Vandendriessche S, De Boeck H, Deplano A, Phoba M-F, Lunguya O, Falay D, Dauly N, Verhaegen J, Denis O, Jacobs J
National Reference Centre for Staphylococcus aureus, Laboratory of Microbiology, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
Eur J Clin Microbiol Infect Dis. 2017 Jul;36(7):1163-1171. doi: 10.1007/s10096-017-2904-0. Epub 2017 Jan 23.
Staphylococcus aureus is known worldwide as an invasive pathogen, but information on S. aureus from bloodstream infections in Central Africa remains scarce. A collection of S. aureus blood culture isolates recovered from hospitals in four provinces in the Democratic Republic of the Congo (2009-2013) was assessed. A total of 27/108 isolates were methicillin-resistant S. aureus (MRSA), of which >70% were co-resistant to aminoglycosides, tetracyclines, macrolides and lincosamides. For MRSA and methicillin-susceptible S. aureus (MSSA) isolates, resistance to chloramphenicol and trimethoprim-sulphamethoxazole (TMP-SMX) was <10%. However, 66.7% (72/108) of all isolates harboured the trimethoprim resistance gene dfrG. More than three-quarters (84/108, 77.8%) of isolates belonged to CC5, CC8, CC121 or CC152. Genetic diversity was higher among MSSA (31 spa types) compared to MRSA (four spa types). Most MRSA (23/27, 85.2%) belonged to CC8-spa t1476-SCCmec V and 17/23 (73.9%) MRSA ST8 were oxacillin susceptible but cefoxitin resistant. Among MRSA and MSSA combined, 49.1% (53/108) and 19.4% (21/108) contained the genes encoding for Panton-Valentine leucocidin (lukS-lukF PV, PVL) and toxic shock syndrome toxin-1 (tst, TSST-1), respectively. PVL was mainly detected among MSSA (51/53 isolates harbouring PVL were MSSA, 96.2%) and associated with CC121, CC152, CC1 and CC5. TSST-1 was associated with CC8-spa t1476-SCCmec V. The immune evasion cluster (IEC) genes scn, sak and chp were detected in 81.5% of isolates (88/108, equally represented among MSSA and MRSA). The present study confirms the occurrence of MRSA with high levels of multidrug co-resistance and PVL-positive MSSA among invasive S. aureus isolates in Central Africa.
金黄色葡萄球菌作为一种侵袭性病原体在全球范围内广为人知，但关于中非血流感染中金黄色葡萄球菌的信息仍然匮乏。对从刚果民主共和国四个省份的医院收集的（2009 - 2013年）金黄色葡萄球菌血培养分离株进行了评估。总共27/108株分离株为耐甲氧西林金黄色葡萄球菌（MRSA），其中>70%对氨基糖苷类、四环素类、大环内酯类和林可酰胺类药物共耐药。对于MRSA和甲氧西林敏感金黄色葡萄球菌（MSSA）分离株，对氯霉素和甲氧苄啶 - 磺胺甲恶唑（TMP - SMX）的耐药率<10%。然而，所有分离株中有66.7%（72/108）携带甲氧苄啶耐药基因dfrG。超过四分之三（84/108，77.8%）的分离株属于CC5、CC8、CC121或CC152。与MRSA（四种spa型）相比，MSSA（31种spa型）的遗传多样性更高。大多数MRSA（23/27，85.2%）属于CC8 - spa t1476 - SCCmec V，并且17/23（73.9%）的MRSA ST8对苯唑西林敏感但对头孢西丁耐药。在MRSA和MSSA合并样本中，分别有49.1%（53/108）和19.4%（21/108）含有编码杀白细胞素（lukS - lukF PV，PVL）和中毒性休克综合征毒素 - 1（tst，TSST - 1）的基因。PVL主要在MSSA中检测到（携带PVL的53株分离株中有51株为MSSA，96.2%），并与CC121、CC152、CC1和CC5相关。TSST - 1与CC8 - spa t1476 - SCCmec V相关。在81.5%的分离株（88/108）中检测到免疫逃避簇（IEC）基因scn、sak和chp（在MSSA和MRSA中分布均匀）。本研究证实了在中非侵袭性金黄色葡萄球菌分离株中存在具有高水平多药共耐药性的MRSA和PVL阳性的MSSA。
