Alp Emine, Klaassen Corné H W, Doganay Mehmet, Altoparlak Ulku, Aydin Kemalettin, Engin Aynur, Kuzucu Cigdem, Ozakin Cuneyt, Ozinel Mehmet Ali, Turhan Ozge, Voss Andreas
Erciyes University, Department of Infectious Diseases and Clinical Microbiology, Kayseri 38039, Turkey.
J Infect. 2009 Jun;58(6):433-8. doi: 10.1016/j.jinf.2009.04.006. Epub 2009 Apr 22.
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of life-threatening human infections. The clinical impact of MRSA is mounting, not only due to the ever-increasing prevalence but also due to the occurrence of new, community-acquired MRSA strains. The aim of this prospective, multi-centre study was to determine the prevalence and genetic relatedness of clinically relevant MRSA isolates, in Turkey.
During a 1-year period, data from 20 successive patients with invasive S. aureus infections were collected from eight university hospitals, geographically distributed over the six main regions of Turkey. Among these S. aureus isolates, the genetic association of MRSA isolates was investigated by pulsed-field gel electrophoresis (PFGE) and spa typing. A selected number of isolates were also analyzed by multilocus sequence typing (MLST). Furthermore, Panton Valentine leucocidin (PVL) genes were examined.
In this study, the rate of methicillin resistance in S. aureus in patients with apparent infections (sepsis, meningitis, lung abscess or septic arthritis) ranged from 12 to 75% within the seven participating centres. Typing by pulsed-field gel electrophoresis and spa typing revealed the presence of 22 closely related genotypes. According to the PFGE and spa typing results, 53 out of 54 MRSA isolates were closely related. These isolates were of spa type t030 or a related spa type, contain an SCC mec type III element and belong to sequence type ST239. None of the isolates contained the PVL genes.
Despite the broad surface area of Turkey, a single predominant clone of ST239 circulates in hospitals in different regions and only few new types of MRSA were introduced over the past years. These results place Turkey in the epicenter of ST239 prevalence.
耐甲氧西林金黄色葡萄球菌（MRSA）是导致人类危及生命感染的重要原因。MRSA对临床的影响日益增大，这不仅归因于其患病率不断上升，还由于新的社区获得性MRSA菌株的出现。这项前瞻性多中心研究的目的是确定土耳其临床相关MRSA分离株的患病率及基因相关性。
在1年期间，从土耳其六个主要地区地理分布的八所大学医院收集了连续20例金黄色葡萄球菌侵袭性感染患者的数据。在这些金黄色葡萄球菌分离株中，通过脉冲场凝胶电泳（PFGE）和spa分型研究MRSA分离株的基因关联。还对选定数量的分离株进行多位点序列分型（MLST）分析。此外，检测了杀白细胞素（PVL）基因。
在本研究中，七个参与中心中明显感染（败血症、脑膜炎、肺脓肿或化脓性关节炎）患者的金黄色葡萄球菌耐甲氧西林率在12%至75%之间。通过脉冲场凝胶电泳和spa分型显示存在22种密切相关的基因型。根据PFGE和spa分型结果，54株MRSA分离株中有53株密切相关。这些分离株为spa型t030或相关spa型，含有III型葡萄球菌盒式染色体（SCCmec）元件，属于序列型ST239。所有分离株均未检测到PVL基因。
尽管土耳其地域广阔，但ST239单一优势克隆在不同地区的医院中传播，过去几年仅引入了少数新型MRSA。这些结果使土耳其处于ST239流行的中心。
