Junie Lia Monica, Jeican Ionuţ Isaia, Matroş Luminiţa, Pandrea Stanca Lucia
Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clujul Med. 2018;91(1):7-11. doi: 10.15386/cjmed-807. Epub 2018 Jan 15.
The article presents a synthetic molecular characterization of the methicillin-resistant Staphylococcus aureus and describes the most important community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clones that circulate nowadays in the world: the main molecular and epidemiological characteristics, as well as notions related to the clinic of infections produced by these clones and their antibiotic resistance spectrum. The predominant clone of CA-MRSA in North America is USA300 - ST8-IV in North America, in Australia - Queensland (Qld) MRSA (ST93-IV), in Europe - ST80-IV, in Asia there is a high heterogeneity of clones population, in Africa the distribution of CA-MRSA clones is unclear, and in South America - USA 1100 and USA300-Latin American variant are predominant. The molecular diagnosis is performed by highly specialized institutions. The knowledge of clones allows the study of antibiotic resistance spectrum for each one, a fact of great importance for medical practice. Molecular epidemiology of the CA-MRSA shows that lowly restricted sales of antibiotics in shops and pharmacies, as well as medical prescribing practices without a laboratory investigation, especially in Eastern Europe and Asia, contribute to the development of new MRSA clones with increased resistance to antibiotics.
本文介绍了耐甲氧西林金黄色葡萄球菌的综合分子特征，并描述了当今世界流行的最重要的社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）克隆：主要的分子和流行病学特征，以及与这些克隆引起的感染临床情况及其抗生素耐药谱相关的概念。北美CA-MRSA的主要克隆是USA300 - ST8-IV，澳大利亚昆士兰（Qld）MRSA（ST93-IV），欧洲是ST80-IV，亚洲克隆群体高度异质性，非洲CA-MRSA克隆的分布情况不明，南美洲主要是USA 1100和USA300-拉丁美洲变体。分子诊断由高度专业化机构进行。了解克隆有助于研究每个克隆的抗生素耐药谱，这对医疗实践非常重要。CA-MRSA的分子流行病学表明，商店和药店抗生素销售限制宽松，以及在没有实验室检查的情况下进行医疗处方，尤其是在东欧和亚洲，导致了对抗生素耐药性增强的新MRSA克隆的出现。
