Shore Anna C, Tecklenborg Sarah C, Brennan Gráinne I, Ehricht Ralf, Monecke Stefan, Coleman David C
Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College, Dublin, Ireland.
J Clin Microbiol. 2014 Mar;52(3):859-70. doi: 10.1128/JCM.02799-13. Epub 2013 Dec 26.
There has been a worldwide increase in community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) infections. CA-MRSA isolates commonly produce the Panton-Valentine leukocidin toxin encoded by the pvl genes lukF-PV and lukS-PV. This study investigated the clinical and molecular epidemiologies of pvl-positive MRSA and methicillin-susceptible S. aureus (MSSA) isolates identified by the Irish National MRSA Reference Laboratory (NMRSARL) between 2002 and 2011. All pvl-positive MRSA (n=190) and MSSA (n=39) isolates underwent antibiogram-resistogram typing, spa typing, and DNA microarray profiling for multilocus sequence type, clonal complex (CC) and/or sequence type (ST), staphylococcal cassette chromosome mec type assignment, and virulence and resistance gene detection. Where available, patient demographics and clinical data were analyzed. The prevalence of pvl-positive MRSA increased from 0.2% to 8.8%, and that of pvl-positive MSSA decreased from 20% to 2.5% during the study period. The pvl-positive MRSA and MSSA isolates belonged to 16 and 5 genotypes, respectively, with CC/ST8-MRSA-IV, CC/ST30-MRSA-IV, CC/ST80-MRSA-IV, CC1/ST772-MRSA-V, CC30-MSSA, CC22-MSSA, and CC121-MSSA predominating. Temporal shifts in the predominant pvl-positive MRSA genotypes and a 6-fold increase in multiresistant pvl-positive MRSA genotypes occurred during the study period. An analysis of patient data indicated that pvl-positive S. aureus strains, especially MRSA strains, had been imported into Ireland several times. Two hospital and six family clusters of pvl-positive MRSA were identified, and 70% of the patient isolates for which information was available were from patients in the community. This study highlights the increased burden and changing molecular epidemiology of pvl-positive S. aureus in Ireland over the last decade and the contribution of international travel to the influx of genetically diverse pvl-positive S. aureus isolates into Ireland.
社区获得性（CA）耐甲氧西林金黄色葡萄球菌（MRSA）感染在全球范围内呈上升趋势。CA-MRSA分离株通常产生由pvl基因lukF-PV和lukS-PV编码的杀白细胞素毒素。本研究调查了2002年至2011年间爱尔兰国家MRSA参考实验室（NMRSARL）鉴定的pvl阳性MRSA和甲氧西林敏感金黄色葡萄球菌（MSSA）分离株的临床和分子流行病学。所有pvl阳性MRSA（n = 190）和MSSA（n = 39）分离株均进行了抗菌谱-耐药谱分型、spa分型以及多位点序列分型、克隆复合体（CC）和/或序列类型（ST）、葡萄球菌盒式染色体mec分型的DNA微阵列分析，以及毒力和耐药基因检测。在可行的情况下，对患者人口统计学和临床数据进行了分析。在研究期间，pvl阳性MRSA的患病率从0.2%上升至8.8%，而pvl阳性MSSA的患病率从20%降至2.5%。pvl阳性MRSA和MSSA分离株分别属于16种和5种基因型，以CC/ST8-MRSA-IV、CC/ST30-MRSA-IV、CC/ST80-MRSA-IV、CC1/ST772-MRSA-V、CC30-MSSA、CC22-MSSA和CC121-MSSA为主。在研究期间，主要的pvl阳性MRSA基因型出现了时间上的变化，多重耐药的pvl阳性MRSA基因型增加了6倍。对患者数据的分析表明，pvl阳性金黄色葡萄球菌菌株，尤其是MRSA菌株，已多次传入爱尔兰。鉴定出两个医院和六个家庭的pvl阳性MRSA聚集性病例，70%有信息可查的患者分离株来自社区患者。本研究强调了过去十年爱尔兰pvl阳性金黄色葡萄球菌负担的增加和分子流行病学的变化，以及国际旅行对基因多样的pvl阳性金黄色葡萄球菌分离株流入爱尔兰的影响。
