7.5 年间以色列某地区医院耐甲氧西林金黄色葡萄球菌临床分离株的分子流行病学研究。
Molecular Epidemiology of Methicillin-Resistant Clinical Isolates during 7.5 Years in One Regional Hospital in Israel.
机构信息
Head of Infectious Diseases Unit and Infection Control Unit, Sanz Medical Center, Laniado Hospital, 16 Divrei Haim St. Kiryat Sanz, 42150 Netanya, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
出版信息
J Environ Public Health. 2021 Mar 5;2021:6643108. doi: 10.1155/2021/6643108. eCollection 2021.
BACKGROUND
The clonal repertoire of community-associated Methicillin-resistant (CA-MRSA) strains appear to differ between hospitals and geographic locations. We aimed to study the molecular epidemiology of MRSA infections in our regional hospital in Israel.
METHODS
A retrospective analysis of MRSA isolates from hospitalized patients, which underwent typing between 2012 and 2019. Mainly, MRSA-bloodstream isolates were typed. Isolates were grouped into healthcare-associated (HcA) or community-associated (CA). HcA were further divided into hospital-related or long-term care facility- (LTCF-) related. Several representatives underwent SCC typing.
RESULTS
We analyzed 166 clinical MRSA isolates: 115 (70%) bloodstream, 42 (25%) wounds/abscesses, and 9 (5%) screening isolates. 145 (87%) were HcA, and 21 (13%) were CA. Common (72%) types were t002, t032, t008, t001, and t065. Eighty (55%) isolates were attributed to LTCFs and 65 isolates to our hospital, both showing similar types distribution. The most prevalent type among patients with HcA infection was t002 (50 isolates, 32%), followed by t032, t065, t578, t008, and t001. Most (88/115, 77%) bloodstream infections (BSIs) were HcA, typically occurring in the same facility in which the infection was acquired. In 27 cases (23%), the BSI developed in the community setting, and in half of these cases, a previous healthcare system exposure was evident.
CONCLUSIONS
The MRSA clonal population in this longitudinal study was stable and consisted mainly of molecular lineages widespread in Europe. SCC-IV strains play a major role in causing MRSA infections in the healthcare settings, especially in LTCFs. Community-acquired MRSA BSIs without any previous healthcare exposure are still relatively rare.
背景
社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）菌株的克隆谱系似乎在医院和地理位置之间存在差异。我们旨在研究我们在以色列地区医院的 MRSA 感染的分子流行病学。
方法
对 2012 年至 2019 年间进行的 MRSA 分离株进行回顾性分析。主要对 MRSA-血流感染分离株进行分型。将分离株分为医源性相关（HcA）或社区获得性（CA）。HcA 进一步分为医院相关或长期护理机构（LTCF）相关。对几个代表进行 SCC 分型。
结果
我们分析了 166 例临床 MRSA 分离株：115 例（70%）血流，42 例（25%）伤口/脓肿，9 例（5%）筛查分离株。145 例（87%）为 HcA，21 例（13%）为 CA。常见（72%）类型为 t002、t032、t008、t001 和 t065。80 例（55%）分离株归因于 LTCFs，65 例分离株归因于我们的医院，两者显示出相似的类型分布。HcA 感染患者中最常见的类型是 t002（50 株，32%），其次是 t032、t065、t578、t008 和 t001。大多数（115 例中的 88%，77%）血流感染（BSI）为 HcA，通常发生在感染获得的同一设施中。在 27 例（23%）中，BSI 发生在社区环境中，其中一半有先前的医疗系统暴露史。
结论
在这项纵向研究中，MRSA 克隆种群是稳定的，主要由广泛分布在欧洲的分子谱系组成。SCC-IV 菌株在引起医疗保健环境中的 MRSA 感染中起主要作用，特别是在长期护理机构中。没有任何先前医疗暴露的社区获得性 MRSA BSI 仍然相对较少。
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