Hidalgo Marylin, Carvajal Lina P, Rincón Sandra, Faccini-Martínez Álvaro A, Tres Palacios Alba A, Mercado Marcela, Palomá Sandra L, Rayo Leidy X, Acevedo Jessica A, Reyes Jinnethe, Panesso Diana, García-Padilla Paola, Alvarez Carlos, Arias Cesar A
Department of Microbiology, Pontificia Universidad Javeriana, Bogotá, Colombia.
Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia.
PLoS One. 2015 Oct 16;10(10):e0140748. doi: 10.1371/journal.pone.0140748. eCollection 2015.
We aimed to determine the prevalence of MRSA colonization and examine the molecular characteristics of colonizing isolates in patients receiving hemodialysis and HIV-infected in a Colombian hospital. Patients on hemodialysis and HIV-infected were prospectively followed between July 2011 and June 2012 in Bogota, Colombia. Nasal and axillary swabs were obtained and cultured. Colonizing S. aureus isolates were identified by standard and molecular techniques. Molecular typing was performed by using pulse-field gel electrophoresis and evaluating the presence of lukF-PV/lukS-PV by PCR. A total of 29% (n = 82) of HIV-infected and 45.5% (n = 15) of patients on hemodialysis exhibited S. aureus colonization. MSSA/MRSA colonization was observed in 28% and 3.6% of the HIV patients, respectively and in 42.4% and 13.3% of the hemodialysis patients, respectively. Staphylococcal cassette chromosome mec typing showed that four MRSA isolates harbored the type IV cassette, and one type I. In the hemodialysis group, two MRSA isolates were classified as belonging to the USA300-LV genetic lineage. Conversely, in the HIV infected group, no colonizing isolates belonging to the USA300-Latin American Variant (UDA300-LV) lineage were identified. Colonizing isolates recovered from the HIV-infected group belonged to the prevalent hospital-associated clones circulating in Latin America (Chilean [n = 1] and Pediatric [n = 2]). The prevalence of MRSA colonization in the study groups was 3.6% (HIV) and 13.3% (hemodialysis). Surveillance programs should be implemented in this group of patients in order to understand the dynamics of colonization and infection in high-risk patients.
我们旨在确定哥伦比亚一家医院中接受血液透析的患者和感染艾滋病毒患者的耐甲氧西林金黄色葡萄球菌（MRSA）定植率，并研究定植菌株的分子特征。2011年7月至2012年6月，在哥伦比亚波哥大对接受血液透析的患者和感染艾滋病毒的患者进行了前瞻性随访。采集鼻拭子和腋拭子并进行培养。通过标准技术和分子技术鉴定定植的金黄色葡萄球菌菌株。采用脉冲场凝胶电泳进行分子分型，并通过聚合酶链反应评估lukF-PV/lukS-PV的存在情况。共有29%（n = 82）的感染艾滋病毒患者和45.5%（n = 15）的血液透析患者出现金黄色葡萄球菌定植。在艾滋病毒患者中，分别有28%和3.6%观察到甲氧西林敏感金黄色葡萄球菌/耐甲氧西林金黄色葡萄球菌定植，在血液透析患者中，分别为42.4%和13.3%。葡萄球菌盒式染色体mec分型显示，4株耐甲氧西林金黄色葡萄球菌分离株携带IV型盒式结构，1株携带I型。在血液透析组中，2株耐甲氧西林金黄色葡萄球菌分离株被归类为属于USA300-LV基因谱系。相反，在感染艾滋病毒组中，未鉴定出属于USA300-拉丁美洲变体（UDA300-LV）谱系的定植菌株。从感染艾滋病毒组中分离出的定植菌株属于在拉丁美洲流行的医院相关克隆（智利株[n = 1]和儿科株[n = 2]）。研究组中耐甲氧西林金黄色葡萄球菌定植率为3.6%（艾滋病毒感染组）和13.3%（血液透析组）。应为这类患者实施监测计划，以了解高危患者定植和感染的动态情况。
