Uehara Yuki, Mori Miki, Tauchi Mutsuhiro, Nishimura Shu, Sakurai Hiroki, Murai Takemi, Okazaki Kaoru, Kinoshita Kazue, Horikoshi Yuho, Hiramatsu Keiichi
Department of Infection Control Science, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; Department of General Medicine, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Department of Infection Control Science, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
J Infect Chemother. 2019 May;25(5):400-403. doi: 10.1016/j.jiac.2018.12.002. Epub 2018 Dec 28.
Outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) in the neonatal intensive care unit (NICU) have been reported worldwide. Some outbreaks were caused by USA300, which is a community-associated MRSA clone. In 2011, polymerase chain reaction-based open reading frame typing (POT) for the initial MRSA isolates from all inpatients was started at the Tokyo Metropolitan Children's Medical Center. From March 2014 to April 2015, a total of 131 MRSA strains were isolated, 104 of which were analyzed as healthcare-associated MRSA. Thirteen stains (12.5%) had a POT number of 106-9-93, which strongly suggested USA300; these included 6 from nasal swabs, 6 from blood cultures and 1 from subcutaneous pus. All the MRSA strains were isolated from patients in the NICU; were typed as sequence type 8, spa type t008, and staphylococcal cassette chromosome type mec IVa; and possessed the lukS-lukF and arginine catabolic mobile element-arcA gene. Pulsed-field gel electrophoresis of all the strains, with USA300-0114 as a reference, showed indistinguishable banding pattern. Based on these results, POT was useful in recognizing this first MRSA outbreak of USA300 in a Japanese NICU and was advantageous in terms of swiftness, less cost and monitoring change of the epidemic MRSA lineage.
耐甲氧西林金黄色葡萄球菌（MRSA）在新生儿重症监护病房（NICU）的暴发在全球范围内均有报道。部分暴发是由USA300引起的，它是一种社区相关性MRSA克隆株。2011年，东京都儿童医疗中心开始对所有住院患者的初始MRSA分离株进行基于聚合酶链反应的开放阅读框分型（POT）。2014年3月至2015年4月，共分离出131株MRSA菌株，其中104株被分析为医疗保健相关MRSA。13株（12.5%）的POT编号为106 - 9 - 93，强烈提示为USA300；其中6株来自鼻拭子，6株来自血培养，1株来自皮下脓液。所有MRSA菌株均从NICU的患者中分离得到；被分型为序列型8、spa型t008和葡萄球菌盒式染色体mec型IVa；并拥有lukS - lukF和精氨酸分解代谢移动元件 - arcA基因。以USA300 - 0114为参照对所有菌株进行脉冲场凝胶电泳，结果显示条带模式无法区分。基于这些结果，POT有助于识别日本NICU首次出现的USA300 MRSA暴发，且在快速性、低成本以及监测流行MRSA谱系变化方面具有优势。
