Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Jagiellonian University, 31-121 Krakow, Poland.
Doctoral School of Medical Sciences and Health Sciences, Jagiellonian University Medical College, Jagiellonian University, 31-530 Krakow, Poland.
Int J Environ Res Public Health. 2021 Apr 27;18(9):4662. doi: 10.3390/ijerph18094662.
Infected chronic venous ulcers (VUs) represent a major health problem. We analysed the aerobic microbiome in the VUs, the virulence, and drug-resistance of (SA) strains. Swabs from 143 outpatients and inpatients Polish subjects were collected. SA strains were tested for drug sensitivity using a phenotyping method and for methicillin-resistant SA (MRSA) and macrolide-lincosamide-streptogramin B (MLSB) resistance using PCR. We analysed virulence genes, the genetic similarity of strains, and performed Staphylococcal cassette chromosome typing and Staphylococcal protein A typing. SA was isolated as a single one in 34.9% of cases, 31.5% paired with another pathogen, and 33.6% combined with at least two other strains. The majority of SA isolates (68.5%) possessed the virulence lukE gene. Drug resistance was significantly common in hospitalised than in ambulatory patients (OR 3.8; 95%CI 1.8-7.91). MLSB (altogether in 19.6% isolates) were observed mostly in non-hospitalised patients (OR 9.1; 95%CI 1.17-71.02), while MRSA was detected in 11.9% of strains equally. Hospitalisation and patient's age group (aged > 78.0 or < 54.5 years) were significant predictors of the multi-drug resistant SA (MDR-SA). Over 30% of the infected VUs were associated with multi-species biofilms and presence of potentially highly pathogenic microorganisms. Elderly hospitalised patients with chronic venous ulcers are prone to be infected with a MDR-SA.
感染性慢性静脉溃疡（VUs）是一个主要的健康问题。我们分析了 VUs 中的需氧微生物组、金黄色葡萄球菌（SA）菌株的毒力和耐药性。从 143 名波兰门诊和住院患者中采集了拭子。使用表型法测试 SA 菌株对药物的敏感性，使用 PCR 测试耐甲氧西林金黄色葡萄球菌（MRSA）和大环内酯-林可酰胺-链阳菌素 B（MLSB）耐药性。我们分析了毒力基因、菌株的遗传相似性，并进行了葡萄球菌盒染色体分型和葡萄球菌蛋白 A 分型。SA 作为单一菌株分离的比例为 34.9%，与另一种病原体配对的比例为 31.5%，与至少两种其他菌株结合的比例为 33.6%。大多数 SA 分离株（68.5%）具有毒力 lukE 基因。与门诊患者相比，住院患者的耐药性明显更为常见（OR 3.8；95%CI 1.8-7.91）。在非住院患者中观察到 MLSB（在总共 19.6%的分离株中）最为常见（OR 9.1；95%CI 1.17-71.02），而 MRSA 在 11.9%的菌株中同样被检出。住院和患者年龄组（年龄>78.0 或<54.5 岁）是多药耐药性 SA（MDR-SA）的显著预测因子。超过 30%的感染性 VUs 与多物种生物膜和潜在高致病性微生物的存在有关。患有慢性静脉溃疡的老年住院患者易感染 MDR-SA。
