Abdel-Maksoud Mohamed, El-Shokry Mona, Ismail Ghada, Hafez Soad, El-Kholy Amani, Attia Ehab, Talaat Maha
US Naval Medical Research Unit No. 3, Cairo 11517, Egypt.
US Naval Medical Research Unit No. 3, Cairo 11517, Egypt; Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt; Ain Shams University, Cairo 11566, Egypt.
Int J Bacteriol. 2016;2016:5751785. doi: 10.1155/2016/5751785. Epub 2016 Jun 28.
Background. Methicillin-resistant Staphylococcus aureus (MRSA) has created significant epidemiological, infection-control, and therapeutic management challenges during the past three decades. Aim. To analyze the pattern of resistance of healthcare- and community-associated MRSA in Egypt and the trend of resistance of HA-MRSA over time (2005-2013). Methods. MRSA isolates were recovered from healthcare-associated (HA) and community-associated (CA) Staphylococcus aureus (S. aureus) infections. They were tested against 11 antimicrobial discs and the minimal inhibitory concentration (MIC) of vancomycin was determined. Inducible clindamycin resistance (iMLSB) was also screened using D-test. Findings. Of 631 S. aureus, MRSA was identified in 343 (76.6%) and 21 (11.5%) of HA and CA S. aureus isolates, respectively. The proportion of HA-MRSA increased significantly from 48.6% in 2005 to 86.8% in 2013 (p value < 0.001). Multidrug resistance (MDR) was observed in 85.8% of HA-MRSA and 48.6% of CA-MRSA. Vancomycin intermediate resistant S. aureus (VISA) was detected in 1.2% of HA-MRSA and none was detected in CA-MRSA. Among HA-MRSA strains, 5.3% showed iMLSB compared to 9.5% among CA-MRSA. Conclusion. The upsurge of the prevalence rates of HA-MRSA over time is alarming and urges for an effective infection control strategy and continuous monitoring of antimicrobial use.
背景。在过去三十年中，耐甲氧西林金黄色葡萄球菌（MRSA）带来了重大的流行病学、感染控制和治疗管理挑战。目的。分析埃及医疗保健相关和社区相关MRSA的耐药模式以及医院获得性MRSA（HA-MRSA）随时间（2005 - 2013年）的耐药趋势。方法。从医疗保健相关（HA）和社区相关（CA）金黄色葡萄球菌（S. aureus）感染中分离出MRSA菌株。对它们进行11种抗菌药物纸片测试，并测定万古霉素的最低抑菌浓度（MIC）。还使用D试验筛选诱导型克林霉素耐药（iMLSB）。结果。在631株金黄色葡萄球菌中，分别在343株（76.6%）HA金黄色葡萄球菌分离株和21株（11.5%）CA金黄色葡萄球菌分离株中鉴定出MRSA。HA-MRSA的比例从2005年的48.6%显著增加到2013年的86.8%（p值<0.001）。85.8%的HA-MRSA和48.6%的CA-MRSA表现出多重耐药（MDR）。在1.2%的HA-MRSA中检测到万古霉素中介耐药金黄色葡萄球菌（VISA），在CA-MRSA中未检测到。在HA-MRSA菌株中，5.3%表现出iMLSB，而CA-MRSA中这一比例为9.5%。结论。HA-MRSA患病率随时间的激增令人担忧，迫切需要有效的感染控制策略和对抗菌药物使用的持续监测。
