PDF(Pubmed)
Abstract：
Macau, recognized as a global tourism hub and the world\'s most densely populated region, provides a unique environment conducive to methicillin-resistant Staphylococcus aureus (MRSA) transmission in healthcare and community settings, posing a significant public health concern both locally and globally. The epidemiology and molecular characteristics of MRSA in the distinct city of Macau remain largely unelucidated. This five-year longitudinal study (2017-2022) examined the local prevalence and molecular typing of MRSA in Macau, with future MRSA type distribution predicted through ARIMA modeling. We subsequently analyzed the epidemiological characteristics of MRSA, including specimen source, clinical department, collection year, season, patient age, sex, and the annual number of tourists. Comprehensive antibiotic resistance profiles of the strains were also assessed. Of 504 clinically isolated S. aureus strains, 183 (36.3%) were identified as MRSA by the cefoxitin disk diffusion method and validated through multi-locus sequence typing (MLST). The MRSA detection rate showed an upward trend, increasing from 30.1% in 2017 to 45.7% in 2022. SCCmec type IV was predominant (28.9%), followed by types II (25.4%), III (22.1%), and V (22.1%). The primary sources of MRSA isolates were sputum (39.2%) and secretions (25.6%). Older age emerged as a risk factor for MRSA infection, whereas no significant associations were found with seasonal variations, gender, or the annual number of tourists. Despite displaying universal resistance to cefoxitin, oxacillin, and benzylpenicillin, MRSA isolates in Macau remained fully sensitive to vancomycin, tigecycline, quinupristin, nitrofurantoin, and linezolid. Continuous surveillance and analysis of MRSA distribution in Macau could provide invaluable insights for the effective management of MRSA prevention and control measures within healthcare settings.
摘要：
澳门,被公认为全球旅游中心和世界上人口最稠密的地区，提供了一个独特的环境，有利于耐甲氧西林金黄色葡萄球菌（MRSA）在医疗保健和社区环境中的传播，在本地和全球都构成了重大的公共卫生问题。在独特的澳门城市，MRSA的流行病学和分子特征仍未阐明。这项为期五年的纵向研究（2017-2022年）检查了澳门MRSA的本地患病率和分子分型，通过ARIMA建模预测未来MRSA类型分布。我们随后分析了MRSA的流行病学特征，包括标本来源,临床科室,收集年,季节,患者年龄,性别,以及每年的游客数量。还评估了菌株的综合抗生素抗性概况。在临床分离的504株金黄色葡萄球菌中，183（36.3％）通过头孢西丁纸片扩散法鉴定为MRSA，并通过多位点序列分型（MLST）进行验证。MRSA检出率呈上升趋势,从2017年的30.1%增加到2022年的45.7%。SCCmecIV型占主导地位（28.9%），其次是II型(25.4%)，III（22.1%），和V（22.1%）。MRSA分离株的主要来源为痰液(39.2%)和分泌物(25.6%)。高龄成为MRSA感染的危险因素，而没有发现与季节性变化的显著关联，性别,或每年的游客数量。尽管显示出对头孢西丁的普遍抵抗力，苯唑西林,和青霉素,澳门的MRSA分离株对万古霉素仍然完全敏感，替加环素,奎尼普斯汀,呋喃妥因,和利奈唑胺.对澳门MRSA分布的持续监测和分析可为医疗机构有效管理MRSA预防和控制措施提供宝贵的见解。
