Dermota Urška, Košnik Irena Grmek, Janežič Sandra, Rupnik Maja
National Laboratory for Health, Environment and Food, Centre of Medical Microbiology, Prvomajska ulica 1, 2000 Maribor, Slovenia.
National Institute of Public Health, Gosposvetska ulica 12, 4000 Kranj, Slovenia.
Zdr Varst. 2020 Oct 18;59(4):236-244. doi: 10.2478/sjph-2020-0030. eCollection 2020 Dec.
Although the distinction between the Community-Associated-Methicillin-Resistant (CA-MRSA) and Hospital-Associated-Methicillin-Resistant (HA-MRSA) has blurred in recent years, the CA-MRSA is an important group because of its potential to cause fulminant and severe infections. Its importance has further increased with the emergence of Livestock-Associated-Methicillin-Resistant (LA-MRSA).
In the present study we analysed clonal distributions and virulence factors in presumptive CA-MRSA isolated from January 2014 to December 2015 and compared the results with our previous study from 2010. Phenotypic definition for presumptive CA-MRSA was based on resistance to cefoxitin and oxacillin and susceptibility to at least two of the following four antibiotics: ciprofloxacin, erythromycin, clindamycin and gentamicin.
In 2014 and 2015 altogether 304 MRSA isolates fulfilled our screening phenotypic definition, 45 isolates were cultivated from clinical specimens and 259 from screening specimens. Sequence types ST398, LA-MRSA and C MRSA increased significantly in 2015 compared to 2010 (p-value <0.05) and were spread over Slovenia.
The clonal distribution of presumptive CA-MRSA has changed within the study period in Slovenia. In 2015 the most frequent clone among clinical and screening specimens was a pig-associated clone, ST398, but the number of confirmed ST398 infections remains low. While previously ST398 and C positive MRSA strains were geographically limited, they have spread throughout the country since 2010.
尽管近年来社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）和医院获得性耐甲氧西林金黄色葡萄球菌（HA-MRSA）之间的区别已变得模糊，但CA-MRSA因其有可能引发暴发性严重感染，仍是一个重要的类别。随着家畜相关耐甲氧西林金黄色葡萄球菌（LA-MRSA）的出现，其重要性进一步增加。
在本研究中，我们分析了2014年1月至2015年12月分离出的疑似CA-MRSA的克隆分布和毒力因子，并将结果与我们2010年的先前研究进行了比较。疑似CA-MRSA的表型定义基于对头孢西丁和苯唑西林的耐药性以及对以下四种抗生素中至少两种的敏感性：环丙沙星、红霉素、克林霉素和庆大霉素。
2014年和2015年共有304株MRSA分离株符合我们的筛选表型定义，45株从临床标本中培养得到，259株从筛选标本中培养得到。与2010年相比，2015年序列类型ST398、LA-MRSA和C型MRSA显著增加（p值<0.05），且在斯洛文尼亚广泛传播。
在研究期间，斯洛文尼亚疑似CA-MRSA的克隆分布发生了变化。2015年，临床和筛选标本中最常见的克隆是与猪相关的克隆ST398，但确诊的ST398感染数量仍然较低。虽然以前ST398和C阳性MRSA菌株在地理上受到限制，但自2010年以来它们已在全国范围内传播。
