A molecular epidemiological investigation of methicillin-susceptible Staphylococcus aureus causing bloodstream infections in Ireland, 2006-2017
A molecular epidemiological investigation of methicillin-susceptible Staphylococcus aureus causing bloodstream infections in Ireland, 2006-2017
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DOI：
10.1007/s10096-019-03523-0
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发表时间：
2019-05-01
影响因子：
4.5
通讯作者：
Shore, Anna C.
中科院分区：
文献类型：
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作者：
Deasy, Emily C.;Brennan, Grainne L.;Shore, Anna C.
在包括爱尔兰在内的许多国家，甲氧西林敏感的金黄色葡萄球菌(MSSA)血流感染(BSI)的流行率都有所增加。这项研究旨在调查2006年至2017年期间导致爱尔兰医院BSI的MSSA的分子流行病学，当时MSSA BSI增加，以确定任何潜在的患者或病原体促成因素。2006/2007、2011和2017年，共有252株来自爱尔兰医院患者的MSSA分离株进行了SPA分型和DNA微阵列分析。记录每个患者的性别、年龄、14天死亡率和感染的流行病学背景。社区起病(CO)MSSA、BSI和患者平均年龄显着增加，住院起病(HO)MSSA显着减少。虽然在这些分离物中检测到了广泛的遗传多样性，即24个多位点序列类型克隆复合体(CCS)/序列类型和124个SpA类型，但在研究期间，3个CCS(CC30、CC45、CC5)占主导地位，尽管所占比例不同。CC30显著下降，尤其是spa型t021，在HO-MSSA中更常见，而CC45和CC8增加，特别是spa型t015和t008，在CO-MSSA中更常见。在七种最常见的水疗类型中，有五种在CO-MSSA中更为常见。虽然多重耐药总体上有所下降，但erm(C)的流行显著增加，毒力基因减少，主要是EGC、TST、SCN、SEP和FNBB。这项研究强调了CO-MSSA BSI发病率上升带来的威胁，并建议与CC45 CO-MSSA发病率上升、CC30 HO-MSSA发病率下降、人口老龄化以及毒力和耐药性基因的整体下降有关。
The prevalence of methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections (BSIs) has increased in many countries, including Ireland. This study aimed to investigate the molecular epidemiology of MSSA causing BSIs in Irish hospitals between 2006 and 2017, when MSSA BSIs increased, to identify any potential patient or pathogen contributing factors. A total of 252 MSSA isolates from patients in Irish hospitals in 2006/2007, 2011 and 2017 underwent spa typing and DNA microarray profiling. Each patient's gender, age, 14-day mortality and epidemiological context of infection were recorded. Significant increases in community-onset (CO) MSSA BSIs and the average patient's age and decreases in hospital-onset (HO) MSSA were identified. Although, extensive genetic diversity was detected amongst the isolates, i.e. 24 multilocus sequence type clonal complexes (CCs)/sequence types and 124 spa types, three CCs (CC30, CC45, CC5) dominated, albeit in different proportions, during the study periods. CC30 declined significantly, in particular spa type t021, and was more common amongst HO-MSSA and CC45 and CC8 increased, particularly spa types t015 and t008, respectively, and were more common amongst CO-MSSA. Five of the seven most frequent spa types were more common amongst CO-MSSA. Although overall multidrug resistance decreased, the prevalence of erm(C) increased significantly and virulence genes decreased, mostly notably egc, tst, scn, sep and fnbB. This study highlights the threat posed by the increasing prevalence of CO-MSSA BSIs and suggests an association with the increasing prevalence of CC45 CO-MSSA, decreasing prevalence of CC30 HO-MSSA, an ageing population and an overall decrease in virulence and resistance genes.