Characterization of community-associated Staphylococcus aureus from skin and soft-tissue infections: a multicenter study in China.
Characterization of community-associated Staphylococcus aureus from skin and soft-tissue infections: a multicenter study in China.
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DOI：
10.1038/emi.2016.128
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发表时间：
2016-12-21
影响因子：
13.2
通讯作者：
Ma, Lin
中科院分区：
文献类型：
--
作者：
Liu, Ying;Xu, Zhe;Yang, Zhou;Sun, Juan;Ma, Lin
关键词：
我们评估了社区相关的耐甲氧西林金黄色葡萄球菌（CA-MRSA）和甲氧西林敏感的金黄色葡萄球菌的流行病学和分子特征。金黄色葡萄球菌（MSSA）从儿童和成人患者的皮肤和软组织感染（SSTI）在中国。社区获得性S.在23家医院进行了为期24个月的金黄色葡萄球菌SSTI监测。采用琼脂稀释法评价了对16种抗菌药物的敏感性。StatApriori用于确定统计学显著性相关趋势。采用葡萄球菌盒式染色体mec（SCCmec）分型、葡萄球菌蛋白A（spa）分型和多位点序列分型方法检测CA-MRSA分离株的基因型特征。确定Panton-Valentine杀白细胞素（pvl）基因的存在。总体而言，71.6%（1946/2716）的病例为社区相关性S。金黄色。CA-MRSA占2.6%（51）。在1895株甲氧西林敏感的S.金黄色葡萄球菌对红霉素耐药率为97.3%，对青霉素耐药率为96.6%，对克林霉素耐药率为89.1%。没有S。金黄色葡萄球菌对万古霉素耐药。CA-MRSA中检出13种序列型和17种spa型。最常见的序列类型是ST 121（19/51，37.3%），其次是ST 59（13/51，25.5%）。此外，t437占优势，占43.1%（22/51）。CA-MRSA中只有5株（9.8%）携带pv1基因。ST121和非ST121 MRSA分离株之间的抗生素敏感性没有显著差异。然而，ST 121菌株倾向于对头孢唑啉更耐药，而非ST 121菌株对氯霉素更耐药。总之，CA-MRSA感染在中国SSTI患者中是罕见的。我国MRSA菌株具有不同的遗传背景，以ST 121为优势克隆。夫西地酸和莫匹罗星对于局部治疗仍然有效。
We evaluated the epidemiological and molecular features of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) and methicillin-sensitive S. aureus (MSSA) from children and adult patients with skin and soft-tissue infections (SSTIs) in China. Prospective community-acquired S. aureus SSTI surveillance was conducted in 23 hospitals over a 24-month period. Susceptibility to 16 antimicrobials was evaluated using the agar dilution method. StatApriori was used to determine statistically significant association trends. The genotypic characteristics of CA-MRSA isolates were tested by staphylococcal cassette chromosome mec (SCCmec) typing, staphylococcal protein A (spa) typing, and multilocus sequence typing. The presence of Panton–Valentine leukocidin (pvl) genes was determined. Overall, 71.6% (1946/2716) of cases were community-associated S. aureus. CA-MRSA accounted for 2.6% (51). Out of 1895 methicillin-sensitive S. aureus strains, 97.3% were resistant to erythromycin, 96.6% to penicillin and 89.1% to clindamycin. No S. aureus strains were resistant to vancomycin. Thirteen sequence types (STs) and 17 spa types were detected among the CA-MRSA strains. The most prevalent sequence type was ST121 (19/51, 37.3%), followed by ST59 (13/51, 25.5%). In addition, t437 was predominant, accounting for 43.1% (22/51). Only five (9.8%) of the CA-MRSA strains harbored pvl genes. There were no significant differences in antibiotic sensitivity profiles between ST121 and non-ST121 MRSA isolates. However, ST121 strains tended to be more resistant to cefazolin, whereas non-ST121 strains were more resistant to chloramphenicol. In conclusion, CA-MRSA infections are rare among Chinese SSTI patients. MRSA strains in China have diverse genetic backgrounds, with ST121 being the predominant clone. Fusidic acid and mupirocin remain effective for topical treatment.
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影响因子：
168.9
作者：
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中国皮肤软组织感染儿童金黄色葡萄球菌对夫西地酸的敏感性和耐药性决定因素。
影响因子：
--
作者：
Liu, Yingchao;Geng, Wenjing;Shen, Xuzhuang
通讯作者：
Shen, Xuzhuang