The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA)
The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA)
复制标题
DOI：
10.1073/pnas.122108599
复制
发表时间：
2002-05-28
影响因子：
11.1
通讯作者：
Spratt, BG
中科院分区：
文献类型：
--
作者：
Enright, MC;Robinson, DA;Spratt, BG
耐甲氧西林金黄色葡萄球菌（MRSA）是医院获得性感染的主要原因，由于对所有现有抗生素类别的新耐药性，这种感染正变得越来越难以对抗。人们对MRSA的进化起源知之甚少，没有合理的命名法，对主要MRSA克隆的数量或来自不同国家的克隆的相关性也没有达成共识。我们解决了所有这些问题，并提供了比以前更彻底、更精确的MRSA克隆进化分析。使用多位点序列分型和BURST算法，我们分析了912株MRSA和甲氧西林敏感金黄色葡萄球菌（MSSA）的国际收集。我们在5组相关基因型中鉴定了11个主要的MRSA克隆。利用BURST技术推断出每个群体的假定祖先基因型和每个祖先分离株的最节俭的遗传模式，并结合对甲氧西林耐药基因的分析，确定了每个主要MRSA克隆的可能进化起源、原始MRSA克隆及其MSSA祖基因的基因型，以及甲氧西林耐药基因的获取和水平移动程度。从成功流行的MSSA菌株中反复出现了主要的MRSA克隆，并且从这些主要的MRSA克隆中产生了对万古霉素（最后的抗生素）敏感性降低的分离株，突出了在少数生态上成功的金黄色葡萄球菌基因型中增加耐药性的令人沮丧的进展。
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of hospital-acquired infections that are becoming increasingly difficult to combat because of emerging resistance to all current antibiotic classes. The evolutionary origins of MRSA are poorly understood, no rational nomenclature exists, and there is no consensus on the number of major MRSA clones or the relatedness of clones described from different countries. We resolve all of these issues and provide a more thorough and precise analysis of the evolution of MRSA clones than has previously been possible. Using multilocus sequence typing and an algorithm, BURST, we analyzed an international collection of 912 MRSA and methicillin-susceptible S. aureus (MSSA) isolates. We identified 11 major MRSA clones within five groups of related genotypes. The putative ancestral genotype of each group and the most parsimonious patterns of descent of isolates from each ancestor were inferred by using BURST, which, together with analysis of the methicillin resistance genes, established the likely evolutionary origins of each major MRSA clone, the genotype of the original MRSA clone and its MSSA progenitor, and the extent of acquisition and horizontal movement of the methicillin resistance genes. Major MRSA clones have arisen repeatedly from successful epidemic MSSA strains, and isolates with decreased susceptibility to vancomycin, the antibiotic of last resort, are arising from some of these major MRSA clones, highlighting a depressing progression of increasing drug resistance within a small number of ecologically successful S. aureus genotypes.