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耐甲氧西林金黄色葡萄球菌引起的人乳和牛乳乳腺炎。

Methicillin resistant S. aureus in human and bovine mastitis.

机构信息

Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK.

出版信息

J Mammary Gland Biol Neoplasia. 2011 Dec;16(4):373-82. doi: 10.1007/s10911-011-9237-x. Epub 2011 Oct 8.

Abstract

Staphylococcus aureus is a ubiquitous organism that causes a variety of diseases including mastitis in cattle and humans. High-level resistance of S. aureus to β-lactams conferred by a mecA gene encoding a modified penicillin binding protein (PBP2a) was first observed in the early 1960's. These methicillin resistant S. aureus (MRSA) have been responsible for both hospital acquired infections (HA-MRSA) and, more recently, community acquired MRSA (CA-MRSA). A small number of human MRSA mastitis cases and outbreaks in maternity or neonatal units have been reported which are generally the result of CA-MRSA. The establishment of the sequence type 398 (ST398) in farm animals, primarily pigs, in the early 2000's has provided a reservoir of infection for humans and dairy cattle, particularly in continental Europe, described as livestock-associated MRSA (LA-MRSA). Prior to the emergence of ST398 there were sporadic reports of MRSA in bovine milk and cases of mastitis, often caused by strains from human associated lineages. Subsequently, there have been several reports describing bovine udder infections caused by ST-398 MRSA. Recently, another group of LA-MRSA strains was discovered in humans and dairy cattle in Europe. This group carries a divergent mecA gene and includes a number of S. aureus lineages (CC130, ST425, and CC1943) that were hitherto thought to be bovine-specific but are now also found as carriage or clinical isolates in humans. The emergence of MRSA in dairy cattle may be associated with contact with other host species, as in the case of ST398, or with the exchange of genetic material between S. aureus and coagulase negative Staphylococcus species, which are the most common species associated with bovine intramammary infections and commonly carry antimicrobial resistance determinants.

摘要

金黄色葡萄球菌是一种无处不在的生物体,可引起多种疾病,包括牛和人类的乳腺炎。早在 20 世纪 60 年代初,就首次观察到 mecA 基因编码的一种修饰青霉素结合蛋白(PBP2a)赋予金黄色葡萄球菌对β-内酰胺类药物的高水平耐药性。这些耐甲氧西林金黄色葡萄球菌(MRSA)一直是医院获得性感染(HA-MRSA)的原因,最近更是社区获得性 MRSA(CA-MRSA)的原因。已经报道了少数人类 MRSA 乳腺炎病例和产科或新生儿病房爆发,这些通常是 CA-MRSA 的结果。2000 年代初,在农场动物(主要是猪)中建立的序列类型 398(ST398)为人类和奶牛提供了感染源,特别是在欧洲大陆,被描述为与牲畜相关的耐甲氧西林金黄色葡萄球菌(LA-MRSA)。在 ST398 出现之前,曾有零星报道称牛乳中存在 MRSA 以及乳腺炎病例,这些病例通常是由与人类相关谱系的菌株引起的。随后,有几篇报道描述了由 ST-398 MRSA 引起的牛乳房感染。最近,在欧洲的人类和奶牛中发现了另一组 LA-MRSA 菌株。该组携带一种不同的 mecA 基因,包括一些金黄色葡萄球菌谱系(CC130、ST425 和 CC1943),这些谱系以前被认为是牛特异性的,但现在也被发现作为人类的携带或临床分离株。奶牛中 MRSA 的出现可能与与其他宿主物种的接触有关,如 ST398 一样,或者与金黄色葡萄球菌和凝固酶阴性葡萄球菌之间的遗传物质交换有关,凝固酶阴性葡萄球菌是与牛乳腺炎最常见的相关物种,并且通常携带抗菌药物耐药决定因子。

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