金黄色葡萄球菌鼻腔携带与糖尿病足感染性溃疡之间的联系。
Link between nasal carriage of Staphylococcus aureus and infected diabetic foot ulcers.
作者信息
Dunyach-Remy C, Courtais-Coulon C, DeMattei C, Jourdan N, Schuldiner S, Sultan A, Carrière C, Alonso S, Sotto A, Lavigne J-P
机构信息
U1047, National Institute of Health and Medical Research, Montpellier University, Faculty of Medicine, 30908 Nîmes cedex 02, France; Department of Microbiology, University Hospital Carémeau, 30029 Nîmes cedex 9, France.
Department of Microbiology, University Hospital Carémeau, 30029 Nîmes cedex 9, France.
出版信息
Diabetes Metab. 2017 Apr;43(2):167-171. doi: 10.1016/j.diabet.2016.09.003. Epub 2016 Oct 5.
AIMS
Nasal carriage of Staphylococcus aureus in diabetic patients may be a risk factor for diabetic foot lesion infections. The aims of this study were to compare the genotypic profiles of S. aureus strains isolated from nares and diabetic foot ulcers (DFUs) using microarray technology.
METHODS
Patients were included if they were admitted for diabetic foot infection (DFI) at any of three diabetology departments of Montpellier and Nîmes University Hospitals between 1 September 2010 to 30 June 2012. All S. aureus isolates were analyzed using oligonucleotides arrays; S. aureus resistance and virulence genes were determined and each isolate was affiliated to a clonal complex.
RESULTS
The prevalence of S. aureus nasal carriage among the 276 included patients was 39.5% (n=109), while 36.6% (n=101) had S. aureus at both sites (nares and foot wounds) and, of these patients, 65.3% of patients harboured the same strain at both sites. In addition, the spread of the methicillin-resistant S. aureus (MRSA) ST398 clone in DFI and its tropism for bone were also further confirmed.
CONCLUSION
These findings appear to provide new arguments in favour of the systematic detection of nasal S. aureus carriage to anticipate the management of DFI.
目的
糖尿病患者鼻腔携带金黄色葡萄球菌可能是糖尿病足病变感染的一个危险因素。本研究的目的是使用微阵列技术比较从鼻孔和糖尿病足溃疡（DFU）分离出的金黄色葡萄球菌菌株的基因分型。
方法
纳入2010年9月1日至2012年6月30日期间在蒙彼利埃和尼姆大学医院的三个糖尿病科之一因糖尿病足感染（DFI）入院的患者。所有金黄色葡萄球菌分离株均使用寡核苷酸阵列进行分析；确定金黄色葡萄球菌的耐药性和毒力基因，并将每个分离株归入一个克隆复合体。
结果
在纳入的276例患者中，金黄色葡萄球菌鼻腔携带率为39.5%（n = 109），而36.6%（n = 101）在两个部位（鼻孔和足部伤口）均携带金黄色葡萄球菌，在这些患者中，65.3%的患者在两个部位携带相同菌株。此外，耐甲氧西林金黄色葡萄球菌（MRSA）ST398克隆在DFI中的传播及其对骨骼的嗜性也得到了进一步证实。
结论
这些发现似乎为系统性检测鼻腔金黄色葡萄球菌携带情况以预测DFI的管理提供了新的依据。
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