Epidemiological characteristics of methicillin-resistant Staphylococcus aureus isolates from children with eczematous atopic dermatitis lesions
Epidemiological characteristics of methicillin-resistant Staphylococcus aureus isolates from children with eczematous atopic dermatitis lesions
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DOI：
10.1128/jcm.00698-07
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发表时间：
2008-03-01
影响因子：
9.4
通讯作者：
Hong, Soo-Jong
中科院分区：
文献类型：
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作者：
Chung, Hee-Jung;Jeon, Hong-Seon;Hong, Soo-Jong
在这项研究中，我们调查了特应性皮炎（AD）儿童皮肤的耐甲氧西林金黄色葡萄球菌（MRSA）的定植率和特点的菌株。用罗氏葡萄球菌（Komed，韩国）培养儿童AD患者的活动性皮肤病变。S.检测金黄色葡萄球菌分离株的药物敏感性，分析eta、etb、tst和pvl基因，并使用agr多态性、SmaI限制性染色体DNA的脉冲场凝胶电泳和葡萄球菌盒式染色体mec（SCCmec）分型进行分型。115例患者中87例（75.4%）有可培养的S.金黄色葡萄球菌16株（18.3%）。所有MRSA分离株均对氯霉素、利福平、复方新诺明和环丙沙星敏感。而对甲氧西林敏感的S.金黄色葡萄球菌（MSSA）分离株由23个单一型分离株和9个包括48个分离株的簇组成，MRSA分离株被分型为3个克隆：8个脉冲型A-agr-1-SCCmec IV分离株，5个脉冲型B-agr-3-SCCmec IIb-etb阳性分离株和3个脉冲型C-agr-3-SCCmec IV分离株。3株SCCmec IVA MRSA分离株为tst阳性，但pvl或eta基因均为阴性。71株MSSA中7株tst阳性，其中6株为脉冲型F-agr-3，10株agr-4中9株为eta阳性。携带MSSA、SCCmec IVA MRSA和SCCmec IIb MRSA的患者的平均年龄分别为7.7 ± 4.6、3.1 ± 1.5和8.2 ± 3.1岁。在携带MRSA的患者中，有两名患者接受了口服抗菌药物治疗，一名患者在18个月前入院。总之，社区获得性MRSA分离株的几个克隆定植于AD患者的皮肤，而没有获得医院获得性MRSA的风险因素，这表明AD儿童的皮肤可能是社区MRSA定植的重要储库。
In this study, we investigated the rate of colonization of skin of children with atopic dermatitis (AD) by methicillin-resistant Staphylococcus aureus (MRSA) and characterized the isolates. Active skin lesions in pediatric AD patients were cultured with Rodac Staph (Komed, Korea). S. aureus isolates were examined for drug susceptibilities, analyzed for the eta, etb, tst, and pvl genes, and typed using agr polymorphism, pulsed-field gel electrophoresis of SmaI-restricted chromosomal DNA, and staphylococcal cassette chromosome mec (SCCmec) typing. Eighty-seven (75.4%) of 115 patients had cultivable S. aureus isolates, 16 of which (18.3%) were MRSA. All MRSA isolates were susceptible to chloramphenicol, rifampin, cotrimoxazole, and ciprolloxacin. While methicillin-susceptible S. aureus (MSSA) isolates were composed of 23 isolates of singular types and nine clusters comprising 48 isolates, MRSA isolates were typed into three clones: eight isolates of pulsotype A-agr-1-SCCmec IV, five isolates of pulsotype B-agr-3-SCCmec IIb-etb positive, and three isolates of pulsotype C-agr-3-SCCmec IV. Three SCCmec IVA MRSA isolates were tst positive, but none were positive for the pvl or eta gene. Among 71 MSSA isolates, 7 isolates were tst positive, 6 of which were pulsotype F-agr-3, and 9 of 10 agr-4 isolates were eta positive. The average ages of patients carrying MSSA, SCCmec IVA MRSA, and SCCmec IIb MRSA were 7.7 +/- 4.6, 3.1 +/- 1.5, and 8.2 +/- 3.1 years, respectively. Among the patients carrying MRSA, two patients had been treated with oral antimicrobials, and one had been admitted to the hospital 18 months previously. In conclusion, community-acquired MRSA isolates of a few clones colonized the skin of patients with AD without risk factors for the acquisition of hospital-acquired MRSA, which suggested that the skin of children with AD may represent a significant reservoir of MRSA colonization in the community.