Molecular Epidemiology of Invasive Staphylococcus aureus Infections and Concordance with Colonization Isolates.
Molecular Epidemiology of Invasive Staphylococcus aureus Infections and Concordance with Colonization Isolates.
复制标题
侵袭性金黄色葡萄球菌感染的分子流行病学及其与定植分离株的一致性。
DOI：
10.1016/j.jpeds.2019.03.004
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Shaw,Jana
中科院分区：
文献类型：
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作者：
Thomsen,IsaacP;Kadari,Priyanka;Soper,NicoleR;Riddell,Scott;Kiska,Deanna;Creech,CBuddy;Shaw,Jana
ObjectivesTo characterizeStaphylococcusaureusisolates从住院儿童中恢复，并确定殖民和侵入性isolation.Study designChildren之间的一致性与文化证实，社区发病，invasiveS aureusinfections被纳入这个前瞻性的情况下，从一个大型儿童医院在5年的时间内。从前鼻孔、口咽和腹股沟皱襞获得定植分离株，并通过重复元件、基于序列的聚合酶链反应检测与侵袭性分离株进行比较。与≥96%的遗传匹配的分离物的特点是concordant.ResultsA共86 S aureussisolates（44侵入性，42殖民）收集44例儿童侵袭性感染。临床分离株的遗传多样性，64%的侵袭性分离株是甲氧西林耐药金黄色葡萄球菌（MSSA），59%的病例在住院时有定植金黄色葡萄球菌。在那些被定殖的人中，在88%的病例中，至少有一种定殖分离株与感染分离株无法区分。与侵袭性耐甲氧西林金黄色葡萄球菌（MRSA）患者相比，侵袭性MSSA患者更可能存在一致的MSSA定植分离株。（61%vs38%，P <0.05）.结论在该儿科队列中，侵袭性MSSA感染比MRSA感染更常见，MSSA感染的患者比MRSA感染的患者更可能在多个解剖部位具有一致的定殖分离株。这些发现值得更大规模的验证，并可能具有重要的感染控制和流行病学意义，因为与MRSA不同，MSSA的传播性在医疗环境中很大程度上被忽视。
ObjectivesTo characterizeStaphylococcus aureusisolates recovered from hospitalized children and to determine the concordance between colonizing and invasive isolates.Study designChildren with culture-confirmed, community-onset, invasiveS aureusinfections were enrolled in this prospective case series from a large children's hospital over a 5-year period. Colonization isolates were obtained from the anterior nares, oropharynx, and inguinal folds and were compared with invasive isolates via repetitive-element, sequence-based polymerase chain reaction testing. Isolates with a ≥96% genetic match were characterized as concordant.ResultsA total of 86S aureusisolates (44 invasive, 42 colonization) were collected from 44 children with invasive infections. Clinical isolates were genetically diverse, 64% of invasive isolates were methicillin-susceptibleS aureus(MSSA), and 59% of cases had a colonizingS aureusisolate at the time of hospitalization. Of those who were colonized, at least 1 of their colonization isolates was indistinguishable from the infecting isolate in 88% of cases. Patients with invasive MSSA were significantly more likely to have a concordant MSSA colonization isolate present compared with patients with invasive methicillin-resistantS aureus(MRSA) (61% vs 38%,P< .05).ConclusionsInvasive MSSA infection was more common than MRSA infection in this pediatric cohort, and patients with MSSA infection were significantly more likely than those with MRSA infection to have concordant colonizing isolates across multiple anatomic sites. These findings warrant larger scale validation and may have important infection control and epidemiologic implications, as unlike MRSA, transmissibility of MSSA largely is ignored in healthcare settings.