Decreasing methicillin-resistant Staphylococcus aureus (MRSA) infections is attributable to the disappearance of predominant MRSA ST239 clones, Shanghai, 2008-2017
Decreasing methicillin-resistant Staphylococcus aureus (MRSA) infections is attributable to the disappearance of predominant MRSA ST239 clones, Shanghai, 2008-2017
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耐甲氧西林金黄色葡萄球菌 (MRSA) 感染的减少归因于主要 MRSA ST239 克隆的消失，上海，2008-2017 年。
DOI：
10.1080/22221751.2019.1595161
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发表时间：
2019-03-29
影响因子：
13.2
通讯作者：
Li, Min
中科院分区：
文献类型：
--
作者：
Dai, Yingxin;Liu, Junlan;Li, Min
据报道，中国MRSA感染的患病率持续下降，然而，对导致MRSA感染下降的分子过程的潜在机制知之甚少。我们进行了流行病学调查，以确定金黄色葡萄球菌感染的动态变化。总共3695个S。从2008年至2017年回收了金黄色葡萄球菌分离株，随后通过感染类型、耐药性特征和克隆类型进行了表征。在研究期间，呼吸道感染的频率从76%下降到52%。MRSA的比例显著下降（从83.5%降至54.2%，2008-2017年）（p < .0001）。主要医疗保健相关MRSA（HA-MRSA）克隆ST 239-t030和ST 239-t037的患病率显著下降（分别从20.3%降至1%和18.4%降至0.5%，2008-2017年）;它们都被不断增长的ST 5-t2460克隆（从0%降至17.3%，2008-2017年）所取代。流行性社区获得性MRSA（CA-MRSA）ST 59和ST 398克隆也有所增加（分别从1.0%增加到5.8%和1.8%增加到10.5%，2008-2017年）。这些结果表明，以前占主导地位的HA-MRSA ST 239克隆显着减少，导致MRSA的流行率在过去十年中显着下降，并揭示了S.金黄色葡萄球菌克隆在卫生保健环境中占主导地位。
A consistently decreasing prevalence of MRSA infections in China has been reported, however, the underlying mechanism of molecular processes responsible for this decline in MRSA infections has been poorly understood. We conducted an epidemiologic investigation to determine the dynamic changes of Staphylococcus aureus infections. A total of 3695 S. aureus isolates was recovered from 2008 to 2017, and subsequently characterized by infection types, resistance profile, and clone types. The frequency of respiratory infection decreased over the study period from 76% to 52%. The proportion of MRSA remarkably decreased (from 83.5% to 54.2%, 2008-2017) (p < .0001). The prevalence of predominant healthcare-associated MRSA (HA-MRSA) clones, ST239-t030 and ST239-t037, significantly decreased (from 20.3% to 1% and 18.4% to 0.5%, 2008-2017, respectively); both of them were replaced by the continually growing ST5-t2460 clone (from 0% to 17.3%, 2008-2017). Epidemic community-acquired MRSA (CA-MRSA) ST59 and ST398 clones also increased (from 1.0% to 5.8% and 1.8% to 10.5%, 2008-2017, respectively). These results demonstrated a significant decrease in the previously dominant HA-MRSA ST239 clones, leading to a marked decrease in the prevalence of MRSA over the past decade, and shed new light on the complex competition of S. aureus clones predominating within the health-care environment.