Department of Pediatrics, Nîmes University Hospital, Nîmes, France.
INSERM U 1183, Team 3, Immune Regulation and Microbiota, Medical University of Montpellier Nîmes, Nîmes, France.
World J Pediatr. 2018 Feb;14(1):35-43. doi: 10.1007/s12519-018-0118-x. Epub 2018 Feb 13.
In children, surveys on Staphylococcus aureus have focused on specific infections, situations or strains but no study has so far given an overview on S. aureus isolation without any selection. Here, we describe the overall bacteriological and clinical characteristics of S. aureus isolation in children, with a special focus on isolates harbouring tst, sea, and/or luk-PV genes, respectively, encoding the three clinically relevant toxins: toxic shock syndrome toxin-1, enterotoxin A and Panton-Valentine leukocidin.
Data associated with S. aureus isolation were reviewed: isolation site, infection status, tst, sea and luk-PV genes, antimicrobial susceptibility pattern, agr typing.
Three hundred and seventy-seven isolates retrieved from 328 children during S. aureus infection (55.2%) or colonisation (44.8%) were included. tst, sea and luk-PV genes were amplified in 14.3, 9.5 and 5.8% of the isolates, respectively. These isolates were significantly more frequently retrieved during infection (69.1%) than colonisation but differences were observed according to isolation site. Methicillin-resistance was found in 7.2% of the isolates, 78% of which harboured ≥ 1 of the targeted toxin-encoding genes.
This first comprehensive study of S. aureus in children showed S. aureus to be mainly retrieved during infection and a high rate of colonisation, not limited to the nasopharynx. Predominant infections were skin and soft tissue infections where tst was most frequently detected. luk-PV was most commonly detected during bone and joint infections. Isolates harbouring targeted toxin-encoding genes were significantly associated with infections but a quarter of children were asymptomatic carriers representing a reservoir for dissemination of isolates with virulence potency.
在儿童中，关于金黄色葡萄球菌的调查侧重于特定的感染、情况或菌株，但迄今为止，尚无研究对无任何选择的金黄色葡萄球菌分离进行全面概述。在这里，我们描述了儿童金黄色葡萄球菌分离的总体细菌学和临床特征，特别关注分别携带 tst、sea 和/或 luk-PV 基因的分离株，这些基因分别编码三种临床相关毒素：中毒性休克综合征毒素-1、肠毒素 A 和 Panton-Valentine 白细胞毒素。
回顾与金黄色葡萄球菌分离相关的数据：分离部位、感染状态、tst、sea 和 luk-PV 基因、抗菌药物敏感性模式、agr 分型。
从 328 名儿童金黄色葡萄球菌感染（55.2%）或定植（44.8%）期间分离的 377 株分离株中，tst、sea 和 luk-PV 基因分别扩增了 14.3%、9.5%和 5.8%。这些分离株在感染期间（69.1%）比定植时更频繁地被分离到，但分离部位存在差异。7.2%的分离株对甲氧西林耐药，其中 78%的分离株携带至少 1 种目标毒素编码基因。
这是第一项关于儿童金黄色葡萄球菌的全面研究，表明金黄色葡萄球菌主要在感染期间分离到，定植率很高，不限于鼻咽部。主要感染是皮肤和软组织感染，其中最常检测到 tst。在骨和关节感染中，luk-PV 最常见。携带目标毒素编码基因的分离株与感染显著相关，但四分之一的儿童无症状携带，代表具有毒力潜力的分离株传播的储存库。
