Ai Xiaolan, Gao Fei, Yao Shuwen, Liang Bingshao, Mai Jialiang, Xiong Zhile, Chen Xiantang, Liang Zhuwei, Yang Hongling, Ou Zhiying, Gong Sitang, Long Yan, Zhou Zhenwen
Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Clinical Laboratory, Guangzhou Children's Hospital, Guangzhou Medical University, Guangzhou, China.
Front Med (Lausanne). 2020 Apr 24;7:127. doi: 10.3389/fmed.2020.00127. eCollection 2020.
() is a major pathogen of human infections. Its fecal carriage serves as a risk factor for nosocomial transmission and disease development. However, the rate of fecal carriage among Chinese children has not yet been reported. Therefore, we sought to investigate the prevalence, characterization, and drug resistance of isolated from pediatric patients' feces in Southern China. Fecal samples (2059) from pediatric patients in three centers in Guangzhou were cultured. From which, 412 isolates were identified via selective mediums and automated VITEK Mass Spectrometer analysis. Antibiotic susceptibility was determined and DNA sequencing of seven housekeeping genes were used for multilocus sequence typing analysis. The fecal carriage rates were 20.0% for and 4.5% for methicillin-resistant (MRSA). Moreover, fecal carriage was positively correlated with outpatient status and gastroenteritis diagnosis. Moreover, age-related patterns were observed with respect to prevalence of . Besides, a total of 76 sequence types (STs) were identified, including 25 newly assigned STs and 28 clonal complexes (CCs). ST188, ST6, and ST15 were the most prevalent methicillin-sensitive (MSSA) clones, while ST59 and ST45 were the major MRSA clones. isolates also exhibited high rates of penicillin (84.2%), erythromycin (38.8%), and clindamycin (35.9%) resistance. Specifically, all ST30 and ST338 isolates were resistant to erythromycin and clindamycin, 61% of ST7 were resistant to tetracycline, and 84% of ST45 exhibited resistance and intermediate resistance to rifampicin. Also, CC59 (ST338 and ST59) and CC45 exhibited different antibiotic resistance patterns. These results demonstrate the colonization dynamics and molecular epidemiology of in child feces in Southern China. Further, they suggest an urgency for strengthening the surveillance programs in China and provide important information for the prevention and treatment of infection.
（）是人类感染的主要病原体。其粪便携带是医院内传播和疾病发展的危险因素。然而，中国儿童的粪便携带率尚未见报道。因此，我们试图调查从中国南方儿科患者粪便中分离出的（）的流行情况、特征及耐药性。对广州三个中心的儿科患者的粪便样本（2059份）进行培养。从中，通过选择性培养基和自动VITEK质谱分析仪分析鉴定出412株（）分离株。测定抗生素敏感性，并使用7个管家基因的DNA测序进行多位点序列分型分析。（）的粪便携带率为20.0%，耐甲氧西林（）（MRSA）的粪便携带率为4.5%。此外，（）粪便携带与门诊状态和肠胃炎诊断呈正相关。此外，观察到（）流行率与年龄相关的模式。此外，共鉴定出76种序列类型（STs），包括25种新指定的STs和28个克隆复合体（CCs）。ST188、ST6和ST15是最常见的甲氧西林敏感（）（MSSA）克隆，而ST59和ST45是主要的MRSA克隆。（）分离株对青霉素（84.2%）、红霉素（38.8%）和克林霉素（35.9%）也表现出高耐药率。具体而言，所有ST30和ST338分离株对红霉素和克林霉素耐药，61%的ST7对四环素耐药，84%的ST45对利福平表现出耐药和中介耐药。此外，CC59（ST338和ST59）和CC45表现出不同的抗生素耐药模式。这些结果表明了中国南方儿童粪便中（）的定植动态和分子流行病学。此外，它们提示了在中国加强监测项目的紧迫性，并为（）感染的预防和治疗提供了重要信息。
