Biber A, Parizade M, Taran D, Jaber H, Berla E, Rubin C, Rahav G, Glikman D, Regev-Yochay G
Infectious Dis. Unit, Sheba Medical Center, Ramat-Gan, The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Eur J Clin Microbiol Infect Dis. 2015 Aug;34(8):1603-13. doi: 10.1007/s10096-015-2395-9. Epub 2015 May 14.
Data on community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) in Israel are scarce. The objective of this study was to characterize the major CA-MRSA clones in Israel. All clinical MRSA isolates detected in the community during a period of 2.5 years (2011-2013) from individuals insured by a major health maintenance organization in Israel were collected, with additional data from medical records. Antibiotic susceptibility patterns and staphylococcal chromosomal cassette mec (SCCmec) typing were determined. SCCmec IV and V isolates were further typed by pulsed-field gel electrophoresis (PFGE), spa typing, and detection of a panel of toxin genes. MRSA were detected in 280 patients, mostly from skin infections. Patients with SCCmec IV (n = 120, 43 %) were younger (p < 0.0001) and reported less contact with healthcare facilities. Almost all isolates were trimethoprim-sulfamethoxazole susceptible (98 %). spa-CC032, a typical nosocomial MRSA clone, accounted for 28 % of SCCmec IV. The two major CA-MRSA clones were t008 USA300 (13 %) and t991 (10 %); t991 was isolated mainly from children (75 %), was Panton-Valentine leukocidin (PVL) negative but eta-positive, and was typically susceptible to most antibiotic groups. PVL-positive strains (n = 31) included mainly USA300 (52 %) and t019 (13 %). While multiple genetic lineages were evident among community-onset MRSA in Israel, approximately 20 % are typical CA-MRSA clones, mainly USA300 and a local clone, t991.
以色列社区获得性（CA）耐甲氧西林金黄色葡萄球菌（MRSA）的数据匮乏。本研究的目的是对以色列主要的CA-MRSA克隆进行特征分析。收集了以色列一家大型健康维护组织承保的个人在2.5年期间（2011 - 2013年）社区中检测到的所有临床MRSA分离株，并从病历中获取了额外数据。确定了抗生素敏感性模式和葡萄球菌染色体盒式mec（SCCmec）分型。对SCCmec IV和V分离株进一步进行脉冲场凝胶电泳（PFGE）、spa分型以及一组毒素基因的检测。在280例患者中检测到MRSA，大多数来自皮肤感染。SCCmec IV型患者（n = 120，43%）更年轻（p < 0.0001），且报告与医疗机构的接触较少。几乎所有分离株对甲氧苄啶 - 磺胺甲恶唑敏感（98%）。spa-CC032，一种典型的医院内MRSA克隆，占SCCmec IV型的28%。两个主要的CA-MRSA克隆是t008 USA300（13%）和t991（10%）；t991主要从儿童中分离得到（75%），为杀白细胞素（PVL）阴性但eta阳性，并且通常对大多数抗生素组敏感。PVL阳性菌株（n = 31）主要包括USA300（52%）和t019（13%）。虽然以色列社区发病的MRSA中存在多种遗传谱系，但约20%是典型的CA-MRSA克隆，主要是USA300和一个本地克隆t991。
