南非公立医院常见接触部位耐甲氧西林金黄色葡萄球菌（MRSA）的基因型和表型特征
Genotypic and Phenotypic Characterizations of Methicillin-Resistant (MRSA) on Frequently Touched Sites from Public Hospitals in South Africa.
作者信息
Mkhize Siyethaba, Amoako Daniel G, Shobo Christiana O, Zishiri Oliver T, Bester Linda A
机构信息
Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
Discipline of Genetics, School of Life Sciences, College of Agriculture Engineering and Science, University of KwaZulu-Natal, Durban 4000, South Africa.
出版信息
Int J Microbiol. 2021 Oct 23;2021:6011045. doi: 10.1155/2021/6011045. eCollection 2021.
The hospital environment acts as a reservoir in the transmission of pathogens, such as MRSA, which may cause hospital-acquired infections. This study aimed to ascertain the prevalence, genetic relatedness, antibiotic resistance, and virulence profile of MRSA on some frequently touched hospital sites in South Africa. A total of 777 swabs were randomly collected from 11 frequently touched sites in the hospital environment of three wards of four public hospitals in the KwaZulu-Natal province of South Africa. Isolation of and confirmation were done using genotypic and phenotypic methods. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk-diffusion method. MRSA isolates were determined by the presence of the gene. Virulence and resistance genes were detected using a standard monoplex PCR assay. ERIC-PCR was conducted to evaluate the genetic relatedness. An overall prevalence of 12.7% for isolates was obtained. Out of these, 89.9% (89/99) were confirmed to be MRSA. The sites with the highest prevalence were the occupied beds (16.2% (16/99)), unoccupied beds (16.2% (16/99)), patient files (14.1% (14/99)), ward phones (13.1% (13/99)), and nurses' tables (14.1% (14/99)). The virulence genes with the highest observed frequency were (87 (87.9%)) and (53 (53.5%)). The resistance genes with the highest frequency were the and genes detected in 60 (60.6%) and 57 (57.6%) isolates, respectively. The ERIC-PCR results obtained indicated a high level of genetic diversity; however, intraclonal (within a hospital) and interclonal (between hospitals) clusters of MRSA were observed. The study showed that MRSA can contaminate various surfaces, and this persistence allows for the dissemination of bacteria within the hospital environment. This highlights the need for improved infection prevention and control (IPC) strategies in public hospitals in the country to curb their potential transmission risks.
医院环境是耐甲氧西林金黄色葡萄球菌（MRSA）等病原体传播的储存库，这些病原体可能导致医院获得性感染。本研究旨在确定南非一些医院常见接触部位MRSA的流行率、基因相关性、抗生素耐药性和毒力特征。从南非夸祖鲁 - 纳塔尔省四家公立医院三个病房的医院环境中11个常见接触部位随机采集了777份拭子。采用基因分型和表型方法进行分离和确认。使用 Kirby - Bauer 纸片扩散法进行抗生素敏感性试验。通过检测 mecA 基因来确定MRSA分离株。使用标准单重PCR检测毒力和耐药基因。进行ERIC - PCR以评估基因相关性。分离株的总体流行率为12.7%。其中，89.9%（89/99）被确认为MRSA。流行率最高 的部位是占用病床（16.2%（16/99））、未占用病床（16.2%（16/99））、患者病历（14.1%（14/99））、病房电话（13.1%（13/99））和护士桌（14.1%（14/99））。观察到频率最高的毒力基因是 sea（87个（87.9%））和 sec（53个（53.5%））。频率最高的耐药基因分别是在60个（60.6%）和57个（57.6%）分离株中检测到的 blaZ 和 ermC 基因。获得的ERIC - PCR结果表明存在高度的基因多样性；然而，观察到了MRSA的克隆内（医院内）和克隆间（医院间）聚类。该研究表明，MRSA可污染各种表面，这种持续性使得细菌在医院环境中得以传播。这凸显了该国公立医院需要改进感染预防和控制（IPC）策略，以遏制其潜在的传播风险。
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