耐甲氧西林金黄色葡萄球菌在巴西初级卫生保健系统中的分子流行病学研究。
Molecular epidemiology of methicillin-resistant Staphylococcus aureus in the Brazilian primary health care system.
机构信息
Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil.
Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil.
出版信息
Trop Med Int Health. 2019 Mar;24(3):339-347. doi: 10.1111/tmi.13192. Epub 2019 Jan 11.
OBJECTIVE
To evaluate the molecular epidemiology and to georeference Staphylococcus aureus isolated from wounds and nares of patients seen at Basic Health Units (BHUs) of a Brazilian city.
METHODS
Observational, cross-sectional study conducted from 2010 to 2013. A total of 119 S. aureus strains isolated from the wounds and nares of 88 patients were studied. The isolates were characterised by identifying virulence genes encoding enterotoxins A-E, haemolysins α, β and δ, exfoliatins A, B and D, biofilm production, Panton-Valentine Leukocidin and toxic shock syndrome toxin 1, and by pulsed-field gel electrophoresis (PFGE), multilocus sequence and spa typing.
RESULTS
Eighteen methicillin-resistant Staphylococcus aureus (MRSA) (6 SCCmec type II and 12 SCCmec type IV) and 101 (85%) MSSA were identified. PFGE typing resulted in the formation of eight clusters, with STs 1, 5, 8, 30, 188, 1176 and 1635 and spa type t002 being the predominant types among MSSA. The 18 MRSA belonged to STs 5, 8 and 1176 and spa types t002 and t062.
CONCLUSION
The results demonstrate widespread dissemination of MSSA and MRSA clones carrying haemolysin, biofilm and toxin genes. Kernel density estimation revealed the highest density of S. aureus in the 4, 5 and 8 BHUs.
目的
评估从巴西某城市基层卫生单位（BHUs）的伤口和鼻腔分离出的金黄色葡萄球菌的分子流行病学，并进行地理定位。
方法
这是一项 2010 年至 2013 年期间进行的观察性、横断面研究。共研究了从 88 名患者的伤口和鼻腔中分离出的 119 株金黄色葡萄球菌。通过鉴定编码肠毒素 A-E、α、β 和 δ 溶血素、表皮剥脱素 A、B 和 D、生物膜产生、潘顿-瓦伦丁白细胞毒素和中毒性休克综合征毒素 1 的毒力基因，以及通过脉冲场凝胶电泳（PFGE）、多位点序列和 spa 分型对分离株进行了特征描述。
结果
鉴定出 18 株耐甲氧西林金黄色葡萄球菌（MRSA）（6 型 SCCmec II 型和 12 型 SCCmec IV 型）和 101 株（85%）甲氧西林敏感金黄色葡萄球菌（MSSA）。PFGE 分型形成了 8 个簇，其中 STs 1、5、8、30、188、1176 和 1635 和 spa 型 t002 是 MSSA 中的主要类型。18 株 MRSA 属于 STs 5、8 和 1176 以及 spa 型 t002 和 t062。
结论
结果表明，携带溶血性、生物膜和毒素基因的 MSSA 和 MRSA 克隆广泛传播。核密度估计显示，金黄色葡萄球菌在 4、5 和 8 个 BHUs 的密度最高。
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