Maruri-Aransolo Ainhize, Hernandez-García Marta, Barbero Raquel, Michelena Malkoa, Pastor-Vivero María Dolores, Mondejar-Lopez Pedro, Solé Amparo, Cantón Rafael, Caballero-Pérez Juan de Dios
Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España.
CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, España.
JAC Antimicrob Resist. 2024 Oct 17;6(5):dlae160. doi: 10.1093/jacamr/dlae160. eCollection 2024 Oct.
Chronic bronchopulmonary infection due to MRSA in people with cystic fibrosis (pwCF) has been associated with accelerated decline in lung function, increased hospitalizations and increased mortality.
We studied microbiological and genomic characteristics of MRSA isolates recovered from pwCF in two Spanish multicentre studies (2013, 2021). Antimicrobial susceptibility was performed. WGS was carried out to determine population structure [MLST, -typing, staphylococcal cassette chromosome (SCC)], resistome and virulome. Clinical charts of MRSA-infected and MRSA-non-infected pwCF were also reviewed.
MRSA infection prevalence decreased between 2013 (29/341, 8.5%) and 2021 (21/326, 6.4%) ( = 0.378). Differences in lung function were observed between infected and non-infected patients ( < 0.005). A higher prevalence of hospital-acquired (HA) clones was found compared with community-acquired (CA) clones (2013: 67% versus 33%; and 2021: 71% versus 29%). Overall, we noted clustering of isolates based on year of sampling, type of acquisition and clonal complex (CC). HA-MRSA population was dominated by CC5, with ST125-MRSA-IVc-t067 the most prevalent lineage (37%). A higher clonal diversity was detected among CA-MRSA. One Panton-Valentine leucocidin (PVL)-positive strain (ST8-MRSA-IV) and three strains of porcine origin (two ST398-MRSA-V-t011, one ST398-MRSA-V-t8567) were found. Additionally, acquired resistance genes ( = 24) were detected, including the gene conferring linezolid resistance. A higher gentamicin resistance was found in 2021 (42%) compared with 2013 (7%) ( = 0.046), associated with the gene.
Despite a decrease in MRSA prevalence, we showed its potential impact on CF severity and progression. Moreover, we observed great genotypic and phenotypic diversity in MRSA isolates from pwCF as well as an MDR trait.
囊性纤维化患者（pwCF）中耐甲氧西林金黄色葡萄球菌（MRSA）引起的慢性支气管肺部感染与肺功能加速下降、住院次数增加和死亡率上升有关。
我们在两项西班牙多中心研究（2013年、2021年）中研究了从pwCF分离出的MRSA菌株的微生物学和基因组特征。进行了药敏试验。开展全基因组测序（WGS）以确定群体结构[多位点序列分型（MLST）、-分型、葡萄球菌盒式染色体（SCC）]、耐药基因组和毒力基因组。还回顾了MRSA感染和未感染的pwCF的临床病历。
MRSA感染患病率在2013年（29/341，8.5%）至2021年（21/326，6.4%）之间有所下降（P = 0.378）。观察到感染患者和未感染患者之间肺功能存在差异（P < 0.005）。与社区获得性（CA）克隆相比，医院获得性（HA）克隆的患病率更高（2013年：67%对33%；2021年：71%对29%）。总体而言，我们注意到分离株根据采样年份、获得类型和克隆复合体（CC）聚类。HA-MRSA群体以CC5为主，ST125-MRSA-IVc-t067是最常见的谱系（37%）。在CA-MRSA中检测到更高的克隆多样性。发现一株杀白细胞素（PVL）阳性菌株（ST8-MRSA-IV）和三株猪源菌株（两株ST398-MRSA-V-t011，一株ST398-MRSA-V-t8567）。此外，检测到获得性耐药基因（n = 24），包括赋予利奈唑胺耐药性的基因。与2013年（7%）相比，2021年庆大霉素耐药率更高（42%）（P = 0.046），与该基因有关。
尽管MRSA患病率有所下降，但我们显示了其对CF严重程度和进展的潜在影响。此外，我们观察到来自pwCF的MRSA分离株在基因型和表型上具有很大的多样性以及多重耐药特征。
