Peterson Jeffrey C, Durkee Heather, Miller Darlene, Maestre-Mesa Jorge, Arboleda Alejandro, Aguilar Mariela C, Relhan Nidhi, Flynn Harry W, Amescua Guillermo, Parel Jean-Marie, Alfonso Eduardo
Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA.
Infect Drug Resist. 2019 Apr 11;12:831-843. doi: 10.2147/IDR.S190245. eCollection 2019.
To characterize the molecular, epidemiological, and resistance profiles of methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) keratitis isolates.
We used a combination of standard microbiological techniques and DNA microarray analysis to characterize the molecular and antibiotic resistance profiles of 75 keratitis isolates collected over an 11-year period (2006-2016).
Two major USA clonal complexes (CC), CC5 (n=30, 40%) and CC8 (n=28, 37.3%), accounted for 77.3% of the collected isolates. USA100, traditionally healthcare associated (n=18/47, 38.3%), and USA300, traditionally community associated (n=12/47, 25.5%), were the dominant MRSA strains. Four (22.2%) of the USA100 MRSA isolates were recovered from patients with no prior healthcare exposure. Eleven (91.7%) of the USA300 isolates were recovered from patients with documented healthcare risk factors. MSSA isolates were polyclonal (n=13). Ninety-three percent of MSSA infections were of healthcare origin. Thirty-seven of 61 (60.6%) healthcare- and 11 of 14 (78.6%) community-associated strains were resistant to three or more antibiotic classes. Sixty-eight percent (n=51) of isolates harbored three of more resistance determinants (genes). The Panton-Valentine Leucocidin gene was detected in 11 (14.7%) of the study isolates. The majority (72.7%) of the strains were members of the USA300 MRSA clone.
Clonal complexes CC5 and CC8 were the most frequent clones detected among both the MSSA and the MRSA keratitis isolates. USA100 and USA300 clones were the dominant MRSA genotypes. The USA300 MRSA clone has become a leading cause of healthcare-associated keratitis in South Florida. The USA100 MRSA clone has emerged as an increasing cause of community-associated corneal infections in our outpatient population. This shifting epidemiology coupled with the increasing prevalence of multidrug resistance among both MSSA and MRSA keratitis is a cause of concern.
对耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）角膜感染分离株的分子特征、流行病学特征及耐药谱进行分析。
我们采用标准微生物学技术与DNA微阵列分析相结合的方法，对11年期间（2006 - 2016年）收集的75株角膜感染分离株的分子特征和抗生素耐药谱进行分析。
两个主要的美国克隆复合体（CC），CC5（n = 30，40%）和CC8（n = 28，37.3%），占所收集分离株的77.3%。传统上与医疗保健相关的USA100（n = 18/47，38.3%）和传统上与社区相关的USA300（n = 12/47，25.5%）是主要的MRSA菌株。4株（22.2%）USA100 MRSA分离株来自无既往医疗保健接触史的患者。11株（91.7%）USA300分离株来自有记录的医疗保健风险因素的患者。MSSA分离株为多克隆性（n = 13）。93%的MSSA感染起源于医疗保健。61株（60.6%）与医疗保健相关的菌株和14株（78.6%）与社区相关的菌株中有37株对三种或更多类抗生素耐药。68%（n = 51）的分离株含有三种或更多耐药决定簇（基因）。在所研究的分离株中，11株（14.7%）检测到杀白细胞素基因。大多数（72.7%）菌株是USA300 MRSA克隆的成员。
CC5和CC8克隆复合体是在MSSA和MRSA角膜感染分离株中最常检测到的克隆。USA100和USA300克隆是主要的MRSA基因型。USA300 MRSA克隆已成为南佛罗里达州医疗保健相关角膜炎的主要原因。USA100 MRSA克隆已成为我们门诊患者中社区相关角膜感染日益增加的原因。这种流行病学的变化以及MSSA和MRSA角膜炎中多重耐药性患病率的增加令人担忧。
