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耐甲氧西林金黄色葡萄球菌和万古霉素中介金黄色葡萄球菌定植患者和重症监护病房环境:毒力特征和遗传变异性。

Methicillin-resistant and vancomycin-intermediate Staphylococcus aureus colonizing patients and intensive care unit environment: virulence profile and genetic variability.

机构信息

Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil.

Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil.

出版信息

APMIS. 2019 Nov;127(11):717-726. doi: 10.1111/apm.12989.

Abstract

This study aims to determine the prevalence of Staphylococcus aureus colonizing patients and ICU environment of a teaching hospital, the virulence and antimicrobial susceptibility profile of the isolates, and to evaluate the genetic relationship among them. A total of 536 swabs (134 of patients and 402 of ICU environment) were collected and analyzed to detect S. aureus. The antimicrobial susceptibility of the isolates was determined by disk diffusion test, and the detection of the mecA and virulence factors genes was performed by PCR, in addition to SCCmec typing. The genetic similarity of the isolates was determined by PFGE. Staphylococcus aureus was isolated in 12.7% of the swabs. The prevalence of colonization was 13.4% in patients and 12.4% in the environmental samples. The multidrug resistance was determined in 82.4% of the isolates. The prevalence of methicillin-resistant S. aureus was 20.6%, with 50.0% classified as SCCmec IV. The intermediate resistance to vancomycin was detected in 5.9% and 4.4% of the isolates obtained from patients and environment, respectively. Identical isolates obtained from different patients and sources were grouped into several clusters. The results showed dissemination of multidrug-resistant strains between patients and fomites and the persistence of MRSA and VISA isolates in the ICU environment.

摘要

本研究旨在确定教学医院中金黄色葡萄球菌定植患者和 ICU 环境的流行率、分离株的毒力和抗菌药物敏感性谱,并评估它们之间的遗传关系。共采集 536 份标本(患者 134 份,ICU 环境 402 份)进行金黄色葡萄球菌检测。采用纸片扩散法检测分离株的抗菌药物敏感性,并通过 PCR 检测 mecA 和毒力因子基因,同时进行 SCCmec 分型。采用 PFGE 确定分离株的遗传相似性。在 12.7%的拭子中分离出金黄色葡萄球菌。患者定植率为 13.4%,环境样本为 12.4%。82.4%的分离株表现出多重耐药性。耐甲氧西林金黄色葡萄球菌的检出率为 20.6%,其中 50.0%为 SCCmec IV 型。从患者和环境中获得的分离株中分别有 5.9%和 4.4%对万古霉素中介。从不同患者和来源获得的相同分离株被分为几个聚类。结果表明,耐多药菌株在患者和污染物之间传播,以及 MRSA 和 VISA 分离株在 ICU 环境中的持续存在。

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