Viana Alice Slotfeldt, Tótola Laís Pires do Valle, Figueiredo Agnes Marie Sá
Departamento de Microbiologia Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil.
Faculdade de Medicina, Programa de Pós-Graduação em Patologia, Universidade Federal Fluminense, Niterói 24033-900, Brazil.
Antibiotics (Basel). 2024 Sep 18;13(9):893. doi: 10.3390/antibiotics13090893.
Sequence-type 5 (ST5) of methicillin-resistant (MRSA), harboring the staphylococcal chromosomal cassette type IV (SCCIV), was first detected in Portugal. It emerged as a significant cause of healthcare-associated (HA) infection in pediatric units and was hence named the pediatric clone. Another ST5 lineage, which carries SCCII, also prevailed in the USA and Japan for multiple years. More recently, another MRSA lineage, ST105-SCCII, part of the evolution of clonal complex 5 (CC5) MRSA, has emerged as the cause of hospital-acquired bloodstream infection outbreaks in countries including Portugal, the USA, and Brazil. This article reviews studies on the epidemiology and evolution of these newly emerging pathogens. To this end, a search of PUBMED from inception to 2024 was performed to find articles reporting the occurrence of ST105 MRSA in epidemiologic studies. A second search was performed to find studies on MRSA, CC5, ST5, and SCCII. A search of PUBMED from 1999 to 2024 was also performed to identify studies on the genomics and evolution of ST5, CC5, and ST105 MRSA. Further studies were identified by analyzing the references of the previously selected articles from PUBMED. Most articles on ST105 MRSA were included in this review. Only articles written in English were included. Furthermore, only studies that used a reliable genotyping method (e.g., whole genome sequencing, or MLST) to classify the CC5 lineages were selected. The quality and selection of articles were based on the consensus assessment of the three authors in independent evaluations. In conclusion, ST105-SCCII is an emerging MRSA in several countries, being the second/third most important CC5 lineage, with a relatively high frequency in bloodstream infections. Of concern is the increased mortality from BSI in patients older than 15 years and the higher prevalence of ST105-SCCII in the blood of patients older than 60 years reported in some studies.
耐甲氧西林金黄色葡萄球菌（MRSA）的序列型5（ST5），携带葡萄球菌染色体盒式元件IV型（SCCIV），最早在葡萄牙被检测到。它成为儿科病房医疗保健相关（HA）感染的一个重要原因，因此被命名为儿科克隆株。另一个携带SCCII的ST5谱系，在美国和日本也流行了多年。最近，另一种MRSA谱系，ST105 - SCCII，作为克隆复合体5（CC5）MRSA进化的一部分，已成为包括葡萄牙、美国和巴西在内的多个国家医院获得性血流感染暴发的原因。本文综述了关于这些新出现病原体的流行病学和进化的研究。为此，对PUBMED自创建至2024年进行检索，以查找在流行病学研究中报告ST105 MRSA发生情况的文章。进行了第二次检索以查找关于MRSA、CC5、ST5和SCCII的研究。还对PUBMED从1999年至2024年进行检索，以识别关于ST5、CC5和ST105 MRSA的基因组学和进化的研究。通过分析先前从PUBMED中选择的文章的参考文献来识别更多研究。关于ST105 MRSA的大多数文章都被纳入了本综述。仅纳入英文撰写的文章。此外，仅选择使用可靠基因分型方法（如全基因组测序或多位点序列分型）对CC5谱系进行分类的研究。文章的质量和选择基于三位作者在独立评估中的共识评估。总之，ST105 - SCCII是几个国家中一种新出现的MRSA，是第二/第三重要的CC5谱系，在血流感染中频率相对较高。令人担忧的是，一些研究报告称，15岁以上患者因血流感染导致的死亡率增加，以及60岁以上患者血液中ST105 - SCCII的患病率较高。
