Challenges in Estimating Characteristics of Staphylococcus aureus Nasal Carriage Among Humans Enrolled in Surveillance Studies.
Challenges in Estimating Characteristics of Staphylococcus aureus Nasal Carriage Among Humans Enrolled in Surveillance Studies.
复制标题
DOI：
10.3389/fpubh.2018.00163
复制
发表时间：
2018
影响因子：
5.2
通讯作者：
Stewart JR
中科院分区：
文献类型：
--
作者：
Le TT;Nadimpalli M;Wu J;Heaney CD;Stewart JR
金黄色葡萄球菌是人类和动物的一种机会性病原体，能够引起抗生素耐药感染，评估其携带情况在流行病学上具有重要意义。然而，金黄色葡萄球菌的临床和流行病学监测研究通常依赖于每个个体一个分离株的特征，这可能不能代表携带者的实际种群多样性。本研究的目的是确定一种分离物是否足以确定健康（非住院）人群中特定菌株的携带者状态或金黄色葡萄球菌的特征。我们比较了19名参与者（共190株）的spa类型、遗传标记（mecA、scn）和10株金黄色葡萄球菌的耐药谱，这些参与者从工业生猪操作工人及其家庭成员中选出。参与者包括持续（n = 10）和中间（n = 9）金黄色葡萄球菌携带者。在参与者中，17人（89%）鼻内携带单一金黄色葡萄球菌spa型，另外2人携带显性spa型。在移动遗传元件（mecA, scn）上编码的基因与抗生素耐药谱的相似性较小。基于接收工作特征曲线的统计建模表明，可能需要三到五个分离株才能准确地为这些更可变的特征分配鼻载状态。在金黄色葡萄球菌的持续携带者和中间携带者中观察到可变性。这些结果表明，依赖于检测一种金黄色葡萄球菌分离物的监测研究可能会确定主要的spa类型，但可能无法完全捕获金黄色葡萄球菌的更多可变特征，包括抗生素耐药性。依赖于检测一种分离物的监测研究可能低估了具有这些更可变特征的金黄色葡萄球菌鼻腔携带的流行程度。
Evaluating carriage of Staphylococcus aureus, an opportunistic pathogen of humans and animals capable of causing antibiotic-resistant infections, is epidemiologically important. However, clinical and epidemiological surveillance studies of S. aureus typically rely on characterizing one isolate per individual, which may not represent the actual population diversity in a carrier. The objective of this study was to determine if one isolate is sufficient for determining carrier status of particular strains or characteristics of S. aureus in a healthy (non-hospitalized) human population. We compared spa types, genetic markers (mecA, scn), and antibiotic resistance profiles of 10 S. aureus isolates recovered from a single nasal swab for each of 19 participants (190 isolates total) selected from a cohort of industrial hog operation workers and their household members. Participants included both persistent (n = 10) and intermediate (n = 9) carriers of S. aureus. Among the participants, 17 (89%) carried a single S. aureus spa type intranasally and the other two carried dominant spa types. Less similarity was observed for genes encoded on mobile genetic elements (mecA, scn) and antibiotic resistance profiles. Statistical modeling, based on receiving operating characteristic curves, suggests that three to five isolates may be necessary to accurately assign nasal carriage status for these more variable characteristics. Variability was observed for both persistent and intermediate carriers of S. aureus. These results suggest that surveillance studies that rely on testing one S. aureus isolate are likely to identify predominant spa types but may not fully capture more variable characteristics of S. aureus, including antibiotic resistance. Surveillance studies that rely on testing one isolate may underestimate prevalence of nasal carriage of S. aureus with these more variable characteristics.
登录
查看更多内容
影响因子：
3.7
作者：
Stegger M;Liu CM;Larsen J;Soldanova K;Aziz M;Contente-Cuomo T;Petersen A;Vandendriessche S;Jiménez JN;Mammina C;van Belkum A;Salmenlinna S;Laurent F;Skov RL;Larsen AR;Andersen PS;Price LB
通讯作者：
Price LB
金黄色葡萄球菌菌血症的临床管理：评论。
影响因子：
120.7
作者：
Holland, Thomas L.;Arnold, Christopher;Fowler, Vance G., Jr.
通讯作者：
Fowler, Vance G., Jr.
影响因子：
3.7
作者：
Nadimpalli M;Stewart JR;Pierce E;Pisanic N;Love DC;Hall D;Larsen J;Carroll KC;Tekle T;Perl TM;Heaney CD
通讯作者：
Heaney CD
影响因子：
11.8
作者：
van Loo I;Huijsdens X;Tiemersma E;de Neeling A;van de Sande-Bruinsma N;Beaujean D;Voss A;Kluytmans J
通讯作者：
Kluytmans J
影响因子：
9.4
作者：
Votintseva AA;Miller RR;Fung R;Knox K;Godwin H;Peto TE;Crook DW;Bowden R;Walker AS
通讯作者：
Walker AS