Rosenthal Marnie E, Mediavilla Jose, Chen Liang, Sonnenfeld Julian, Pierce Logan, Shannon Alexander, Boucher Helen, Pearlmutter Mark, Kreiswirth Barry, Kuo Yen-Hong, Previl Harold, Rojtman Albert
Department of Medicine, Jersey Shore University Medical Center, 1945 State Route 33, Ackerman 326, Neptune City, NJ 07753, USA; Public Health Research Institute, Rutgers University, Newark, New Jersey, USA.
Public Health Research Institute, Rutgers University, Newark, New Jersey, USA.
Int J Infect Dis. 2014 Dec;29:146-51. doi: 10.1016/j.ijid.2014.08.007. Epub 2014 Oct 24.
Knowledge of nasal carriage is important in predicting staphylococcal infection, and no information exists regarding the endemicity of Staphylococcus aureus in Haiti.
We performed a cross-sectional analysis of S. aureus nasal screening in an acute care, a subacute rehabilitation, and a community setting, with a brief medical and epidemiological history. PCR-positive S. aureus screening nasal cultures underwent molecular analysis for spa type, SCCmec type, and virulence genes (Panton-Valentine leukocidin (PVL), toxic shock syndrome toxin (TSST), and arginine catabolic mobile element (ACME)), and were evaluated for antibiotic susceptibility using commercial tests.
Overall carriage rates of 8.4% methicillin-susceptible S. aureus (MSSA) and 2.8% methicillin-resistant S. aureus (MRSA) were identified, with a high rate of tetracycline resistance. TSST and PVL genes were identified in MSSA. MRSA isolates contained no virulence markers. Unique MSSA phenotypes (i.e., linezolid-resistant, vancomycin-sensitive/daptomycin non-susceptible) were identified, as were two PVL-positive ST152 MSSA colonization isolates, previously geographically limited to Africa.
We found a low S. aureus carriage rate with complete vancomycin susceptibility and high tetracycline resistance, which has important public health implications with regard to treatment. Additionally, the finding of PVL-positive MSSA isolates, including the expansion of a previously described limited 'divergent' clone, ST152, warrants further evaluation.
鼻腔带菌情况的了解对于预测葡萄球菌感染很重要，而海地金黄色葡萄球菌的流行情况尚无相关信息。
我们在急症护理、亚急性康复和社区环境中对金黄色葡萄球菌进行鼻腔筛查，并采集简要的医学和流行病学病史，进行横断面分析。对聚合酶链反应（PCR）阳性的金黄色葡萄球菌鼻腔培养物进行spa分型、SCCmec分型和毒力基因（杀白细胞素（PVL）、中毒性休克综合征毒素（TSST）和精氨酸分解代谢移动元件（ACME））的分子分析，并使用商业检测评估抗生素敏感性。
确定了甲氧西林敏感金黄色葡萄球菌（MSSA）的总体携带率为8.4%，甲氧西林耐药金黄色葡萄球菌（MRSA）的总体携带率为2.8%，四环素耐药率较高。在MSSA中鉴定出TSST和PVL基因。MRSA分离株未包含毒力标记。鉴定出独特的MSSA表型（即耐利奈唑胺、万古霉素敏感/对达托霉素不敏感），以及两株PVL阳性的ST152 MSSA定植分离株，该克隆以前在地理上仅限于非洲。
我们发现金黄色葡萄球菌携带率较低，对万古霉素完全敏感，但四环素耐药率较高，这在治疗方面具有重要的公共卫生意义。此外，PVL阳性MSSA分离株的发现，包括先前描述的有限“分歧”克隆ST152的扩展，值得进一步评估。
