在遗传性大疱性表皮松解症中金黄色葡萄球菌的流行情况和抗菌药物耐药谱：巴西的一项横断面多中心研究。

Prevalence and antimicrobial resistance profile of Staphylococcus aureus in inherited epidermolysis bullosa: a cross-sectional multicenter study in Brazil.

机构信息

Postgraduate Program in Child and Adolescent Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.

Postgraduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

Int J Dermatol. 2021 Sep;60(9):1126-1130. doi: 10.1111/ijd.15634. Epub 2021 May 28.

DOI:10.1111/ijd.15634

PMID:34047367

Abstract

BACKGROUND

Infection is an important complication of epidermolysis bullosa (EB), and Staphylococcus aureus has been pointed out as the most common pathogen among this population. The objective of this study was to investigate the prevalence and antimicrobial resistance profile of S. aureus colonizing EB patients in Brazil.

METHODS

This cross-sectional multicenter study was conducted between December 2015 and December 2017. We included a total of 89 individuals with EB from medical centers across Brazil. Data were obtained through clinical and bacteriological investigation. S. aureus were identified by biochemical tests. The nuc and mecA genes were confirmed by PCR assay. Antimicrobial susceptibility was investigated by disk diffusion method.

RESULTS

The overall prevalence of S. aureus was 51.7% (46/89). Methicillin-resistant S. aureus (MRSA) was detected in 24.7% (19/77) of all S. aureus isolates, colonizing 15.7% (14/89) of all patients. Community-associated (CA)-MRSA strains were resistant against sulfamethoxazole/trimethoprim and levofloxacin (P < 0.05%). S. aureus colonization of the nares and belly button represented a 3.4 times higher risk of simultaneous skin lesion colonization (P < 0.05%).

CONCLUSIONS

The high frequency of MRSA colonizing patients with EB is alarming considering its association with life-threatening complications and poorer outcomes. EB patients are at increased risk of colonization and infection by Staphylococcus aureus and CA-MRSA. Getting to know S. aureus carriage sites and its antimicrobial susceptibility profile is key when planning new individualized and more effective prophylactic and therapeutic measures.

摘要

背景

感染是大疱性表皮松解症（EB）的一种重要并发症，金黄色葡萄球菌已被指出是该人群中最常见的病原体。本研究的目的是调查巴西 EB 患者金黄色葡萄球菌定植的流行率和抗菌药物耐药谱。

方法

这是一项横断面多中心研究，于 2015 年 12 月至 2017 年 12 月进行。我们共纳入了来自巴西各地医疗中心的 89 名 EB 患者。通过临床和细菌学调查获取数据。金黄色葡萄球菌通过生化试验进行鉴定。通过 PCR 试验确认 nuc 和 mecA 基因。通过纸片扩散法检测抗菌药物敏感性。

结果

金黄色葡萄球菌的总流行率为 51.7%（46/89）。在所有金黄色葡萄球菌分离株中，检出耐甲氧西林金黄色葡萄球菌（MRSA）占 24.7%（19/77），定植于所有患者的 15.7%（14/89）。社区相关（CA）-MRSA 菌株对磺胺甲噁唑/甲氧苄啶和左氧氟沙星耐药（P<0.05）。鼻腔和肚脐金黄色葡萄球菌定植与皮肤同时感染的风险增加 3.4 倍（P<0.05）。