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医院获得性耐甲氧西林金黄色葡萄球菌的系统发育及其与万古霉素耐药金黄色葡萄球菌(VRSA)的表型临床流行病学比较。

Phylogeny of hospital acquired MRSA, and its comparative phenotypic clinico-epidemiology with vancomycin resistant S. aureus (VRSA).

机构信息

Institute of Microbiology, University of Agriculture, Agriculture, Faisalabad, 38000, Pakistan.

Department of Medicine, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, 63100, Pakistan.

出版信息

Microb Pathog. 2020 Dec;149:104537. doi: 10.1016/j.micpath.2020.104537. Epub 2020 Sep 24.

Abstract

Staphylococcus aureus is emerging as complicated pathogen because of its wide-ranging origin, multiple variants, and compromised antibiotic susceptibilities. Current study was planned to find lineage of hospital acquired methicillin resistant Staphylococcus aureus (HA-MRSA), and its comparative phenotypic clinico-epidemiology with vancomycin resistant S. aureus (VRSA). A total of (n = 200) samples were aseptically collected from wound, nose, and cerebrospinal fluid of patients from metropolitan and rural background hospitals along with on spot filling in of questionnaire. Phylogenetic analysis of HA-MRSA was identified by targeting mecA gene in S. aureus. At optimal tree branch length of 1.91 and evolutionary distance 0.1, high level sequence similarity (97%-99%) was observed with different strains of S. aureus isolated from both human and animal. Non-descriptive statistics at 5% probability found 61% S. aureus, while 43.44% of them were HA-MRSA, 92.62% VRSA, and 42.62% were both MRSA and VRSA. Among assumed risk factors, use of antibiotics, venous catheterization, chronic disease, pre-hospital visits, and ICU admitted patients showed significant association (p<0.05) with pathogen. HA-MRSA was 37.50%, 80%, and 37.50% sensitive to chloramphenicol, gentamicin, and oxacillin, respectively. While <50% of VRSA were sensitive against oxacillin, enoxacin, and chloramphenicol. A significant difference (p<0.05) of percentage responses of MRSA and VRSA at resistant, intermediate, and sensitive cadre against all antibiotics except chloramphenicol was obvious in this study. The Current study concluded higher prevalence of MRSA & VRSA, significant association of risk factors, limiting antibiotic susceptibility profile, and genetic transfer at animal-human interface which suggests further studies cum preventive strategies to be planned.

摘要

金黄色葡萄球菌因其广泛的起源、多种变体和对抗生素的敏感性降低而成为一种复杂的病原体。本研究旨在寻找医院获得性耐甲氧西林金黄色葡萄球菌(HA-MRSA)的谱系,并将其与万古霉素耐药金黄色葡萄球菌(VRSA)的表型临床流行病学进行比较。共从大都市和农村背景医院的患者的伤口、鼻子和脑脊液中无菌采集了 200 份样本,并现场填写了问卷。通过在金黄色葡萄球菌中靶向 mecA 基因来鉴定 HA-MRSA 的系统发育分析。在最优树分支长度为 1.91 和进化距离为 0.1 的情况下,观察到与从人和动物分离的不同金黄色葡萄球菌菌株具有高度的序列相似性(97%-99%)。在 5%概率的非描述性统计中,发现 61%的金黄色葡萄球菌,其中 43.44%为 HA-MRSA,92.62%为 VRSA,42.62%为 MRSA 和 VRSA 均为阳性。在假设的危险因素中,抗生素使用、静脉置管、慢性疾病、院前就诊和 ICU 入院患者与病原体呈显著相关性(p<0.05)。HA-MRSA 对氯霉素、庆大霉素和苯唑西林的敏感性分别为 37.50%、80%和 37.50%。而 VRSA 对苯唑西林、恩诺沙星和氯霉素的敏感性均<50%。在这项研究中,MRSA 和 VRSA 对所有抗生素(除氯霉素外)的耐药、中介和敏感级别中的百分比反应明显不同(p<0.05)。本研究得出结论,MRSA 和 VRSA 的流行率较高,危险因素显著相关,抗生素敏感性有限,以及在动物-人类界面的遗传转移,这表明需要进一步研究和制定预防策略。

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