A 5-year Survey Reveals Increased Susceptibility to Glycopeptides for Methicillin-Resistant Staphylococcus aureus Isolates from Staphylococcus aureus Bacteremia Patients in a Chinese Burn Center.
A 5-year Survey Reveals Increased Susceptibility to Glycopeptides for Methicillin-Resistant Staphylococcus aureus Isolates from Staphylococcus aureus Bacteremia Patients in a Chinese Burn Center.
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一项为期 5 年的调查显示，中国烧伤中心的金黄色葡萄球菌菌血症患者对耐甲氧西林金黄色葡萄球菌的糖肽敏感性增加
DOI：
10.3389/fmicb.2017.02531
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发表时间：
2017
影响因子：
5.2
通讯作者：
Peng Y
中科院分区：
文献类型：
--
作者：
Jiang B;Yin S;You B;Huang G;Yang Z;Zhang Y;Chen Y;Chen J;Yuan Z;Rao X;Hu X;Gong Y;Peng Y
耐甲氧西林金黄色葡萄球菌（MRSA）感染在烧伤病房中很普遍，在金黄色葡萄球菌菌血症（SAB）患者中尤为严重。糖肽和达托霉素对MRSA感染有效，但MIC蠕变会降低其疗效。我们的目的是对烧伤中心的金黄色葡萄球菌分离株进行分子流行病学调查，并评估mic对sab相关MRSA分离株的抗菌剂。本研究使用2011年8月至2016年7月获得的259株金黄色葡萄球菌分离株。采用多分子分型方法进行分子流行病学分析。e -试验用于测定万古霉素、替柯planin和达托霉素对sabb相关MRSA分离株的mic。MIC值按收集日期或来源分层并进行比较。Spearman试验用于分析被测抗菌素之间的mic相关性。ST239-MRSA-III-t030-agrI克隆在SAB和非SAB患者中均占优势，且在SAB患者中显著高于ST239-MRSA-III-t030-agrI克隆（P < 0.0001）。sabb - mrsa分离株在5年期间表现出万古霉素、替可普宁和达托霉素的mic降低。与那些从导管或伤口中分离出来的相比，从血液中分离出来的SAB-MRSA对万古霉素和达托霉素不太敏感，但对替柯planin更敏感。血液中MRSA分离物中万古霉素和达托霉素的mic仅存在相关性（rho = 0.250, P = 0.024）。总之，我们的结果表明，在烧伤中心，MRSA感染仍然是一个严重的问题。与大多数其他研究相比，我们观察到2011年至2016年我们中心对糖肽和达托霉素对sabb相关MRSA的敏感性增加，这表明糖肽的使用不会导致MIC蠕变。来自身体不同部位的分离株可能对不同抗菌素表现出不同的敏感性水平和随时间的变化趋势，因此应综合考虑MRSA感染的抗菌素选择。
Methicillin-resistant Staphylococcus aureus (MRSA) infections are prevalent in burn wards, and are especially serious in S. aureus bacteremia (SAB) patients. Glycopeptides and daptomycin are effective against MRSA infections, but MIC creeps can reduce their efficacy. Our object was to perform a molecular epidemiological investigation of S. aureus isolates in our burn center and to evaluate MICs for antimicrobials against SAB-associated MRSA isolates. A total of 259 S. aureus isolates, obtained from August 2011 to July 2016, were used in this study. Multiple molecular typing was used for molecular epidemiological analysis. E-tests were used to determine MICs of vancomycin, teicoplanin, and daptomycin for SAB-associated MRSA isolates. MIC values were stratified by collection date or source and compared. Spearman's test was used to analyze MICs correlations amongst tested antimicrobials. ST239-MRSA-III-t030-agrI clone was found to be dominant in both SAB and non-SAB patients, and significantly more in SAB patients (P < 0.0001). SAB-MRSA isolates exhibited decreased MICs for vancomycin, teicoplanin, and daptomycin during the 5-year period. Compared to those isolated from catheters or wounds, SAB-MRSA isolates from the bloodstream were less susceptible to vancomycin and daptomycin, but more susceptible to teicoplanin. MICs Correlation was found only between vancomycin and daptomycin in MRSA isolates from the bloodstream (rho = 0.250, P = 0.024). In conclusion, our results suggest that MRSA infections are still serious problems in burn centers. In contrast to most other studies, we observed increased susceptibility to glycopeptides and daptomycin against SAB-associated MRSA in our center from 2011 to 2016, suggesting the use of glycopeptides does not lead to MIC creeps. Isolates from different sites of the body may exhibit different levels of susceptibility and change trend over time for different antimicrobials, antimicrobials selection for MRSA infections should be considered comprehensively.