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住院患者中与牲畜相关的耐甲氧西林金黄色葡萄球菌:来自意大利一家医院的快照。

Livestock-associated methicillin-resistant Staphylococcus aureus in inpatients: a snapshot from an Italian hospital.

机构信息

UOC Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Dipartimento di Biotecnologie L. Spallanzani, Università degli Studi di Pavia, Pavia, Italy.

出版信息

J Glob Antimicrob Resist. 2022 Sep;30:10-15. doi: 10.1016/j.jgar.2022.05.013. Epub 2022 May 26.

DOI:10.1016/j.jgar.2022.05.013
PMID:35644436
Abstract

OBJECTIVES

This study aimed to characterize livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) strains isolated from patients admitted to Policlinico San Matteo in Pavia, located in an Italian region with high livestock density.

METHODS

The starting dataset was composed by 353 MRSA strains isolated from blood cultures between 2011 and 2019 and in 954 MRSA isolated from nasal swabs, wound swabs, skin swabs, ulcer swabs, conjunctival swabs, urine and respiratory samples collected between 2018 and 2019. LA-MRSA was identified based on being MRSA resistant to tetracycline and negative for the PCR amplification of scn locus. Whole genome sequencing of the selected strains was performed, and virulence and resistance genes searched.

RESULTS

Five out of 353 MRSA isolates from blood cultures (1.4%) and nine out of 904 MRSA isolates obtained from other materials (1%) were resistant to tetracycline and negative for the scn locus. The 14 strains were also negative for the lukS-pv, tsst, eta and etb loci. Nine of the 14 strains belonged to ST398, the most common ST of LA-MRSA in Europe. ST398 isolates belonged to four spa-types, of which the prevalent was t899. Eight genomes had the cassette SCCmec type V, five genomes had SCCmec type IV and one genome lacked SCCmec, mecA and mecC.

CONCLUSION

The frequency of LA-MRSA in the patients of this study (1.4% in blood cultures, 1% in other samples) is low but relatively constant over time prevalence and comparable to that found in the few studies performed on patients to date.

摘要

目的

本研究旨在分析从意大利皮埃蒙特大区帕维亚市圣马泰奥综合医院(Policlinico San Matteo)住院患者中分离出的耐甲氧西林金黄色葡萄球菌(MRSA)的特征,该地区的牲畜密度较高。

方法

本研究的起始数据集由 2011 年至 2019 年血培养中分离的 353 株 MRSA 菌株和 2018 年至 2019 年从鼻拭子、伤口拭子、皮肤拭子、溃疡拭子、结膜拭子、尿液和呼吸道样本中分离的 954 株 MRSA 菌株组成。基于对四环素耐药且 scn 基因 PCR 扩增阴性的 MRSA 菌株被鉴定为 livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA)。对选定的菌株进行全基因组测序,并对毒力和耐药基因进行搜索。

结果

353 株血培养 MRSA 分离株中,有 5 株(1.4%)对四环素耐药且 scn 基因 PCR 扩增阴性;904 株其他标本中分离的 MRSA 分离株中,有 9 株(1%)对四环素耐药且 scn 基因 PCR 扩增阴性。这 14 株菌也对 lukS-pv、tsst、eta 和 etb 基因呈阴性。14 株菌中的 9 株属于 ST398,是欧洲最常见的 livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) 血清型。ST398 分离株属于 4 种 spa 型,其中最常见的是 t899。8 个基因组含有 SCCmec 类型 V 盒,5 个基因组含有 SCCmec 类型 IV,1 个基因组缺乏 SCCmec、mecA 和 mecC。

结论

本研究中患者中 livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) 的频率(血培养中为 1.4%,其他样本中为 1%)较低,但在时间流行率上相对稳定,与迄今为止对患者进行的少数研究中的发现相似。

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