Epidemiological typing of community-acquired methicillin-resistant Staphylococcus aureus isolates from children in Taiwan
Epidemiological typing of community-acquired methicillin-resistant Staphylococcus aureus isolates from children in Taiwan
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DOI：
10.1086/422642
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发表时间：
2004-08-15
影响因子：
11.8
通讯作者：
Siu, LK
中科院分区：
文献类型：
--
作者：
Wang, CC;Lo, WT;Siu, LK
背景本研究以台湾北方一家拥有1400张病床的三级医疗中心为研究对象，对5年间因社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）感染而住院的儿童进行流行病学研究。19名以前健康的儿童主要是皮肤和软组织CA-MRSA感染的儿童参加了这项研究。对17株CA-MRSA进行了抗菌药物敏感性和分子分型。将我们的结果与其他国家CA-MRSA分离株的报告耐药率进行比较，显示一致的高大环内酯类耐药率（100%）。在我们研究的17株MRSA分离株中，所有菌株均具有大环内酯-林可酰胺-链阳菌素组成型表型和ermB基因。此外，分子分型结果的基础上，11（65%）的17 CA-MRSA菌株的遗传相关（脉冲场凝胶电泳测定），多位点序列分型显示在所有菌株的序列类型为59。所有分离株均检测到葡萄球菌毒素基因lukS-PV和lukF-PV。17株葡萄球菌中仅3株（17.6%）检出葡萄球菌盒式染色体mec IV型，其余14株葡萄球菌均无法分型。我们的数据分析表明，一个单一的地方性CA-MRSA菌株在我们的社区具有高大环内酯类耐药的优势。尽管抗生素治疗无效，但大多数患者的切开引流临床改善，因此应解决治疗指南变更的需求。
Background. A 1400-bed tertiary medical center in northern Taiwan was used to conduct an epidemiological study of children hospitalized with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection during a 5-year period.Methods. Nineteen previously healthy children with predominantly skin and soft-tissue CA-MRSA infections were enrolled into the study. Seventeen CA-MRSA isolates were examined for antimicrobial susceptibility and molecular typing.Results. A comparison of our results with the reported resistance rates among CA-MRSA isolates from other countries showed uniformly high macrolide resistance (100%). Of the 17 MRSA isolates in our study, all had the macrolide-lincosamide-streptogramin-constitutive phenotype and the ermB gene. Moreover, on the basis of molecular typing results, 11 (65%) of 17 CA-MRSA isolates were genetically related (as determined by pulsed-field gel electrophoresis), and multilocus sequence typing revealed a sequence type of 59 in all isolates. Staphylococcal toxin genes lukS-PV and lukF-PV were detected in all isolates. However, staphylococcal cassette chromosome mec type IV was only detected in 3 (17.6%) of 17 isolates; the remaining 14 isolates were untypeable.Conclusions. Analysis of our data suggests the predominance of a single endemic CA-MRSA strain with high macrolide resistance in our community. Clinical improvement with incision and drainage was noted for most patients, despite treatment with an ineffective antibiotic, so the need for a change in treatment guidelines should be addressed.