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日本东京多家医院中 Panton-Valentine 白细胞毒素阳性耐甲氧西林金黄色葡萄球菌 USA300 克隆的传播。

Dissemination of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus USA300 clone in multiple hospitals in Tokyo, Japan.

机构信息

Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Japan.

Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Japan.

出版信息

Clin Microbiol Infect. 2018 Nov;24(11):1211.e1-1211.e7. doi: 10.1016/j.cmi.2018.02.012. Epub 2018 Feb 16.

DOI:10.1016/j.cmi.2018.02.012
PMID:29454850
Abstract

OBJECTIVES

Panton-Valentine leukocidin (PVL) gene (lukS/F-PV)-positive community-acquired methicillin-resistant Staphylococcus aureus (MRSA), particularly the USA300 clone, is a health concern worldwide. Recently, community-acquired MRSA clones have been found to spread and persist in hospital settings. We aimed to investigate the prevalence and molecular epidemiologic features of lukS/F-PV-positive MRSA in Japanese hospitals.

METHODS

A total of 3433 MRSA isolated from nine hospitals in 2011-2015 were assessed. Molecular epidemiologic analysis performed by staphylococcal cassette chromosome mec typing, PVL typing, arginine catabolic mobile element typing, detection of virulence determinants, multilocus sequence typing, pulsed-field gel electrophoresis and antimicrobial susceptibility testing.

RESULTS

The detection rate of lukS/F-PV was increased annually from 0.6% (5/817) in 2011 to 3.1% (17/544) in 2015. Molecular epidemiologic analysis for 64 lukS/F-PV-positive MRSA isolates revealed that 42 isolates (65.6%) were the USA300 clone. Resistance rates of levofloxacin and gentamicin among lukS/F-PV-positive isolates increased annually as a result of increased prevalence of the multidrug-resistant USA300 clone.

CONCLUSIONS

This is the first report on dissemination of the USA300 clone and PVL-positive MRSA in multiple Japanese hospitals. Our data strongly suggest that the USA300 clone may become epidemic in Japanese hospitals.

摘要

目的

潘顿-瓦伦丁白细胞毒素(PVL)基因(lukS/F-PV)阳性社区获得性耐甲氧西林金黄色葡萄球菌(MRSA),尤其是 USA300 克隆,是全球关注的健康问题。最近,已发现社区获得性 MRSA 克隆在医院环境中传播和持续存在。我们旨在研究日本医院中 lukS/F-PV 阳性 MRSA 的流行情况和分子流行病学特征。

方法

评估了 2011 年至 2015 年来自 9 家医院的 3433 株 MRSA。通过葡萄球菌盒式染色体 mec 分型、PVL 分型、精氨酸分解移动元件分型、毒力决定因素检测、多位点序列分型、脉冲场凝胶电泳和抗菌药物敏感性试验进行分子流行病学分析。

结果

lukS/F-PV 的检出率从 2011 年的 0.6%(5/817)逐年增加到 2015 年的 3.1%(17/544)。对 64 株 lukS/F-PV 阳性 MRSA 分离株进行分子流行病学分析显示,42 株(65.6%)为 USA300 克隆。由于多药耐药 USA300 克隆的流行率增加,lukS/F-PV 阳性分离株对左氧氟沙星和庆大霉素的耐药率逐年增加。

结论

这是首次在多家日本医院报告 USA300 克隆和 PVL 阳性 MRSA 的传播。我们的数据强烈表明,USA300 克隆可能在日本医院流行。

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