Lin Jialing, Xu Ping, Peng Yang, Lin Dongxin, Ou Qianting, Zhang Ting, Bai Chan, Ye Xiaohua, Zhou Junli, Yao Zhenjiang
Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China.
left for Chronic Disease, University of Queensland, Brisbane, Queensland, Australia.
J Diabetes Investig. 2017 May;8(3):383-391. doi: 10.1111/jdi.12591. Epub 2016 Dec 15.
AIMS/INTRODUCTION: Evidence suggests that diabetes might cause an increase in colonization of Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) in community settings. We carried out a cross-sectional study to determine the prevalence and influencing factors of S. aureus and MRSA nasal colonization among a community-based diabetes population, and to identify the characteristics of the isolated strains.
A total of 956 participants from 11 community settings were included in the study.
Of the 529 diabetes participants, 46 were colonized with S. aureus and 22 were colonized with MRSA. Of the 427 non-diabetes participants, 25 were colonized with S. aureus and 12 were colonized with MRSA. Men (odds ratio 0.45, 95% confidence interval 0.20-0.99, P = 0.047) were less likely to have S. aureus nasal colonization, and those with well-controlled blood glucose (odds ratio 2.04, 95% confidence interval 1.01-4.13, P = 0.047) among the diabetes population were more likely to have S. aureus nasal colonization. The proportion of multidrug-resistant S. aureus strains in the diabetes population (52.17%) was higher than that in the non-diabetes population (28.00%; χ = 3.848, P = 0.050). The most common clonal complex type and Staphylococcal chromosome cassette mec type of MRSA in diabetes population was clonal complex 5 (40.91%) and type IV (27.27%), respectively. The proportion of Panton-Valentine leukocidin gene in MRSA strains was 17.65%. There was great sequence type diversity in MRSA strains.
The prevalence of MRSA in the community-based diabetes population was moderate, and the high proportions of multidrug-resistant S. aureus strains and diverse molecular characteristics in the diabetes population should be noticed.
目的/引言：有证据表明，糖尿病可能导致社区环境中金黄色葡萄球菌（S. aureus）和耐甲氧西林金黄色葡萄球菌（MRSA）的定植增加。我们开展了一项横断面研究，以确定社区糖尿病患者群体中金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌鼻腔定植的患病率及影响因素，并鉴定分离菌株的特征。
该研究共纳入了来自11个社区的956名参与者。
在529名糖尿病参与者中，46人金黄色葡萄球菌定植，22人耐甲氧西林金黄色葡萄球菌定植。在427名非糖尿病参与者中，25人金黄色葡萄球菌定植，12人耐甲氧西林金黄色葡萄球菌定植。男性（比值比0.45，95%置信区间0.20 - 0.99，P = 0.047）金黄色葡萄球菌鼻腔定植的可能性较小，而糖尿病患者群体中血糖控制良好者（比值比2.04，95%置信区间1.01 - 4.13，P = 0.047）金黄色葡萄球菌鼻腔定植的可能性更大。糖尿病患者群体中多重耐药金黄色葡萄球菌菌株的比例（52.17%）高于非糖尿病患者群体（28.00%；χ = 3.848，P = 0.050）。糖尿病患者群体中耐甲氧西林金黄色葡萄球菌最常见的克隆复合体类型和葡萄球菌染色体盒式mec类型分别为克隆复合体5（40.91%）和IV型（27.27%）。耐甲氧西林金黄色葡萄球菌菌株中杀白细胞素基因的比例为17.65%。耐甲氧西林金黄色葡萄球菌菌株存在很大的序列类型多样性。
社区糖尿病患者群体中耐甲氧西林金黄色葡萄球菌的患病率中等，应注意糖尿病患者群体中多重耐药金黄色葡萄球菌菌株比例高和分子特征多样的情况。
