González-Domínguez María, Seral Cristina, Potel Carmen, Sáenz Yolanda, Álvarez Maximiliano, Torres Carmen, Castillo Francisco Javier
Servicio de Microbiología, Hospital Clínico Universitario Lozano Blesa, San Juan Bosco s/n, 50009, Zaragoza, Spain.
Servicio de Microbiología, Hospital Clínico Universitario Lozano Blesa, San Juan Bosco s/n, 50009, Zaragoza, Spain; Departamento de Microbiología, Facultad de Medicina, Universidad de Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain.
Diagn Microbiol Infect Dis. 2016 Jun;85(2):213-7. doi: 10.1016/j.diagmicrobio.2016.02.021. Epub 2016 Feb 28.
A high proportion of methicillin-resistant Staphylococcus aureus isolates recovered in one year period showed high-level mupirocin-resistance (HLMUPR-MRSA) in our environment (27.2%). HLMUPR-MRSA isolates were mainly collected from skin and soft tissue samples, and diabetes was the main related comorbidity condition. These isolates were more frequently found in vascular surgery. HLMUPR-MRSA was more resistant to aminoglycosides than mupirocin-susceptible MRSA, linked to the presence of bifunctional and/or nucleotidyltransferase enzymes with/without macrolide resistance associated with the msr(A) gene. Most of HLMUPR-MRSA isolates belonged to ST125/t067. Nine IS257-ileS2 amplification patterns (p3 was the most frequent) were observed in HLMUPR-MRSA isolates, suggesting the presence of several mupirocin-resistance-carrying plasmids in our environment and promoting the emergence of mupirocin resistance. The presence of the same IS257-ileS2 amplification pattern p3 in 65% of HLMUPR-MRSA, all of them ST125/t067, suggests a clonal spread in our hospital and community environment which could explain the high prevalence of HLMUPR-MRSA during the study period. An outbreak situation or an increase in mupirocin consumption was not observed.
在我们的环境中，一年内分离出的耐甲氧西林金黄色葡萄球菌中有很大比例表现出对莫匹罗星的高水平耐药性（HLMUPR-MRSA，占27.2%）。HLMUPR-MRSA分离株主要从皮肤和软组织样本中收集，糖尿病是主要的相关合并症。这些分离株在血管外科中更常见。与对莫匹罗星敏感的MRSA相比，HLMUPR-MRSA对氨基糖苷类药物的耐药性更强，这与存在双功能和/或核苷酸转移酶有关，这些酶带有/不带有与msr(A)基因相关的大环内酯耐药性。大多数HLMUPR-MRSA分离株属于ST125/t067。在HLMUPR-MRSA分离株中观察到9种IS257-ileS2扩增模式（p3最常见），这表明我们的环境中存在几种携带莫匹罗星耐药性的质粒，并促进了莫匹罗星耐药性的出现。65%的HLMUPR-MRSA（均为ST125/t067）中存在相同的IS257-ileS2扩增模式p3，这表明在我们医院和社区环境中存在克隆传播，这可以解释研究期间HLMUPR-MRSA的高流行率。未观察到暴发情况或莫匹罗星消耗量增加。
