Abstract：
To reduce the high rates of morbidity and mortality caused by methicillin-resistant Staphylococcus aureus (MRSA) strains, it is essential to prevent their transmission. This can be achieved through molecular surveillance of the infecting strains, for which the detection of the entry of new strains, the analysis of antimicrobial resistance, and their containment are essential. In this study, we have analyzed 190 MRSA isolates obtained at the Consorcio Hospital General Universitario de Valencia (Spain) from 2013 to 2018 with three approaches: Multilocus Sequence Typing, spa, and SCCmec typing. Although the incidence of S. aureus infections detected in the hospital increased in the study period, the frequency of MRSA isolates decreased from 33% to 18%. One hundred seventy-two MRSA isolates were resistant to three or more classes of antimicrobials, especially to fluoroquinolones. No relevant temporal trend in the distribution of antibiotic susceptibility was observed. The combination of the three typing schemes allowed the identification of 74 different clones, of which the combination ST125-t067-IV was the most abundant in the study (27 cases). Members of three clonal complexes, CC5, CC8, and CC22, comprised 91% of the isolates, and included 32 STs and 32 spa types. The emergence of low incidence strains throughout the study period and a large number of isolates resistant to different classes of antibiotics shows the need for epidemiological surveillance of this pathogen. Our study demonstrates that epidemiological and molecular surveillance is a powerful tool to detect the emergence of clinically important MRSA clones.
摘要：
为了降低耐甲氧西林金黄色葡萄球菌（MRSA）菌株的高发病率和死亡率，必须防止它们的传播。这可以通过感染菌株的分子监测来实现，检测新菌株的进入，抗菌素耐药性分析，他们的遏制是必不可少的。在这项研究中,我们分析了从2013年至2018年在瓦伦西亚大学综合医院（西班牙）获得的190个MRSA分离株，采用三种方法：多位点序列分型，spa,和SCCmec打字。尽管在研究期间在医院检测到的金黄色葡萄球菌感染的发生率有所增加，MRSA分离株的频率从33%降至18%.一百七十二株MRSA分离株对三类或更多类抗菌药物具有抗性，尤其是氟喹诺酮类药物.未观察到抗生素敏感性分布的相关时间趋势。三种分型方案的组合允许鉴定74个不同的克隆，其中ST125-t067-IV组合在研究中最丰富（27例）。三个克隆复合物的成员，CC5、CC8和CC22占分离株的91%，包括32个STs和32个spa类型。在整个研究期间，低发病率菌株的出现以及对不同类别抗生素具有抗性的大量分离株表明需要对这种病原体进行流行病学监测。我们的研究表明，流行病学和分子监测是检测临床上重要的MRSA克隆出现的强大工具。
