Department of Bacteriology, Hôpital Arnaud de Villeneuve, 34295, Montpellier, France.
Eur J Clin Microbiol Infect Dis. 2012 Jun;31(6):1279-84. doi: 10.1007/s10096-011-1441-5. Epub 2011 Oct 14.
The epidemiology of staphylococcal community-acquired skin and soft tissues infections (CA-SSTIs) has changed dramatically. We described prospectively the characteristics of the Staphylococcus aureus isolated from 71 non-teaching French hospitals and implicated in CA-SSTIs: antimicrobial susceptibility (mecA polymerase chain reaction [PCR], disk diffusion method), virulence factor gene (sea, tst, pvl) prevalence and genetic background (agr allele). During November 2006, 235 strains were collected (wound infection: 51%, abscess: 21%, whitlow: 8%, diabetic foot: 7%, furunculosis: 3%). sea, tst and pvl were identified in 22.1, 13.2 and 8.9% strains, respectively. agr allele 1 was the most frequently encountered genetic background, whatever the methicillin susceptibility. Among the 34 methicillin-resistant S. aureus (MRSA, 14.5% of all S. aureus), only one strain (2.9%) harboured pvl (belonging to the European ST80 clone), four (11.8%) tst (belonging to two endemic French clones) and 18 (52.9%) sea gene (mainly the Lyon clone). According to their in vitro activity, pristinamycin or trimethoprim/sulfamethoxazole could be considered as first-choice antibiotics. To date, the international pvl-positive MRSA clones have not spread in France. MRSA strains isolated from putative CA-SSTIs exhibited a genetic and phenotypic background of hospital-acquired (HA) clones. National survey should be continued, in order to monitor the emergence of virulent clones.
葡萄球菌社区获得性皮肤和软组织感染（CA-SSTIs）的流行病学已发生显著变化。我们前瞻性地描述了从法国 71 家非教学医院分离的金黄色葡萄球菌的特征，这些菌株与 CA-SSTIs 有关：抗菌药物敏感性（mecA 聚合酶链反应 [PCR]、药敏纸片扩散法）、毒力因子基因（sea、tst、pvl）流行情况和遗传背景（agr 等位基因）。2006 年 11 月，共收集了 235 株菌株（伤口感染：51%，脓肿：21%，白疖子：8%，糖尿病足：7%，疖：3%）。分别在 22.1%、13.2%和 8.9%的菌株中鉴定到了 sea、tst 和 pvl 基因。agr 等位基因 1 是最常见的遗传背景，与耐甲氧西林的情况无关。在 34 株耐甲氧西林金黄色葡萄球菌（MRSA，占所有金黄色葡萄球菌的 14.5%）中，只有 1 株（2.9%）携带 pvl（属于欧洲 ST80 克隆），4 株（11.8%）携带 tst（属于两个法国地方性克隆），18 株（52.9%）携带 sea 基因（主要是里昂克隆）。根据其体外活性，可考虑使用普那霉素或复方新诺明/磺胺甲恶唑作为一线抗生素。迄今为止，国际上流行的 pvl 阳性 MRSA 克隆尚未在法国传播。从疑似 CA-SSTIs 中分离出的 MRSA 菌株表现出医院获得性（HA）克隆的遗传和表型背景。应继续进行全国性调查，以监测毒力克隆的出现。
