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监测和分子特征分析慢性伤口分离的金黄色葡萄球菌。

Monitoring and Molecular Characterization of Staphylococcus aureus Isolated from Chronic Wounds.

机构信息

At the Universidade Federal Fluminense in Niterói, Rio de Janeiro, Brazil, Bruna Maiara Ferreira Barreto Pires, MA, and Fernanda Pessanha de Oliveira, MA, are Doctoral Students; and Beatriz Guitton Renaud Baptista de Oliveira, PhD; Patrícia dos Santos Claro Fuly, PhD; Bernadete Teixeira Ferreira-Carvalho, PhD; Geraldo Renato de Paula, PhD; and Lenise Arneiro Teixeira, PhD, are Professors. Acknowledgments: This work was supported by grants from MCT/CNPq/MEC/Capes (no. 06/2011 Casadinho/Procad), CNPq Universal (no. 466064/2011-2), and FAPERJ (no. E-26/010.002812/2014). The authors have disclosed no other financial relationships related to this article. Submitted August 21, 2017; accepted in revised form December 19, 2017.

出版信息

Adv Skin Wound Care. 2018 Sep;31(9):399-405. doi: 10.1097/01.ASW.0000540069.99416.a6.

Abstract

OBJECTIVE

Researchers analyzed chronic wounds treated with 2% hydrogel to determine whether the presence of methicillin-resistant Staphylococcus aureus (MRSA) is related to the presence of clinical signs of infection.

METHODS

Thirty-five patients were recruited for this descriptive study using a quantitative approach. Staphylococcus aureus was identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Antibiotic susceptibility was determined using a disk diffusion test according to Clinical and Laboratory Standards Institute standards. Polymerase chain reaction, pulsed-field gel electrophoresis, and multilocus sequence typing were performed. Statistical analyses were performed using Spearman correlation coefficients for the variables MRSA and clinical signs of infection.

MAIN OUTCOME MEASURES

The identification of MRSA or methicillin-sensitive S aureus (MSSA), presence or absence of an infection in the wound, and molecular characterization of bacteria were measured.

MAIN RESULTS

Of the 35 patients analyzed, 8 (22.9%) were classified as having an infection in their wounds. Spearman ρ indicated a strong positive correlation between the increase in the number of clinical signs of infection and MSSA (P =.84), but only a moderate positive correlation with MRSA (P =.60). The S aureus clonal pattern was unique for each of the major bacteria isolated. Global MRSA sequence-type clones (ST-1 and ST-72) were detected in 2 patients.

CONCLUSIONS

Compared with those colonized by MSSA, chronic wounds colonized by MRSA did not display a strong correlation with the presence of a greater number of clinical signs of infection.

摘要

目的

研究人员分析了使用 2%水凝胶治疗的慢性伤口,以确定耐甲氧西林金黄色葡萄球菌(MRSA)的存在是否与感染的临床体征有关。

方法

本研究采用定量方法招募了 35 名患者。通过基质辅助激光解吸电离飞行时间质谱法鉴定金黄色葡萄球菌。根据临床和实验室标准协会的标准,使用圆盘扩散试验确定抗生素敏感性。进行聚合酶链反应,脉冲场凝胶电泳和多位点序列分型。使用 Spearman 相关系数对 MRSA 和感染的临床体征变量进行统计分析。

主要观察指标

MRSA 或甲氧西林敏感金黄色葡萄球菌(MSSA)的鉴定,伤口中是否存在感染以及细菌的分子特征。

主要结果

在所分析的 35 例患者中,有 8 例(22.9%)被归类为伤口感染。Spearman ρ表明,感染的临床体征数量增加与 MSSA 之间呈强烈正相关(P =.84),但与 MRSA 仅呈中度正相关(P =.60)。每个主要分离细菌的金黄色葡萄球菌克隆模式都是独特的。在 2 名患者中检测到全球 MRSA 序列型克隆(ST-1 和 ST-72)。

结论

与被 MSSA 定植的慢性伤口相比,被 MRSA 定植的慢性伤口与存在更多临床感染体征之间没有很强的相关性。

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