van Belkum Alex, Melles Damian C, Nouwen Jan, van Leeuwen Willem B, van Wamel Willem, Vos Margreet C, Wertheim Heiman F L, Verbrugh Henri A
Department of Medical Microbiology and Infectious Diseases, Unit Research and Development, Erasmus MC, Rotterdam, The Netherlands.
Infect Genet Evol. 2009 Jan;9(1):32-47. doi: 10.1016/j.meegid.2008.09.012. Epub 2008 Oct 19.
Although Staphylococcus aureus is a bacterial species of medical significance, only approximately 30% of all humans carry staphylococcal cells persistently but asymptomatically in their nasopharynx and/or other body sites. This goes largely unnoticed by the host, which shows that in the natural situation the human ecosystem is hospitable or at least receptive to the bacteria and that by a process of co-evolution this has lead to a state of mutual acceptance or tolerance. However, upon disturbance of this balanced, neutral state, localized or disseminated invasive infection can occur. Unfortunately, the events leading to infection are still largely unknown and especially the causal events leading to the transition from colonization to infection are ill-defined in vivo. Whether certain genotypes of S. aureus are more prone to colonise and/or infect humans is still quite heavily debated. The genetic population structure of S. aureus has been largely solved by using a number of different DNA polymorphism-interrogating laboratory methods. However, even this major effort has not (yet) revealed major clues with respect to colonisation and infection potency of the clonal lineages that were thus identified, except for the fact that certain lineages are highly epidemic. The overall picture is that in principle all S. aureus strains can become invasive given the proper circumstances. What these, primarily host-defined circumstances are is still enigmatic. However, a large variety of staphylococcal virulence and colonization factors have been identified as well as a number of host' colonisation and infection susceptibility traits. How these are specifically involved in colonisation and infection has been experimentally substantiated in only a limited number of cases. The present review paper will explore the relevance of these and other, for instance environmental factors that define the colonisation or infection state in humans. When the nature of these states would be known in more detail, this knowledge could be used to design novel and empirical, knowledge-driven means of preventing colonisation from proceeding into S. aureus infection.
尽管金黄色葡萄球菌是一种具有医学意义的细菌物种，但在所有人类中，只有约30%的人在其鼻咽部和/或其他身体部位持续携带葡萄球菌细胞且无症状。宿主在很大程度上并未注意到这一点，这表明在自然情况下，人类生态系统对该细菌是友好的，或者至少是接纳的，并且通过共同进化过程，这已导致一种相互接受或耐受的状态。然而，一旦这种平衡的、中性的状态受到干扰，就可能发生局部或播散性侵袭性感染。不幸的是，导致感染的事件在很大程度上仍然未知，尤其是导致从定植转变为感染的因果事件在体内尚不明确。金黄色葡萄球菌的某些基因型是否更易于定植和/或感染人类仍存在激烈争论。通过使用多种不同的检测DNA多态性的实验室方法，金黄色葡萄球菌的遗传种群结构已基本得到解决。然而，即使付出了这一巨大努力，除了某些谱系具有高度流行性这一事实外，对于由此确定的克隆谱系的定植和感染能力，尚未（尚未）揭示出主要线索。总体情况是，原则上在适当情况下，所有金黄色葡萄球菌菌株都可能具有侵袭性。这些主要由宿主定义的情况究竟是什么仍然是个谜。然而，已经鉴定出了多种葡萄球菌毒力和定植因子以及一些宿主的定植和感染易感性特征。这些因素如何具体参与定植和感染仅在少数情况下得到了实验证实。本综述文章将探讨这些因素以及其他因素（例如定义人类定植或感染状态的环境因素）的相关性。如果能更详细地了解这些状态的性质，这些知识可用于设计新的、基于经验的、以知识为驱动的方法来预防定植发展为金黄色葡萄球菌感染。
