Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S aureus, in nine European countries: a cross-sectional study
Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S aureus, in nine European countries: a cross-sectional study
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DOI：
10.1016/s1473-3099(13)70036-7
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发表时间：
2013-05-01
影响因子：
56.3
通讯作者：
Stobberingh, Ellen E.
中科院分区：
文献类型：
--
作者：
den Heijer, Casper D. J.;van Bijnen, Evelien M. E.;Stobberingh, Ellen E.
背景 有关金黄色葡萄球菌对抗菌药物耐药性流行情况的信息主要是从入侵菌株中获得的，尽管共生微生物群被认为是重要的耐药性库。我们的目的是比较九个欧洲国家健康患者中鼻腔金黄色葡萄球菌携带率和抗生素耐药性（包括耐甲氧西林金黄色葡萄球菌 (MRSA)）的患病率。 方法 在这项横断面研究中，从奥地利、比利时、克罗地亚、法国、匈牙利、西班牙、瑞典、荷兰和英国现有全国家庭医生网络中的家庭医生招募的 32 206 名患者中获取了鼻拭子。符合条件的患者年龄为 4 岁或以上（在英国≥ 18 岁）并且患有非传染性疾病。拭子被送往国家微生物实验室进行金黄色葡萄球菌的鉴定和分离。抗生素耐药性测试是在一个中央微生物实验室进行的。我们用spa分型方法建立了分离的MRSA菌株的基因型结构。结果从32206名患者拭子中的6956名（21.6％）分离出金黄色葡萄球菌。 18 岁以上患者的调整后金黄色葡萄球菌患病率范围为 12.1%（匈牙利）至 29.4%（瑞典）。除青霉素外，记录的耐药率最高的是阿奇霉素（从瑞典的1.6%到法国的16.9%）。总共分离出 91 种 MRSA 菌株，其中比利时报告的 MRSA 流行率最高（2.1%）。检测到 53 种不同的水疗类型，最常见的是 t002 (n=9) 和 t008 (n=8)。 解释 即使在对年龄、性别和家庭医生进行校正后，金黄色葡萄球菌鼻腔携带率在所评估的九个欧洲国家中也存在差异。一般来说，包括 MASA 在内的耐药率较低。记录的 MRSA 菌株在国家内部和国家之间都表现出基因型异质性。
Background Information about the prevalence of Staphylococcus aureus resistance to antimicrobial drugs has mainly been obtained from invasive strains, although the commensal microbiota is thought to be an important reservoir of resistance. We aimed to compare the prevalence of nasal S aureus carriage and antibiotic resistance, including meticillin-resistant S aureus (MRSA), in healthy patients across nine European countries.Methods In this cross-sectional study, nasal swabs were obtained from 32 206 patients recruited by family doctors participating in existing nationwide family doctor networks in Austria, Belgium, Croatia, France, Hungary, Spain, Sweden, the Netherlands, and the UK. Eligible patients were aged 4 years or older (>= 18 years in the UK) and presented with a non-infectious disorder. Swabs were sent to national microbiological laboratories for identification and isolation of S aureus. Antibiotic resistance testing was done at one central microbiological laboratory. We established the genotypic structure of the isolated MRSA strains with the spa typing method.Findings S aureus was isolated from 6956 (21.6%) of 32206 patients swabbed. The adjusted S aureus prevalence for patients older than 18 years ranged from 12.1% (Hungary) to 29.4% (Sweden). Except for penicillin, the highest recorded resistance rate was to azithromycin (from 1.6% in Sweden to 16.9% in France). In total, 91 MRSA strains were isolated, and the highest MRSA prevalence was reported in Belgium (2.1%). 53 different spa types were detected the-most prevalent were t002 (n=9) and t008 (n=8).Interpretation The prevalence of S aureus nasal carriage differed across the nine European countries assessed, even after correction for age, sex, and family doctor. Generally, the prevalence of resistance, including that of MASA, was low. The MRSA strains recorded showed genotypic heterogeneity, both within and between countries.