目的:耐甲氧西林金黄色葡萄球菌(MRSA)是一种具有挑战性的全球健康威胁,在全球范围内导致显著的发病率和死亡率。本研究旨在确定浙江省263株MRSA分离株的分子特征和抗菌药物敏感性。中国东部。
方法:2014-2019年,从浙江省4个城市的6家医院收集了263株MRSA血流感染分离株,中国东部。根据临床和实验室标准研究所(CLSI)制定的指南进行抗菌素敏感性测试。为了表征和分析这些分离株,多位点序列分型(MLST),葡萄球菌盒染色体mec(SCCmec)分型,进行葡萄球菌蛋白A(spa)分型和毒力基因基因谱。
结果:最主要的克隆是ST5-SCCmecII-t311,占41.8%(110/263),其次是ST59(44/263,16.7%)。与非ST5-II-t311分离株相比,ST5-II-t311分离株对红霉素的耐药性更强,四环素,左氧氟沙星,莫西沙星,还有环丙沙星,但更容易感染克林霉素.此外,ST5-II-t311分离株的多药耐药率高于非ST5-II-t311分离株.与非ST5-II-t311分离株相比,ST5-II-t311分离株在检测到的毒力基因中没有显着差异。
结论:MRSAST5-II-t311克隆已成为浙江省最主要的克隆,华东地区的多重耐药率高于其他分离株,在治疗BSI时应牢记这一点。此外,MRSAST59克隆呈上升趋势,并已开始传播到医院。我们的发现强调了东部地区金黄色葡萄球菌携带流行病学研究的重要性。
OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) is a challenging global health threat, resulting in significant morbidity and mortality worldwide. This study aims to determine the molecular characteristics and antimicrobial susceptibility of 263 MRSA isolates in Zhejiang Province, east China.
METHODS: From 2014 to 2019, a total of 263 MRSA isolates from bloodstream infections (BSIs) were collected from 6 hospitals in 4 cities in Zhejiang province, east China. Antimicrobial susceptibility tests were conducted according to the guidelines set forth by the Clinical and Laboratory Standards Institute (CLSI). To characterize and analyze these isolates, multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec) typing, staphylococcal protein A (spa) typing and virulence genes gene profiles were performed.
RESULTS: The most predominant clone was ST5-SCCmec II-t311, which accounted for 41.8% (110/263), followed by ST59 (44/263, 16.7%). Compared with non-ST5-II-t311 isolates, ST5-II-t311 isolates were more resistant to erythromycin, tetracycline, levofloxacin, moxifloxacin, and ciprofloxacin, but more susceptible to clindamycin. Moreover, the rates of multidrug resistance were higher in ST5-II-t311 isolates compared to the non-ST5-II-t311 isolates. In comparison to the non-ST5-II-t311 isolates, ST5-II-t311 isolates showed no significant difference in virulence genes detected.
CONCLUSIONS: MRSA ST5-II-t311 clone has become the most predominant clone in Zhejiang Province, east China and has higher rates of multidrug resistance than other isolates, that should be kept in mind when treating BSI. Moreover, MRSA ST59 clone shows an upward trend and has begun to spread into hospitals. Our findings highlight the importance of epidemiological studies of S. aureus carriage in the eastern region.