中国台湾中部出现耐苯唑西林凝固酶阴性葡萄球菌，其携带 mec 型 V 型葡萄球菌盒式染色体
Emergence of oxacillin-resistant Staphylococcus lugdunensis carrying staphylococcal cassette chromosome mec type V in central Taiwan.
机构信息
Department of Pediatrics, Children's Hospital, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan.
出版信息
J Microbiol Immunol Infect. 2016 Dec;49(6):885-891. doi: 10.1016/j.jmii.2014.11.018. Epub 2014 Dec 11.
BACKGROUND
Staphylococcus lugdunensis has emerged as a key pathogen for clinical infection. It is sensitive to most antistaphylococcal agents, but it is increasingly resistant to β-lactam antibiotics. Oxacillin-resistant S. lugdunensis isolates carrying the mecA gene pose a major concern for therapy failure.
METHODS
To assess the epidemiology and presence of mecA in S. lugdunensis, we gauged the prevalence and antibiotic resistance of S. lugdunensis in clinical specimens by using multiplex polymerase chain reaction (PCR) and pulsed-field gel electrophoresis.
RESULTS
Thirty S. lugdunensis isolates were collected and examined between October 2009 and December 2010. The resistance to penicillin (87%) and oxacillin (20%) was noted. All oxacillin-resistant isolates (6/30) had type V or V SCCmec. Most (67%, 4/6) isolates carried SCCmec type V. These organisms caused invasive infections such as peritonitis, osteomyelitis, and septic arthritis. Pulsed-field gel electrophoresis analyses showed most (83%, 5/6) isolates carrying mecA were pulsotype D with high similarity (93.8%).
CONCLUSIONS
The findings suggest oxacillin-resistant S. lugdunensis carrying SCCmec type V is emerging in central Taiwan.
背景
金黄色葡萄球菌已成为临床感染的重要病原体。它对大多数抗葡萄球菌药物敏感，但对β-内酰胺类抗生素的耐药性日益增加。携带 mecA 基因的耐苯唑西林金黄色葡萄球菌分离株对治疗失败构成重大威胁。
方法
为了评估金黄色葡萄球菌 lugdunensis 的流行病学和 mecA 的存在，我们通过多重聚合酶链反应 (PCR) 和脉冲场凝胶电泳来评估临床标本中金黄色葡萄球菌 lugdunensis 的流行情况和抗生素耐药性。
结果
在 2009 年 10 月至 2010 年 12 月期间收集并检查了 30 株金黄色葡萄球菌 lugdunensis 分离株。对青霉素（87%）和苯唑西林（20%）的耐药性得到了证实。所有耐苯唑西林的分离株（6/30）均具有 V 型或 V 型 SCCmec。大多数（67%，4/6）分离株携带 SCCmec 型 V。这些生物体引起了侵袭性感染，如腹膜炎、骨髓炎和败血症性关节炎。脉冲场凝胶电泳分析显示，大多数携带 mecA 的分离株（83%，5/6）为 D 型脉冲式，相似度高达 93.8%。
结论
这些发现表明，携带 SCCmec 型 V 的耐苯唑西林金黄色葡萄球菌 lugdunensis 正在台湾中部出现。
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