金黄色葡萄球菌是骨髓炎(OM)的最常见病原体。然而,金黄色葡萄球菌引起OM的分子流行病学仍不明确.本研究旨在解决来自OM患者的金黄色葡萄球菌克隆的全球流行病学。
在文献数据库中搜索了2000年1月1日至2020年7月29日发表的报告涉及OM的金黄色葡萄球菌分子分型的研究。对32篇符合纳入标准的文章的数据进行了发表年份的分析,患者的国家,金黄色葡萄球菌分离株的甲氧西林敏感性和基因型特征。
大流行克隆CC5,CC8,CC22,CC30和CC45在OM中最常见。由于金黄色葡萄球菌的局部流行病学和MSSA异质性,克隆的分布在研究中差异很大。属于ST80/CC80和ST8/CC8/USA300的PVL阳性MRSA克隆在欧洲和美国的儿科患者中最常见;在成年人群中观察到更大的变异性。在欧洲,MRSA属于PVL阴性CC5,CC8和CC22,表明医院感染起源;在亚洲,PVL阳性ST59/CC59MRSA最常见。在儿童和成人的血源性OM中经常检测到PVL阳性克隆。虽然MSSA是多克隆的,PVL阴性ST398/CC398MSSA是糖尿病足OM中最普遍的克隆。
在医院和社区环境中循环的所有主要金黄色葡萄球菌克隆似乎都能够引起OM。报告分子分型和基因组数据的未来研究将为引起OM的金黄色葡萄球菌克隆的流行病学和病理学提供更多见解。
Staphylococcus aureus is the most common causative organism of osteomyelitis (OM). Nevertheless, the molecular epidemiology of S. aureus causing OM remains ill-defined. This study aimed to address the global epidemiology of S. aureus clones from OM patients.
Literature databases were searched for studies reporting the molecular typing of S. aureus involved in OM published between 1 January 2000 and 29 July 2020. Data from 32 articles that fulfilled the inclusion criteria were analysed for year of publication, country of patients, methicillin susceptibility and genotypic characteristics of S. aureus isolates.
Pandemic clones CC5, CC8, CC22, CC30 and CC45 were the most common in OM. The distribution of clones differed greatly among studies owing to the local epidemiology of S. aureus and the MSSA heterogeneity. PVL-positive MRSA clones belonging to ST80/CC80 and ST8/CC8/USA300 were the most common among paediatric patients in Europe and the USA; greater variability was observed in the adult population. In Europe, MRSA belonged to PVL-negative CC5, CC8 and CC22 indicating a nosocomial origin of infections; in Asia PVL-positive ST59/CC59 MRSA was the most frequent. PVL-positive clones were often detected in haematogenous OM in children and adults. Although MSSA were polyclonal, PVL-negative ST398/CC398 MSSA was the most prevalent
clone in diabetic foot OM.
All major S. aureus clones circulating both in hospital and community settings appear to be capable of causing OM. Future studies reporting molecular typing and genomic data will provide more insights into the epidemiology and pathobiology of S. aureus clones causing OM.