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Abstract：
Increased rates of methicillin-resistant Staphylococcus aureus (MRSA) antibiotic resistance and the associated morbidity have increased dermatologists\' attention to skin and soft tissue MRSA infections. However, the clinical characterization of MRSA skin and soft tissue infections (SSTIs) in Southwest China is lacking, which precludes optimal prevention and treatment of these infections.
This study was conducted to characterize the prevalence, clinical comorbidities and antibiotic susceptibility of MRSA isolates from SSTIs, including community-associated (CA) and healthcare-associated (HA) isolates.
In the Dermatology Inpatient Department of the First Affiliated Hospital of Guangxi Medical University, a retrospective study was conducted on data, including patient demographics and clinical information, from culture-confirmed S. aureus isolated from skin and soft tissue between January 1, 2015, and December 31, 2021. Isolate susceptibility to 13 antibiotics was determined using the Vitek 2 system.
From among 864 S. aureus strains, we identified 283 MRSA (32.75%) isolates comprising 203 CA-MRSA and 80 HA-MRSA isolates. The average rate of CA-MRSA isolation for MRSA SSTIs was 71.73%. The HA-MRSA isolation rate for MRSA SSTIs increased significantly. HA-MRSA-infected patients were older. The most common dermatological presentation of CA-MRSA infection was staphylococcal scalded skin syndrome, while the comorbidity severe drug eruption was significantly associated with HA-MRSA infection. One CA-MRSA strain was resistant to linezolid, and one HA-MRSA strain had an intermediate phenotype for vancomycin; both strains had low sensitivity to clindamycin and erythromycin (3.70%~19.40%). However, HA-MRSA isolates were more susceptible to trimethoprim/sulfamethoxazole.
CA-MRSA is a predominant pathogen causing SSTIs, and HA-MRSA infection incidence is increasing gradually. Both strains showed increasing antibiotic resistance. Our data on MRSA susceptibility may guide dermatologist antibiotic treatment decisions. Dermatologists should consider these identified comorbidities of MRSA SSTIs when patients are admitted and initiate early prevention and treatment of MRSA.
This study was conducted to characterize the prevalence, clinical comorbidities and antibiotic susceptibility of MRSA isolates from SSTIs, including community-associated (CA) and healthcare-associated (HA) isolates.
In the Dermatology Inpatient Department of the First Affiliated Hospital of Guangxi Medical University, a retrospective study was conducted on data, including patient demographics and clinical information, from culture-confirmed S. aureus isolated from skin and soft tissue between January 1, 2015, and December 31, 2021. Isolate susceptibility to 13 antibiotics was determined using the Vitek 2 system.
From among 864 S. aureus strains, we identified 283 MRSA (32.75%) isolates comprising 203 CA-MRSA and 80 HA-MRSA isolates. The average rate of CA-MRSA isolation for MRSA SSTIs was 71.73%. The HA-MRSA isolation rate for MRSA SSTIs increased significantly. HA-MRSA-infected patients were older. The most common dermatological presentation of CA-MRSA infection was staphylococcal scalded skin syndrome, while the comorbidity severe drug eruption was significantly associated with HA-MRSA infection. One CA-MRSA strain was resistant to linezolid, and one HA-MRSA strain had an intermediate phenotype for vancomycin; both strains had low sensitivity to clindamycin and erythromycin (3.70%~19.40%). However, HA-MRSA isolates were more susceptible to trimethoprim/sulfamethoxazole.
CA-MRSA is a predominant pathogen causing SSTIs, and HA-MRSA infection incidence is increasing gradually. Both strains showed increasing antibiotic resistance. Our data on MRSA susceptibility may guide dermatologist antibiotic treatment decisions. Dermatologists should consider these identified comorbidities of MRSA SSTIs when patients are admitted and initiate early prevention and treatment of MRSA.
摘要：
■耐甲氧西林金黄色葡萄球菌（MRSA）抗生素耐药性的增加和相关的发病率增加了皮肤科医生对皮肤和软组织MRSA感染的关注。然而,中国西南地区MRSA皮肤和软组织感染（STTI）的临床特征缺乏，这妨碍了对这些感染的最佳预防和治疗。
■这项研究是为了表征患病率，来自SSTI的MRSA分离株的临床合并症和抗生素敏感性，包括社区相关（CA）和医疗保健相关（HA）分离株。
■广西医科大学第一附属医院皮肤科住院部,对数据进行了回顾性研究，包括患者人口统计学和临床信息，从2015年1月1日至2021年12月31日之间从皮肤和软组织中分离出的经培养证实的金黄色葡萄球菌。使用Vitek2系统确定分离物对13种抗生素的敏感性。
■来自864株金黄色葡萄球菌，我们鉴定出283个MRSA(32.75%)分离株,包括203个CA-MRSA和80个HA-MRSA分离株.MRSASSTIs的CA-MRSA平均分离率为71.73%。MRSASUTI的HA-MRSA分离率显著增高。HA-MRSA感染患者年龄较大。CA-MRSA感染最常见的皮肤病表现是葡萄球菌性烫伤样皮肤综合征，而严重药疹的合并症与HA-MRSA感染显著相关。一株CA-MRSA菌株对利奈唑胺耐药，1株HA-MRSA菌株具有万古霉素的中间表型；两种菌株对克林霉素和红霉素的敏感性较低（3.70％〜19.40％）。然而,HA-MRSA分离株对甲氧苄啶/磺胺甲恶唑更敏感。
■CA-MRSA是引起SSTI的主要病原体，HA-MRSA感染发病率逐渐增加。两种菌株均显示出增加的抗生素抗性。我们关于MRSA易感性的数据可以指导皮肤科医生的抗生素治疗决策。皮肤科医生在入院时应该考虑这些已确定的MRSASSTI的合并症，并开始早期预防和治疗MRSA。
■这项研究是为了表征患病率，来自SSTI的MRSA分离株的临床合并症和抗生素敏感性，包括社区相关（CA）和医疗保健相关（HA）分离株。
■广西医科大学第一附属医院皮肤科住院部,对数据进行了回顾性研究，包括患者人口统计学和临床信息，从2015年1月1日至2021年12月31日之间从皮肤和软组织中分离出的经培养证实的金黄色葡萄球菌。使用Vitek2系统确定分离物对13种抗生素的敏感性。
■来自864株金黄色葡萄球菌，我们鉴定出283个MRSA(32.75%)分离株,包括203个CA-MRSA和80个HA-MRSA分离株.MRSASSTIs的CA-MRSA平均分离率为71.73%。MRSASUTI的HA-MRSA分离率显著增高。HA-MRSA感染患者年龄较大。CA-MRSA感染最常见的皮肤病表现是葡萄球菌性烫伤样皮肤综合征，而严重药疹的合并症与HA-MRSA感染显著相关。一株CA-MRSA菌株对利奈唑胺耐药，1株HA-MRSA菌株具有万古霉素的中间表型；两种菌株对克林霉素和红霉素的敏感性较低（3.70％〜19.40％）。然而,HA-MRSA分离株对甲氧苄啶/磺胺甲恶唑更敏感。
■CA-MRSA是引起SSTI的主要病原体，HA-MRSA感染发病率逐渐增加。两种菌株均显示出增加的抗生素抗性。我们关于MRSA易感性的数据可以指导皮肤科医生的抗生素治疗决策。皮肤科医生在入院时应该考虑这些已确定的MRSASSTI的合并症，并开始早期预防和治疗MRSA。
