Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection.
Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection.
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DOI：
10.1186/s12879-022-07371-w
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发表时间：
2022-04-24
影响因子：
3.7
通讯作者：
Altman, Deena R.
中科院分区：
文献类型：
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作者：
Schwarz, Erika Reategui;van de Guchte, Adriana;Dupper, Amy C.;Caban, Ana Berbel;Nadkarni, Devika;Fox, Lindsey;Mills, Alexandra;Obla, Ajay;Chacko, Kieran, I;Oussenko, Irina;Samaroo, Flora;Polanco, Jose;Silvera, Richard;Smith, Melissa L.;Patel, Gopi;Gitman, Melissa;Alburquerque, Bremy;Chung, Marilyn;Sullivan, Mitchell J.;van Bakel, Harm;Altman, Deena R.
关键词：
医疗保健相关感染对全球患者构成潜在的致命威胁，金黄色葡萄球菌是医疗保健相关感染的最常见原因之一。金黄色葡萄球菌是一种常见的共生病原体，也是引起菌血症的常见原因，研究表明，来自单个患者的鼻腔和血液分离株的匹配率超过80%。在这里，我们报告了来自耐甲氧西林金黄色葡萄球菌（MRSA）血流感染患者的定植分离株的当代收集，以评估宿主内的多样性，并详细介绍了伴随鼻腔定植的临床特征。从诊断为MRSA菌血症的患者获得双侧前鼻孔拭子。从血液中提取一个菌落培养物，从指甲中提取平均6个菌落，评估MRSA的生长情况。对于葡萄球菌培养物，我们对葡萄球菌蛋白A （spa）进行了多株分型，并获得了克隆复合物。从电子病历系统中回顾性获得人口统计学和临床数据，并使用单变量和多变量回归模型进行分析。在11个月的时间里，68名患者被诊断为MRSA血流感染，53名患者被拭子擦拭，37名（70%）患者在鼻腔前段被MRSA定植。我们对213个鼻腔菌落进行了分子分型。在95%的病例中，在鼻腔中也检测到血液中发现的Spa型和克隆复合物。我们还发现，11%的患者在鼻腔中携带一个以上的MRSA克隆体。男性和过去90天内的住院史增加了MRSA定植的几率。在侵袭性疾病的背景下，定植的分子流行病学景观是多种多样的，确定定植与侵袭性疾病之间的相互作用对于对抗侵袭性MRSA疾病至关重要。在线版本包含补充材料，可在10.1186/s12879-022-07371-w获得。
Healthcare-associated infections pose a potentially fatal threat to patients worldwide and Staphylococcus aureus is one of the most common causes of healthcare-associated infections. S. aureus is a common commensal pathogen and a frequent cause of bacteremia, with studies demonstrating that nasal and blood isolates from single patients match more than 80% of the time. Here we report on a contemporary collection of colonizing isolates from those with methicillin-resistant S. aureus (MRSA) bloodstream infections to evaluate the diversity within hosts, and detail the clinical features associated with concomitant nasal colonization. Swabs of the bilateral anterior nares were obtained from patients diagnosed with MRSA bacteremia. A single colony culture from the blood and an average of 6 colonies from the nares were evaluated for MRSA growth. For the nares cultures, we typed multiple isolates for staphylococcal protein A (spa) and derived the clonal complexes. Demographic and clinical data were obtained retrospectively from the electronic medical record system and analysed using univariate and multivariable regression models. Over an 11-month period, 68 patients were diagnosed with MRSA bloodstream infection, 53 were swabbed, and 37 (70%) were colonized with MRSA in the anterior nares. We performed molecular typing on 213 nasal colonies. Spa types and clonal complexes found in the blood were also detected in the nares in 95% of the cases. We also found that 11% of patients carried more than one clone of MRSA in the nares. Male sex and history of prior hospitalization within the past 90 days increased odds for MRSA colonization. The molecular epidemiological landscape of colonization in the setting of invasive disease is diverse and defining the interplay between colonization and invasive disease is critical to combating invasive MRSA disease. The online version contains supplementary material available at 10.1186/s12879-022-07371-w.
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影响因子：
33.9
作者：
Kourtis, Athena P.;Hatfield, Kelly;Cardo, Denise
通讯作者：
Cardo, Denise
开放式细菌种群基因组学：BIGSDB软件，pubmlst.org网站及其应用。
影响因子：
--
作者：
Jolley KA;Bray JE;Maiden MCJ
通讯作者：
Maiden MCJ
影响因子：
168.9
作者：
DeLeo, Frank R.;Otto, Michael;Kreiswirth, Barry N.;Chambers, Henry F.
通讯作者：
Chambers, Henry F.
影响因子：
11.8
作者：
Davis, KA;Stewart, JJ;Hospenthal, DR
通讯作者：
Hospenthal, DR
DOI：
10.1038/nrmicro.2015.13
发表时间：
2016-03
期刊：
Nature reviews. Microbiology
影响因子：
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作者：
通讯作者：
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