Department of Pediatrics, Columbia University Medical Center, New York, NY 10032, USA.
J Clin Microbiol. 2010 Oct;48(10):3675-80. doi: 10.1128/JCM.01129-10. Epub 2010 Aug 4.
In 2005, the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) anovaginal colonization in pregnant women at our center (Columbia University Medical Center) was 0.5%, and MRSA-colonized women were less likely to carry group B streptococcus (GBS). In this study, our objectives were to identify changing trends in the prevalence of MRSA and methicillin-susceptible S. aureus (MSSA) anovaginal colonization in pregnant women, to assess the association between MRSA and GBS colonization, and to characterize the MRSA strains. From February to July 2009, Lim broths from GBS surveillance samples were cultured for S. aureus. MRSA strains were identified by resistance to cefoxitin and characterized by MicroScan, staphylococcal cassette chromosome mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE), spa typing, and Panton-Valentine leukocidin PCR. A total of 2,921 specimens from different patients were analyzed. The prevalences of MSSA, MRSA, and GBS colonization were 11.8%, 0.6% and 23.3%, respectively. GBS colonization was associated with S. aureus colonization (odds ratio [OR], 1.9; 95% confidence interval [95% CI], 1.5 to 2.4). The frequencies of GBS colonization were similar in MRSA-positive (34.2%) versus MRSA-negative patients (21.8%) (P = 0.4). All MRSA isolates from 2009 and 13/14 isolates from 2005 were SCCmec type IV or V, consistent with community-associated MRSA; 12/18 (2009) and 0/14 (2005) isolates were the USA300 clone. Levofloxacin resistance increased from 14.3% (2005) to 55.6% (2009) (P = 0.028). In conclusion, the prevalence of MRSA anovaginal colonization in pregnant women in New York City, NY, remained stable from 2005 to 2009, and USA300 emerged as the predominant clone with a significant increase in levofloxacin-resistant isolates.
2005 年，我们中心（哥伦比亚大学医学中心）孕妇中耐甲氧西林金黄色葡萄球菌（MRSA）阴道定植的流行率为 0.5%，MRSA 定植的女性携带 B 组链球菌（GBS）的可能性较低。在这项研究中，我们的目标是确定孕妇中 MRSA 和甲氧西林敏感金黄色葡萄球菌（MSSA）阴道定植的流行率变化趋势，评估 MRSA 与 GBS 定植之间的关联，并对 MRSA 菌株进行特征描述。从 2009 年 2 月到 7 月，对 GBS 监测样本的 Lim 肉汤进行了金黄色葡萄球菌培养。通过对头孢西丁的耐药性来鉴定 MRSA 菌株，并通过 MicroScan、葡萄球菌盒染色体 mec（SCCmec）分型、脉冲场凝胶电泳（PFGE）、spa 分型和 Panton-Valentine 白细胞溶解酶 PCR 进行特征描述。分析了来自不同患者的 2921 份标本。MSSA、MRSA 和 GBS 定植的流行率分别为 11.8%、0.6%和 23.3%。GBS 定植与金黄色葡萄球菌定植相关（比值比 [OR]，1.9；95%置信区间 [95%CI]，1.5 至 2.4）。MRSA 阳性（34.2%）与 MRSA 阴性患者（21.8%）的 GBS 定植率相似（P=0.4）。2009 年的所有 MRSA 分离株和 2005 年的 13/14 分离株均为 SCCmec 型 IV 或 V，与社区相关的 MRSA 一致；2009 年的 12/18（2009 年）和 0/14（2005 年）分离株为 USA300 克隆。左氧氟沙星耐药率从 2005 年的 14.3%上升至 2009 年的 55.6%（P=0.028）。总之，2005 年至 2009 年，纽约市孕妇中 MRSA 阴道定植的流行率保持稳定，USA300 成为主要克隆，左氧氟沙星耐药分离株显著增加。
