Clinical and molecular characteristics of invasive community-acquired Staphylococcus aureus infections in Chinese children.
Clinical and molecular characteristics of invasive community-acquired Staphylococcus aureus infections in Chinese children.
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DOI：
10.1186/s12879-014-0582-4
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发表时间：
2014-11-07
影响因子：
3.7
通讯作者：
Shen X
中科院分区：
文献类型：
--
作者：
Qiao Y;Ning X;Chen Q;Zhao R;Song W;Zheng Y;Dong F;Li S;Li J;Wang L;Zeng T;Dong Y;Yao K;Yu S;Yang Y;Shen X
本研究旨在调查中国儿童侵袭性社区获得性金黄色葡萄球菌（CA-SA）感染的临床特征，并分析其分子特征。前瞻性收集临床数据和侵袭性CA-SA分离株。儿科死亡风险（PRISM）评分用于疾病严重程度测量。然后进行分子分型，然后进行毒力基因的表达分析。在163例侵袭性CA-SA感染病例中，耐甲氧西林金黄色葡萄球菌（MRSA）71例（43.6%），甲氧西林敏感金黄色葡萄球菌（MSSA）92例（56.4%）。1岁以下儿童105例（64.4%），3岁以下儿童占79.7%（129/163）。共检出13种疾病，其中菌血症占65.6%（107/163），肺炎占52.8%（86/163）。共有112例（68.1%）患者同时存在两个或两个以上感染部位，其中4例（2.5%）死亡。CA-MSSA比MRSA更常引起多部位感染、菌血症和肌肉骨骼感染。共检测到25种序列类型（ST）。MRSA以ST 59为主（49/71，69%），MSSA以ST 88（15/92，16.3%）、ST 25（13/92，14.1%）、ST 7（13/92，14.1%）、ST 2155（12/92，13%）和ST 188（9/92，9.8%）为最常见的克隆型。MSSA和MRSA组共有7例ST。两组之间或不同ST之间的临床表现或PRISM评分无差异。6个主要ST克隆中4个已知毒力基因的表达水平各不相同。侵袭性CA-SA感染在我国具有发病率高、多部位感染的特点。CA-MSSA较CA-MRSA更易发生多部位感染、菌血症和肌肉骨骼感染。分离的基因型可能与毒力基因的表达有关，但与临床表现无关。本文的在线版本（doi：10.1186/s12879-014-0582-4）包含补充材料，可供授权用户使用。
This study aims to investigate the clinical features of invasive community-acquired Staphylococcus aureus (CA-SA) infection in Chinese children and analyze its molecular features. Clinical data and invasive CA-SA isolates were prospectively collected. Pediatric risk of mortality (PRISM) score was used for disease severity measurement. Molecular typing was then performed, followed by expression analysis for virulence genes. Among 163 invasive CA-SA infection cases, 71 (43.6%) were methicillin-resistant SA (MRSA) infections and 92 (56.4%) were methicillin-susceptible SA (MSSA). A total of 105 (64.4%) children were younger than 1 year old, and 79.7% (129/163) were under 3 years age. Thirteen kinds of diseases were observed, in which bacteremia and pneumonia accounted for 65.6% (107/163) and 52.8% (86/163), respectively. A total of 112 (68.1%) patients had two or more infective sites simultaneously, and four cases (2.5%) died. CA-MSSA more frequently caused multi-sites infections, bacteremia, and musculoskeletal infection than MRSA. A total of 25 sequence types (STs) were detected. MRSA mainly comprised ST59 (49/71, 69%), whereas the most frequent clonotypes were ST88 (15/92, 16.3%), ST25 (13/92, 14.1%), ST7 (13/92, 14.1%), ST2155 (12/92, 13%), and ST188 (9/92, 9.8%) for MSSA. Seven STs were common to both MSSA and MRSA groups. No differences in clinical presentation or PRISM score were found between the two groups or among different ST. The expression levels of the four known virulence genes varied among the six main ST clones. Invasive CA-SA infections were characterized by high incidence and multi-site infections in young children in China. The clinical manifestations of CA-MSSA were more frequently associated with multi-site infections, bacteremia and musculoskeletal infection than those of CA-MRSA. Isolated genotypes may be relevant to the expressions of virulence genes, but not to clinical manifestations. The online version of this article (doi:10.1186/s12879-014-0582-4) contains supplementary material, which is available to authorized users.
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影响因子：
4.1
作者：
Creel, Amy M.;Durham, Spencer H.;Winkler, Margaret K.
通讯作者：
Winkler, Margaret K.
影响因子：
6.4
作者：
Kobayashi, Scott D.;Malachowa, Natalia;DeLeo, Frank R.
通讯作者：
DeLeo, Frank R.
中国儿童流行性耐甲氧西林金黄色葡萄球菌（MRSA）毒力特征对比分析：ST59 MRSA高表达核心基因编码毒素
影响因子：
2.8
作者：
Li, Shipeng;Sun, Jing;Shen, Xuzhuang
通讯作者：
Shen, Xuzhuang
影响因子：
3.7
作者：
Chen FJ;Siu LK;Lin JC;Wang CH;Lu PL
通讯作者：
Lu PL
影响因子：
11.8
作者：
Liu, Catherine;Bayer, Arnold;Chambers, Henry F.
通讯作者：
Chambers, Henry F.