耐甲氧西林金黄色葡萄球菌社区获得性感染克隆的分子特征和危险因素研究

耐甲氧西林金黄色葡萄球菌（MRSA）曾一直被认为是医院感染的重要病原体，即医院获得性MRSA（HA-MRSA）。上世纪90年代以来，社区环境中开始发现无医疗接触史的MRSA感染病例，即社区获得性MRSA（CA-MRSA）感染病例，且CA-和HA-MRSA不仅感染环境不同，且分子特征也存在明显差异。进入2010年代以来，具备CA-MRSA分子特征的克隆扩散进入医院感染的趋势明显。受门诊培养送检率等原因的影响，国内社区获得MRSA感染的研究相对滞后于HA-MRSA的研究，针对这一现状，本研究拟采用病例对照研究设计和分子生物学实验手段，以揭示CA-MRSA感染危险因素和病原体分子生物学特征；探讨CA-MRSA流行克隆和毒力因子与相关感染性疾病的关系，为CA-MRSA感染症预防和流行控制方案（重点人群监控及疫苗开发等）及治疗方案提供依据。

Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen of nosocomial infections which is referred to as hospital-acquired MRSA (HA-MRSA). Since the 90s of last century, MRSA infections have been reported with no history of hospitalization or healthcare in the community as called community-acquired MRSA (CA-MRSA). CA-MRSAand HA-MRSA infections are much different not only in spreading areas but also in the molecular characteristics. However, more and more clones with molecular characterization of CA-MRSA have been isolated in hospital settings since 2010s. Because of the submission rate of outpatient and other reasons, the study of CA-MRSA infections is lagging behind the HA-MRSA study in China.In this study, we will use case-control study and molecular and biological methods to identify the risk factors for CA-MRSA infections and the molecular characteristics of CA-MRSA and in addition to explore the relationship between epidemic clone or virulence factors of CA-MRSA and associated infections. This study shall provide significant basis and evidence for the prevention and control strategies of CA-MRSA infection,as well as the critical information for surveillance, potential vaccine development and the treatment of CA-MRSA infections.