National Reference Centre for Staphylococci, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany.
Clin Microbiol Infect. 2009 Dec;15 Suppl 7:17-25. doi: 10.1111/j.1469-0691.2009.03097.x.
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a matter of concern worldwide, in particular in the USA. For the analysis of emergence and spread, clear definitions based on epidemiological origin are needed for discrimination between CA-MRSA, healthcare-associated community MRSA, and healthcare-associated MRSA (HA-MRSA). Although its role in pathogenesis is currently under debate, the capability for Panton-Valentine leukocidin formation is associated with the majority of CA-MRSA isolates from North America and from Europe. Most CA-MRSA isolates are attributed to clonal lineages different from HA-MRSA; there are, however, clonal lineages from which both HA-MRSA and CA-MRSA have been reported (e.g. ST1, ST5, ST8, and ST22); CA-MRSA ST8 (USA300), which is most frequent in the USA, has meanwhile been reported from Europe. CA-MRSA ST80 is widely disseminated in Europe; because of its pronounced oxacillin heteroresistance phenotype, cefoxitin-based assays are advisable for reliable detection. So far, CA-MRSA infections seem to be much less frequent in Europe than in the USA, where patients with particular predispositions and low social status are at especial risk.
社区相关性耐甲氧西林金黄色葡萄球菌（CA-MRSA）已成为全球关注的问题，尤其是在美国。为了分析其出现和传播，需要基于流行病学起源的明确定义来区分社区相关性耐甲氧西林金黄色葡萄球菌（CA-MRSA）、医疗保健相关性社区 MRSA 和医疗保健相关性 MRSA（HA-MRSA）。虽然其在发病机制中的作用目前仍存在争议，但大多数来自北美的和欧洲的 CA-MRSA 分离株都具有形成杀伤白细胞素的能力。大多数 CA-MRSA 分离株与 HA-MRSA 不同的克隆谱系有关；然而，也有一些克隆谱系既报告了 HA-MRSA 又报告了 CA-MRSA（例如 ST1、ST5、ST8 和 ST22）；目前已在欧洲报道了美国最常见的 CA-MRSA ST8（USA300）。CA-MRSA ST80 在欧洲广泛传播；由于其明显的苯唑西林异质性耐药表型，基于头孢西丁的检测方法是可靠检测的首选。到目前为止，CA-MRSA 感染在欧洲似乎比在美国要少得多，在美国，具有特殊易感性和社会地位较低的患者风险特别高。
