Donker G A, Deurenberg R H, Driessen C, Sebastian S, Nys S, Stobberingh E E
Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
Clin Microbiol Infect. 2009 Feb;15(2):137-43. doi: 10.1111/j.1469-0691.2008.02662.x. Epub 2009 Jan 28.
To investigate the prevalence, the antibiotic resistance pattern and the population structure of Staphylococcus aureus, S. aureus isolates from the anterior nostrils of patients of general practitioners (GPs) were analysed. Insight into the S. aureus population structure is essential, as nasal carriers of S. aureus are at increased risk of developing an S. aureus infection. S. aureus was isolated from nasal swabs from 2691 patients with no sign of an infection collected in 29 GP practices in The Netherlands. The susceptibility pattern for several classes of antibiotics was determined, as well as the S. aureus genetic background, using spa typing. S. aureus was isolated from 617 of the 2691 (23%) nasal swabs. The prevalences of resistance to ciprofloxacin, co-trimoxazole, fusidic acid, macrolides and mupirocin were 0.2%, 0%, 6%, 5% and 1%, respectively. Half of the isolates were associated with a genetic background common to the major methicillin-resistant S. aureus (MRSA) clones, e.g. clonal complex (CC)1, CC5, CC8, CC22, CC30 and CC45, and the remainder were mainly associated with CC7, CC12, CC15, CC26, CC51 and CC101. The low prevalences of resistance suggest that, in the Dutch situation, S. aureus isolates from patients visiting their GP because of complaints not related to infection do not represent a large reservoir of antibiotic resistance genes. Although no MRSA isolates were found, the genetic background of some of the S. aureus isolates is commonly observed among community-associated (CA)-MRSA clones (CC1, CC8 and CC30), and this might suggest that these isolates have the potential to become CA-MRSA.
为了调查金黄色葡萄球菌的流行情况、抗生素耐药模式及种群结构，对来自全科医生（GP）诊所患者前鼻孔的金黄色葡萄球菌分离株进行了分析。深入了解金黄色葡萄球菌的种群结构至关重要，因为金黄色葡萄球菌的鼻腔携带者发生金黄色葡萄球菌感染的风险会增加。从荷兰29家全科医生诊所收集的2691例无感染迹象患者的鼻拭子中分离出金黄色葡萄球菌。确定了几类抗生素的药敏模式以及金黄色葡萄球菌的基因背景，采用spa分型法。在2691份鼻拭子中，有617份（23%）分离出金黄色葡萄球菌。对环丙沙星、复方新诺明、夫西地酸、大环内酯类和莫匹罗星的耐药率分别为0.2%、0%、6%、5%和1%。一半的分离株与主要耐甲氧西林金黄色葡萄球菌（MRSA）克隆常见的基因背景相关，如克隆复合体（CC）1、CC5、CC8、CC22、CC30和CC45，其余主要与CC7、CC12、CC15、CC26、CC51和CC101相关。耐药率较低表明，在荷兰的情况下，因与感染无关的症状就诊的患者分离出的金黄色葡萄球菌并非抗生素耐药基因的主要储存库。虽然未发现MRSA分离株，但在社区相关（CA）-MRSA克隆（CC1、CC8和CC30）中常见一些金黄色葡萄球菌分离株的基因背景，这可能表明这些分离株有成为CA-MRSA的潜力。
