非医院环境中金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌的污染：比例荟萃分析以及抗生素耐药性和分子遗传学特征。
Non-hospital environment contamination with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus: proportion meta-analysis and features of antibiotic resistance and molecular genetics.
机构信息
Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou 510310, China.
Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou 510310, China.
出版信息
Environ Res. 2016 Oct;150:528-540. doi: 10.1016/j.envres.2016.06.040. Epub 2016 Jul 15.
BACKGROUND
Staphylococcus aureus (S. aureus), including methicillin-resistant Staphylococcus aureus (MRSA), survives in dry conditions and can persist for long periods on surfaces touched by humans. Studies that estimate the proportions and characteristics of S. aureus and MRSA contamination in non-hospital environments are lacking. Therefore, we conducted a proportion meta-analysis and reviewed the features of antibiotic resistance and molecular genetics.
METHODS
Articles published between January 2005 and December 2015 that studied proportions of S. aureus and MRSA contamination in non-hospital environments were retrieved from the Medline database, Ovid database and Science Direct database. All statistics were analyzed by STATA 14.1.
RESULTS
Twenty-nine articles were included. The overall proportions of S. aureus and MRSA contamination were 41.1% (95%CI 29-54%) and 8.6% (95%CI 5-13%), respectively. The proportion of MRSA contamination increased over time. From the articles, the proportion of Panton-Valentine Leukociden (PVL) genes among MRSA isolates was 54.5%, and the proportion of the qac gene was 100.0%. Distribution of the multilocus sequence type (MLST) and pulsed-field gel electrophoresis (PFGE) of MRSA indicated that MRSA strains were from both hospitals and communities.
CONCLUSION
The overall proportions of S. aureus and MRSA contamination in non-hospital environments were high. The outcomes of antibiotic resistance and high proportions of PVL genes indicated that the antibiotic resistance of S. aureus and MRSA were notable. According to the different distributions of MLST and SCCmec of MRSA, we can infer that cross-circulation is within hospitals, communities, and livestock. The results also show that the risk from the MRSA strains was cross-transmitted among the population. High proportions of the qac gene of MRSA might indicate that current disinfection of MRSA has not been achieved, and it might be better to further identify the efficiency of the sterilization processes in a non-hospital environment so that relevant departments can take measures to improve disinfection of MRSA in non-hospital environments.
背景
金黄色葡萄球菌（S. aureus），包括耐甲氧西林金黄色葡萄球菌（MRSA），在干燥条件下存活，并能在人类接触过的表面上长时间存活。目前缺乏估计非医院环境中金黄色葡萄球菌和 MRSA 污染比例和特征的研究。因此，我们进行了比例荟萃分析，并回顾了抗生素耐药性和分子遗传学的特征。
方法
从 Medline 数据库、Ovid 数据库和 Science Direct 数据库中检索了 2005 年 1 月至 2015 年 12 月期间发表的研究非医院环境中金黄色葡萄球菌和 MRSA 污染比例的文章。所有统计数据均采用 STATA 14.1 进行分析。
结果
共纳入 29 篇文章。金黄色葡萄球菌和 MRSA 污染的总体比例分别为 41.1%（95%CI 29-54%）和 8.6%（95%CI 5-13%）。MRSA 污染的比例随时间增加。从这些文章中，MRSA 分离株中 Panton-Valentine Leukociden（PVL）基因的比例为 54.5%，qac 基因的比例为 100.0%。MRSA 的多位点序列分型（MLST）和脉冲场凝胶电泳（PFGE）分布表明，MRSA 菌株来自医院和社区。
结论
非医院环境中金黄色葡萄球菌和 MRSA 污染的总体比例较高。抗生素耐药性和高比例的 PVL 基因的结果表明，金黄色葡萄球菌和 MRSA 的抗生素耐药性值得关注。根据 MRSA 的 MLST 和 SCCmec 不同的分布，我们可以推断出医院、社区和家畜之间存在交叉循环。结果还表明，MRSA 菌株的风险在人群中交叉传播。MRSA 中高比例的 qac 基因可能表明目前尚未实现对 MRSA 的消毒，因此最好进一步确定非医院环境中消毒的效率，以便相关部门采取措施改善非医院环境中对 MRSA 的消毒。
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