Huang Y-C, Ho C-F, Chen C-J, Su L-H, Lin T-Y
Division of Paediatric Infectious Diseases, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Clin Microbiol Infect. 2008 Dec;14(12):1167-72. doi: 10.1111/j.1469-0691.2008.02115.x.
From August 2004 to July 2005, 210 clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates were collected prospectively from 173 children admitted to Chang Gung Children's Hospital in Taiwan. A comparative molecular analysis of the 111 community-associated (CA) isolates from 102 children and the 99 healthcare-associated (HA) isolates from 71 children was conducted. In comparison to the HA isolates (31%), the CA isolates (90%) were more likely to have been isolated from pus (p <5 x 10(-8)). For each patient with MRSA infection, only the first isolate was selected for molecular analysis. The molecular characteristics differed significantly between the CA and the HA isolates (p <5 x 10(-8)). The clone characterized as sequence type (ST)59/pulsotype D (similar to USA1000)/staphylococcal chromosomal cassette (SCC)mec V(T)/Panton-Valentine leukocidin (PVL)-positive accounted for 69% of the CA isolates, and another clone, characterized as ST239/pulsotype A (Hungary clone)/SCCmec III/PVL-negative, accounted for 45% of the 71 HA isolates. The CA clone of ST59 also accounted for 20% of the HA isolates, including 47% of the 17 community-onset isolates. It was concluded that the molecular characteristics of clinical MRSA isolates from children differed significantly between the CA and the HA isolates in northern Taiwan. However, the CA clone of ST59 was also identified in a substantial proportion of HA isolates.
2004年8月至2005年7月，前瞻性收集了台湾长庚儿童医院收治的173例儿童的210株临床耐甲氧西林金黄色葡萄球菌（MRSA）分离株。对102例儿童的111株社区相关性（CA）分离株和71例儿童的99株医疗保健相关性（HA）分离株进行了比较分子分析。与HA分离株（31%）相比，CA分离株（90%）更有可能从脓液中分离出来（p <5×10⁻⁸）。对于每例MRSA感染患者，仅选择首次分离株进行分子分析。CA分离株和HA分离株的分子特征有显著差异（p <5×10⁻⁸）。被鉴定为序列型（ST）59/脉冲型D（类似于USA1000）/葡萄球菌染色体盒式（SCC）mec V(T)/杀白细胞素（PVL）阳性的克隆占CA分离株的69%，另一个克隆，被鉴定为ST239/脉冲型A（匈牙利克隆）/SCCmec III/PVL阴性，占71株HA分离株的45%。ST59的CA克隆也占HA分离株的20%，包括17例社区发病分离株中的47%。得出结论，台湾北部儿童临床MRSA分离株的分子特征在CA分离株和HA分离株之间有显著差异。然而，ST59的CA克隆也在相当比例的HA分离株中被鉴定出来。
