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高流行率的泛耐药、耐甲氧西林金黄色葡萄球菌菌株(PVL 阳性)在喀麦隆阿达马瓦和北部地区的临床环境中传播。

High prevalence of Panton-Valentine leukocidin positive, multidrug resistant, Methicillin-resistant Staphylococcus aureus strains circulating among clinical setups in Adamawa and Far North regions of Cameroon.

机构信息

Biosciences Department, COMSATS University Islamabad, Islamabad, Pakistan.

Department of Microbiology, Faculty of Science, University of Yaounde 1, Yaoundé, Cameroon.

出版信息

PLoS One. 2022 Jul 8;17(7):e0265118. doi: 10.1371/journal.pone.0265118. eCollection 2022.

Abstract

Staphylococcus aureus (S. aureus) is one of the earliest pathogens involved in human infections, responsible for a large variety of pathologies. Methicillin was the first antibiotic used to treat infections due to S. aureus but infections due to Methicillin resistant Staphylococcus aureus (MRSA) originated from hospital settings. Later, severe infections due to MRSA without any contact with the hospital environment or health care workers arose. Prevalence of MRSA has shown an alarming increase worldover including Cameroon. This Cross-sectional study was designed to evaluate the occurrence of MRSA infections in five different, most frequented Hospitals in northern Cameroon. Socio demographic data was recorded through questionnaire and different clinical specimens were collected for bacterial isolation. Identification of S. aureus was confirmed via 16s rRNA amplification using S. aureus specific primers. Molecular characterisation was performed through mecA gene, Luk PV gene screening and SCCmec typing. A total of 380 S. aureus clinical isolates were obtained of which 202 (53.2%) were nonduplicate multidrug resistant isolates containing, 45.5% MRSA. Higher number of MRSA was isolated from pus (30.4%) followed by blood culture (18.5%), and urine (17.4%). Patients aged 15 to 30 years presented high prevalence of MRSA (30.4%). Majority isolates (97.8%) carried the mecA gene, PVL toxin screening indicated 53.3% isolates carried the lukPV gene. Based on PVL detection and clinical history, CA-MRSA represented 53.3% of isolates. SCCmec typing showed that the Type IV was most prevalent (29.3%), followed by type I (23.9%). Amongst MRSA isolates high resistance to penicillin (91.1%), cotrimoxazole (86.7%), tetracycline (72.2%), and ofloxacin (70.0%) was detected. Meanwhile, rifampicin, fusidic acid, lincomycin and minocycline presented high efficacy in bacterial control. This study revealed a high prevalence of MRSA among infections due to S. aureus in Northern Cameroon. All MRSA recorded were multidrug resistant and the prevalence of CA MRSA are subsequently increasing, among population.

摘要

金黄色葡萄球菌(S. aureus)是最早参与人类感染的病原体之一,可导致多种疾病。甲氧西林是第一种用于治疗金黄色葡萄球菌感染的抗生素,但耐甲氧西林金黄色葡萄球菌(MRSA)感染起源于医院环境。后来,出现了与医院环境或医护人员没有任何接触的严重 MRSA 感染。包括喀麦隆在内,世界各地 MRSA 的流行率都呈惊人上升趋势。本横断面研究旨在评估 5 家不同的、最常光顾的喀麦隆北部医院的 MRSA 感染发生率。通过问卷调查记录社会人口统计学数据,并收集不同的临床标本进行细菌分离。通过使用金黄色葡萄球菌特异性引物对 16s rRNA 扩增来确认金黄色葡萄球菌的鉴定。通过 mecA 基因、LukPV 基因筛查和 SCCmec 分型进行分子特征分析。共获得 380 株金黄色葡萄球菌临床分离株,其中 202 株(53.2%)为非重复的多药耐药分离株,包括 45.5%的 MRSA。从脓液中分离出的 MRSA 数量最多(30.4%),其次是血液培养(18.5%)和尿液(17.4%)。15 至 30 岁的患者 MRSA 患病率较高(30.4%)。大多数分离株(97.8%)携带 mecA 基因,PVL 毒素筛查表明 53.3%的分离株携带 lukPV 基因。根据 PVL 检测和临床病史,CA-MRSA 占分离株的 53.3%。SCCmec 分型显示,第四型最常见(29.3%),其次是第一型(23.9%)。在 MRSA 分离株中,对青霉素(91.1%)、复方新诺明(86.7%)、四环素(72.2%)和氧氟沙星(70.0%)的耐药率较高。同时,利福平、夫西地酸、林可霉素和米诺环素对细菌控制具有较高的疗效。本研究显示,喀麦隆北部金黄色葡萄球菌感染中 MRSA 流行率较高。所有记录的 MRSA 均为多药耐药,CA-MRSA 的流行率在人群中呈上升趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48a9/9269376/3cccf6462238/pone.0265118.g001.jpg

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