，tst基因阳性菌株之间的异质性有限，在HCI中没有任何爆发。我们的研究强调了感染控制团队需要集中精力预防MRSA和MSSA BSI。如最近在体外证明的，氟喹诺酮类药物可以增强毒力和抗生素抗性基因的水平转移。这些抗生素在法国被广泛使用，因此我们的研究结果提出了一个问题，即它们的使用是否有助于S.金黄色葡萄球菌
We studied 358 Staphylococcus aureus strains isolated from bloodstream infections (BSI) observed during an epidemiological study covering 2,007,681 days of hospitalization in 32 healthcare institutions (110s) between 2004 and 2006. The strains were tested for antibiotic susceptibility and characterized genetically. The incidence of S. aureus BSI declined regularly through 2004 and 2005 and then significantly increased in 2006 (+80%). This was largely due to an increase in BSI involving methicillin-sensitive S. aureus (MSSA) strains and nonmultiresistant methicillin-resistant S. aureus (NORSA) strains. Ninety-six percent of the NORSA strains were resistant only to methicillin and fluoroquinolones. Most of the MSSA strains belonged to a small number of pulsed-field gel electrophoresis (PFGE) divisions and were associated with epidemic phenomena in HCIs. The NORSA strains also clustered into a limited number of PFGE divisions but could not be related to any local outbreak in HCIs. In 2006, there was a significant increase in the incidence of BSI associated with tst gene-positive MSSA strains (+275%) and the first three BSI associated with tst gene-positive MRSA were observed. PFGE data revealed a limited heterogeneity among the tst gene-positive strains without any outbreak in the HCIs. Our study underlines the need for infection control teams to focus efforts on preventing both MRSA and MSSA BSI. As recently demonstrated in vitro, fluoroquinolones may enhance horizontal transfer of virulence and antibiotic resistance genes. These antibiotics are widely used in France, so our findings raise the issue of whether their use has contributed to the acquisition of mecA and tst genes by S. aureus strains.