Antimicrobial Resistance and Molecular Characterization of Staphylococcus aureus Causing Childhood Pneumonia in Shanghai.
Antimicrobial Resistance and Molecular Characterization of Staphylococcus aureus Causing Childhood Pneumonia in Shanghai.
复制标题
上海地区引起儿童肺炎的金黄色葡萄球菌的耐药性及分子特征
DOI：
10.3389/fmicb.2017.00455
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发表时间：
2017
影响因子：
5.2
通讯作者：
Han LZ
中科院分区：
文献类型：
--
作者：
Song Z;Gu FF;Guo XK;Ni YX;He P;Han LZ
金黄色葡萄球菌或耐甲氧西林金黄色葡萄球菌（MRSA）是引起儿童肺炎的主要病原体。目的：了解上海市部分地区血吸虫病流行情况及分子特征。金黄色葡萄球菌肺炎患儿107例，研究了2014年1月至2015年6月来自两家儿童医院的金黄色葡萄球菌肺炎。S.从呼吸道标本中分离的金黄色葡萄球菌通过抗菌药物敏感性、agr分型、毒素基因、多位点序列分型（MLST）、spa和SCCmec分型来表征。其中甲氧西林敏感金黄色葡萄球菌（MSSA）58株（54.2%，58/107），耐甲氧西林金黄色葡萄球菌（MRSA）49株（45.8%，49/107）。未发现分离株对替考拉宁、磺胺甲恶唑/甲氧苄啶、利福平、奎奴普汀/达福普汀、利奈唑胺或万古霉素耐药。但对红霉素、磷霉素-氨丁三醇、克林霉素耐药率较高。最常见的等位基因为agr Ⅰ（87/107，81.3%），其次为agr Ⅲ（10/107，9.3%）、agr Ⅱ（9/107，8.4%）和agr Ⅳ（1/107，0.9%）。鉴定出6株pvl阳性分离株（3株MRSA和3株MSSA）和7株家畜相关克隆ST 398分离株（4株MRSA，3株MSSA）。CC 59在35株MRSA中检出（33株MRSA和2株MSSA），占MRSA的绝大多数（33/49，67.35%）。优势CC为CC 59（32.7%）、CC 188（13.1%）、CC 7（12.1%）和CC 398（9.3%），而t172（16.8%）、t189（12.1%）、t437（9.3%）和t091（9.3%）是最常见的SPA类型。总之，ST 59-SCCmecIV-t172/t437是上海地区儿童肺炎最常见的流行性克隆，应引起特别关注。
Staphylococcus aureus or methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing pneumonia among children. To estimate the prevalence and molecular properties of S. aureus in children pneumonia in Shanghai, China, 107 hospitalized children with S. aureus pneumonia from two children's hospitals from January 2014 through June 2015 were studied. S. aureus isolates from the respiratory specimens were characterized by antimicrobial susceptibility, agr typing, toxin genes, multilocus sequence typing (MLST), spa, and SCCmec typing. Fifty-eight (54.2%, 58/107) were MSSA (methicillin-susceptible Staphylococcus aureus) and 49 (45.8%, 49/107) were MRSA. No isolates were found resistant to teicoplanin, sulfamethoxazole/trimethoprim, rifampicin, quinupristin/dalfopristin, linezolid, or vancomycin. However, these isolates showed high resistant rates to erythromycin, fosfomycin-trometamol and clindamycin. The agrI (87/107, 81.3%) was the most common agr allele, followed by agrIII(10/107, 9.3%), agrII(9/107, 8.4%), and agrIV(1/107, 0.9%). Six pvl-positive isolates (3 MRSA and 3 MSSA) and 7 isolates of livestock associated clone ST398 (4 MRSA, 3 MSSA) were identified. CC59 was found in 35 isolates (33 MRSA and 2 MSSA), constituting majority of MRSA (33/49, 67.35%). The dominant CC were CC59 (32.7%), CC188 (13.1%), CC7 (12.1%) and CC398 (9.3%) while t172 (16.8%), t189 (12.1%), t437 (9.3%), and t091 (9.3%) were the most common spa types. In conclusion, more particular concern should appeal to ST59-SCCmecIV-t172/t437 as it is the most common epidemic clone causing pneumonia among children in Shanghai.