Emergence of a Community-Associated Methicillin-Resistant Staphylococcus aureus Strain with a Unique Resistance Profile in Southwest Nigeria
Emergence of a Community-Associated Methicillin-Resistant Staphylococcus aureus Strain with a Unique Resistance Profile in Southwest Nigeria
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DOI：
10.1128/jcm.00648-09
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发表时间：
2009-09-01
影响因子：
9.4
通讯作者：
Koenig, W.
中科院分区：
文献类型：
--
作者：
Ghebremedhin, B.;Olugbosi, M. O.;Koenig, W.
表型，基因型和毒素基因分析尚未完成所有在一个尼日利亚金黄色葡萄球菌人口。本研究对沙门氏菌的分子流行病学和遗传多样性进行了综述。在尼日利亚的伊巴丹最大的大学诊所里，在2007年为期一年的监测中，从尼日利亚伊巴丹大学教学医院收集的1,300例患者的临床样本中，346例非重复的沙门氏菌。获得金黄色葡萄球菌分离株。所有分离株进行抗生素敏感性试验，毒素基因分析，多位点序列分型，agr组分型和spa分型。对于耐甲氧西林的S.金黄色葡萄球菌（MRSA），葡萄球菌盒式染色体mec（SCCmec）分型。346株耐甲氧西林菌株占20.23%。根据病历回顾，33例患者的分离株（47.15%）符合社区相关MRSA（CA-MRSA）的定义标准。分析的大多数MRSA菌株分离自外科或儿科患者。最常见的MRSA感染类型是泌尿系统感染（> 70%），而CA-MRSA感染类型是结膜炎和耳炎（19例[57.6%]）以及意外皮肤和皮下组织感染（14例[42.4%]）。对甲氧西林敏感的S.金黄色葡萄球菌菌株（ST1、ST5、ST15、ST7、ST8、ST25、ST30、ST72、ST80、ST121和ST508）通过表型和基因型分析是异质的。本研究首次报道了尼日利亚的Panton-Valentine杀白细胞素阳性ST 88菌株（agr III，SCCmec IV），以及该菌株的遗传分析。ST 88菌株对甲氧苄啶-磺胺甲恶唑以及青霉素和苯唑西林耐药。CA-MRSA感染在眼部和耳部感染的年轻患者中迅速增加。城市地区的人口较低的社会经济地位和过度拥挤的证据似乎是在高风险的出现这种克隆。
Phenotypic, genotypic, and toxin gene analyses have not yet been done all in one for the Nigerian Staphylococcus aureus population. This study provides a comprehensive overview of the molecular epidemiology and genetic diversity of S. aureus strains at the largest university clinic in Ibadan, Nigeria. From 1,300 patients' clinical samples collected at the University Teaching Hospital in Ibadan, Nigeria, during a 1-year-surveillance in 2007, 346 nonduplicate S. aureus isolates were obtained. All isolates underwent antibiotic susceptibility testing, toxin gene analysis, multilocus sequence typing, agr group typing, and spa typing. For methicillin (meticillin)-resistant S. aureus (MRSA), staphylococcal cassette chromosome mec (SCCmec) typing was also performed. Of the 346 isolates, 20.23% were methicillin resistant. Thirty-three patients' isolates (47.15%) fulfilled the definition criteria for community-associated MRSA (CA-MRSA) according to a review of the medical charts. The majority of MRSA strains analyzed were isolated from surgical or pediatric patients. The commonest types of MRSA infection identified were surgical-site infections (>70%), whereas those for CA-MRSA were conjunctivitis and otitis ( 19 patients [57.6%]) and accidental skin and subcutaneous tissue infections ( 14 patients [ 42.4%]). The methicillin-susceptible S. aureus strains (ST1, ST5, ST15, ST7, ST8, ST25, ST30, ST72, ST80, ST121, and ST508) were heterogeneous by phenotypic and genotypic analyses. The first report of a Panton-Valentine leukocidin- positive ST88 strain (agr III, SCCmec IV) in Nigeria, as well as genetic analyses of this strain, is presented in this study. The ST88 strain was resistant to trimethoprim-sulfamethoxazole as well as to penicillin and oxacillin. CA-MRSA infections are increasing rapidly among young patients with ophthalmologic and auricular infections. Urban regions with populations of lower socioeconomic status and evidence of overcrowding appear to be at high risk for the emergence of this clone.