van der Mee-Marquet N, Poisson D-M, Lavigne J-P, Francia T, Tristan A, Vandenesch F, Quentin R, Bertrand X
Service de Bactériologie et Hygiène, Hôpital Trousseau, Centre Hospitalier Régional Universitaire, 37044, Tours, France,
Eur J Clin Microbiol Infect Dis. 2015 May;34(5):935-42. doi: 10.1007/s10096-014-2308-3. Epub 2015 Jan 10.
Methicillin-resistant Staphylococcus aureus (MRSA) formerly colonized and infected only inpatients in hospitals, but have been reported in community settings worldwide over the last 20 years. In France, the prevalence of such MRSA remains low and outbreaks have, until now, been mainly due to the ST80 clone. However, there were two outbreaks of MRSA clone ST-USA300 recently in France, including one involving children. To investigate epidemiological developments, we studied the 77 MRSA isolated from pediatric patients hospitalized between 2008 and 2013 in three French hospitals. The median incidence of MRSA was stable and low (0.137 per 100 admissions). The prevalence of Panton-Valentine leukocidin (PVL)-positive MRSA was high (33.8 %). The 26 PVL-positive MRSA were genetically diverse, with two clones being predominant: ST80 (12 isolates, 46.1 %) and ST8-USA300 (8 isolates, 30.8 %). The incidence of ST8-USA300 increased over the 6-year period. We believe that screening for ST8-USA300 should be improved: medical biologists should be encouraged to search for PVL genes in all MRSA isolates recovered from abscesses, whatever the susceptibility pattern of the isolate, and not only when suggestive of ST80.
耐甲氧西林金黄色葡萄球菌（MRSA）以前仅在医院住院患者中定殖和感染，但在过去20年中已在全球社区环境中被报道。在法国，此类MRSA的流行率仍然较低，到目前为止，疫情主要由ST80克隆引起。然而，法国最近发生了两起MRSA克隆ST-USA300疫情，其中一起涉及儿童。为了调查流行病学发展情况，我们研究了2008年至2013年期间在法国三家医院住院的儿科患者中分离出的77株MRSA。MRSA的发病率中位数稳定且较低（每100例入院患者中有0.137例）。杀白细胞素（PVL）阳性MRSA的流行率较高（33.8%）。26株PVL阳性MRSA在基因上具有多样性，有两个克隆占主导地位：ST80（12株，46.1%）和ST8-USA300（8株，30.8%）。ST8-USA300的发病率在6年期间有所增加。我们认为应改进对ST8-USA300的筛查：应鼓励医学生物学家在从脓肿中分离出的所有MRSA菌株中寻找PVL基因，无论该菌株的药敏模式如何，而不仅仅是在提示为ST80时。
