Active Surveillance, Drug Resistance, and Genotypic Profiling of Staphylococcus aureus Among School-Age Children in China.
Active Surveillance, Drug Resistance, and Genotypic Profiling of Staphylococcus aureus Among School-Age Children in China.
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DOI：
10.3389/fmed.2021.701494
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发表时间：
2021
影响因子：
3.9
通讯作者：
Zhou Z
中科院分区：
文献类型：
--
作者：
Liang B;Liang X;Gao F;Long Y;Mai J;Ai X;Wang J;Gao X;Xiong Z;Liang Z;Zhang C;Gong S;Zhou Z
甲氧西林敏感（MSSA）和耐甲氧西林金黄色葡萄球菌（MRSA）鼻定植使个体易于发生内源性感染，是儿童的主要威胁。最近，苯唑西林/头孢西丁敏感的mecA阳性S.金黄色葡萄球菌（OS-MRSA）已在全球范围内报道。在此，一个前瞻性的，横断面研究进行了五所学校，代表三个教育阶段，在广州，中国。对2,375名学生的鼻拭子进行了S。金黄色葡萄球菌和所有分离株进行抗生素敏感性测试表型和femB和mecA基因检测确认;所有分离株被分类为MSSA，MRSA，或OS-MRSA。所有菌株也进行了多位点序列分型。在2，375个拭子中，S.在744名儿童中检测到金黄色葡萄球菌（31.3%，95%CI：25.9-36.7%），其中72名患有MRSA（3.0%，95%CI：0.6-5.4%），4名患有OS-MRSA（0.2%，95%CI：0.1-0.3%），其中鉴定出苯唑西林和头孢西丁敏感的MRSA菌株。S.金黄色葡萄球菌和MRSA在年幼儿童中较高。S. 744株金黄色葡萄球菌对青霉素的敏感性最高（85.5%），其次为红霉素（43.3%）和克林霉素（41.0%）。MSSA中最常见的序列类型（ST）为ST 30、ST 45和ST 188，占总分离株的38.7%，而ST 45、ST 59和ST 338占MRSA分离株的74.6%，ST 338占OS-MRSA分离株的50.0%。MRSA和OS-MRSA分离株（n = 76）分为三个分支和一个单克隆，克隆复合体（CC）45作为最主要的连锁。多位点序列分型前9位的CC（CC 30、CC 45、CC 5、CC 1、CC 15、CC 944、CC 398、CC 59、CC 7）占全部S.金黄色葡萄球菌分离株CC 30菌株对红霉素和克林霉素均耐药，几乎所有菌株对青霉素也耐药（99.2%）。CC 45和CC 59菌株对苯唑西林的耐药率分别为31.5%和59.0%。这项研究提供了最新的数据，为设计有效的控制策略，以减轻疾病的负担，并提高经验性抗菌治疗的潜在有害感染的充分性。
Methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization predisposes individuals for endogenous infections and is a major threat to children. Recently, oxacillin/cefoxitin-susceptible mecA-positive S. aureus (OS-MRSA) has been reported worldwide. Herein, a prospective, cross-sectional study was conducted across five schools, representing three educational stages, in Guangzhou, China. Nasal swabs from 2,375 students were cultured for S. aureus and all isolates were subjected to antibiotic susceptibility testing phenotypically and confirmed by femB and mecA genetic detection; all the isolates were classified as MSSA, MRSA, or OS-MRSA. All strains were also analyzed by multi-locus sequence typing. Among the 2,375 swabs, S. aureus was detected in 744 children (31.3%, 95% CI: 25.9–36.7%), of whom 72 had MRSA (3.0%, 95% CI: 0.6–5.4%) and 4 had OS-MRSA (0.2%, 95% CI: 0.1–0.3%), of which an oxacillin- and cefoxitin-susceptible MRSA strain was identified. The prevalence of S. aureus and MRSA was higher in younger children. The highest percentage of drug resistance of the S. aureus isolates (n = 744) was to penicillin (85.5%), followed by erythromycin (43.3%) and clidamycin (41.0%). The most prevalent sequence types (STs) were ST30, ST45, and ST188 in MSSA, accounting for 38.7% of the total isolates, whereas ST45, ST59, and ST338 accounted for 74.6% of the MRSA isolates and ST338 accounted for 50.0% of the OS-MRSA isolates. The MRSA and OS-MRSA isolates (n = 76) were grouped into three clades and one singleton, with clonal complex (CC) 45 as the most predominant linkage. The top nine multi-locus sequence typing-based CCs (CC30, CC45, CC5, CC1, CC15, CC944, CC398, CC59, CC7) represented 86.7% of all S. aureus isolates. All CC30 isolates were resistant to erythromycin and clidamycin, and almost all these isolates were also resistant to penicillin (99.2%). The CC45 and CC59 isolates exhibited high resistance rates to oxacillin at 31.5 and 59.0%, respectively. This study provides updated data valuable for designing effective control strategies to mitigate the burden of disease and to improve the adequacy of empirical antimicrobial treatments for potentially harmful infections.
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影响因子：
14.2
作者：
Magiorakos, A. -P.;Srinivasan, A.;Monnet, D. L.
通讯作者：
Monnet, D. L.
影响因子：
5.2
作者：
Liang B;Mai J;Liu Y;Huang Y;Zhong H;Xie Y;Deng Q;Huang L;Yao S;He Y;Long Y;Yang Y;Gong S;Yang H;Zhou Z
通讯作者：
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4.9
作者：
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通讯作者：
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影响因子：
81.5
作者：
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通讯作者：
Harbarth, Stephan
影响因子：
5.2
作者：
Pang Rui;Wu Shi;Wu Qingping
通讯作者：
Wu Qingping