Current status of oxacillin-susceptible mecA- positive Staphylococcus aureus infection in Shanghai, China: A multicenter study
Current status of oxacillin-susceptible mecA- positive Staphylococcus aureus infection in Shanghai, China: A multicenter study
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中国上海地区苯唑西林敏感mecA阳性金黄色葡萄球菌感染现状：一项多中心研究
DOI：
10.1016/j.jmii.2020.07.021
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发表时间：
2021-12-13
影响因子：
7.4
通讯作者：
Li, Min
中科院分区：
文献类型：
--
作者：
Liu, Jun-Lan;Li, Tian-Ming;Li, Min
背景：苯唑西林敏感的mecA阳性金黄色葡萄球菌(OS-MRSA)是一个重要的问题，因为它对苯唑西林的敏感性导致了传统药敏试验的误诊，从而导致潜在的治疗失败，但关于中国医院OS-MRSA感染的现状数据有限。方法：对来自10家医院的956株金黄色葡萄球菌进行药敏试验和诊断试验，包括VITEK-2自动药敏试验、微量肉汤稀释法、纸片扩散法、PBB2a、mecA和mecC基因检测。对所有已鉴定的OS-MRSA进行多位点序列分型(MLST)，同时进行SpA分型、SCCmec分型和PVL检测。结果：OS-MRSA以儿科住院患者为主，占分离株的1.8%(17/956)。在17例OS-MRSA中，10例为ST59，其次为ST965(3/17)，11例为SCCmec IV型，5例为SCCmec V型，但仅1例为Panton-Valutine Leucoidin(PVL)阳性，16例mecA启动子存在一个或两个点突变。OS-MRSA对苯唑西林具有诱导性耐药，多药耐药率显著降低。我们观察到VITEK-2系统在检测OS-MRSA方面存在一些不足，而头孢西丁纸片扩散法是一种可靠且经济的替代方法，在检测对苯唑西林敏感的金黄色葡萄球菌时应予以补充。结论：本研究对中国的OS-MRSA的表型和分子特征进行了研究，为更有效地治疗OS-MRSA提供了新的思路。版权所有2020，台湾微生物学会。爱思唯尔台湾有限责任公司出版。这是CC BY-NC-ND License(http://creativecommons.org/licenses/bync-nd/4.0/).下的一篇开放获取文章
Background: Oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) represents an important issue, as its oxacillin susceptibility has contributed to misidentification by conventional susceptibility tests and consequently potential therapeutic failure, but limited data on the current status of OS-MRSA infection in Chinese hospitals are available. Methods: This multicenter study performed a battery of susceptibility tests and diagnostic tests for 956 S. aureus isolates from 10 hospitals, including automated susceptibility testing on VITEK 2, broth microdilution, disk diffusion, and detection of PBB2a, mecA gene and mecC gene. For all identified OS-MRSA, multi-locus sequence typing (MLST), together with spa typing, SCCmec typing and PVL detecting, was carried out. Results: OS-MRSA, most of which were from pediatric inpatients, represented 1.8% (17/956) of total isolates. Of these 17 OS-MRSA, 10 were ST59, followed by ST965 (3/17), and 11 carried SCCmec type IV, while 5 carried SCCmec type V, but only one was Panton-Valentine leucocidin (PVL)-positive, also, 16 had one or two point mutations within mecA promoter. OS-MRSA had inducible oxacillin resistance and significantly lower MDR (Multi-Drug Resistant) rate. We observed that the VITEK 2 system exhibited some deficiency in OS-MRSA detection, whereas cefoxitin disk diffusion was shown to be a reliable and cost-saving alternative and should be supplemented in detecting S. aureus with borderline oxacillin susceptible MICs. Conclusion: This study has characterized phenotypically and molecularly OS-MRSA in China, and provided insights into more effective management of OS-MRSA. Copyright 2020, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).