Ismail Mohd Azrul Hisham, Kamarudin Norhidayah, Abdul Samat Muttaqillah Najihan, Raja Abdul Rahman Raja Mohd Fadhil, Saimun Saberi, Tan Toh Leong, Neoh Hui-Min
UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
Kulliyyah Of Medicine, International Islamic University Malaysia, Pahang 25200, Malaysia.
Antibiotics (Basel). 2021 Mar 19;10(3):320. doi: 10.3390/antibiotics10030320.
Periodical surveillance on nosocomial pathogens is important for antimicrobial stewardship and infection control. The first methicillin-resistant (MRSA) molecular surveillance in Hospital Canselor Tuanku Muhriz (HCTM), a Malaysian teaching hospital, was performed in 2009. The dominant clone was identified as an MRSA carrying SCC type III-SCC with and + toxin genes. In this study, we report the findings of the second HCTM MRSA surveillance carried out in 2017, after an interval of 8 years. Antibiotic susceptibility testing, SCC, toxin gene, and typing were performed for 222 MRSA strains isolated in 2017. Most strains were resistant to ciprofloxacin, erythromycin, clindamycin, cefoxitin, and penicillin ( = 126, 56.8%), belong to SCC type IV ( = 205, 92.3%), type t032 ( = 160, 72.1%) and harboured + toxin genes ( = 172, 77.5%). There was significant association between resistance of the aforementioned antibiotics with SCC type IV ( < 0.05), t032 ( < 0.001), and + carriage ( < 0.05). Results from this second MRSA surveillance revealed the occurrence of clonal replacement in HCTM during an interval of not more than 8 years. Investigation of the corresponding phenotype changes in this new dominant MRSA clone is currently on-going.
定期监测医院病原菌对抗菌药物管理和感染控制很重要。马来西亚教学医院敦库·穆赫里兹总理医院（HCTM）于2009年首次进行了耐甲氧西林金黄色葡萄球菌（MRSA）分子监测。优势克隆被鉴定为携带III型-SCC且带有和+毒素基因的MRSA。在本研究中，我们报告了间隔8年后于2017年在HCTM进行的第二次MRSA监测结果。对2017年分离出的222株MRSA菌株进行了药敏试验、SCC、毒素基因和分型检测。大多数菌株对环丙沙星、红霉素、克林霉素、头孢西丁和青霉素耐药（=126，56.8%），属于IV型SCC（=205，92.3%），t032型（=160，72.1%）并携带+毒素基因（=172，77.5%）。上述抗生素耐药性与IV型SCC（<0.05）、t032（<0.001）和+携带情况（<0.05）之间存在显著关联。第二次MRSA监测结果显示，在不超过8年的时间间隔内，HCTM发生了克隆替代。目前正在对这种新的优势MRSA克隆的相应表型变化进行调查。
