Han Jaijun, Chang Euijin, Jung Jiwon, Kim Min Jae, Chong Yong Pil, Kim Sung-Han, Lee Sang-Oh, Choi Sang-Ho, Kim Yang Soo, Bae Seongman
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Infect Chemother. 2024 Dec;56(4):473-482. doi: 10.3947/ic.2024.0031. Epub 2024 Sep 3.
Sequence type 72 (ST72) is the predominant community-associated methicillin-resistant (MRSA) genotype in Korea. With an increasing prevalence of the ST72 lineage, regardless of methicillin resistance, it is crucial to understand the clinical and microbiological characteristics of ST72 methicillin-susceptible (MSSA) as well as ST72 MRSA.
In this retrospective cohort study, data from patients with bacteremia (SAB) who were admitted to a tertiary hospital in Korea from March 2007 to December 2018 were collected. Multilocus sequence typing was used to identify ST72 isolates. The clinical and microbiological characteristics of ST72 MSSA were compared with those of ST72 MRSA among patients infected with SAB.
Among the 442 SAB patients with ST72, 157 (35.5%) were infected with MSSA and 285 (64.5%) were infected with MRSA. There was a significant increase in the proportion of ST72 MSSA in both the community and hospital settings. Compared to ST72 MRSA, ST72 MSSA isolates were less likely to have multidrug resistance. The main infection foci, infection severity, and duration of bacteremia did not differ significantly between the two groups. The 90-day recurrence rate was significantly lower in the MSSA group (2.5% 8.4%, =0.03), while the 90-day mortality rate was comparable (28.0% 23.9%, =0.40).
ST72 MSSA had similar clinical features as ST72 MRSA in terms of infection site, severity, and 90-day mortality. Despite exhibiting lower levels of antibiotic resistance, ST72 MSSA has increased in the hospital environment concurrently with ST72 MRSA.
72型序列（ST72）是韩国社区获得性耐甲氧西林金黄色葡萄球菌（MRSA）的主要基因型。随着ST72谱系的患病率不断上升，无论是否耐甲氧西林，了解ST72甲氧西林敏感金黄色葡萄球菌（MSSA）以及ST72 MRSA的临床和微生物学特征至关重要。
在这项回顾性队列研究中，收集了2007年3月至2018年12月在韩国一家三级医院住院的菌血症患者（SAB）的数据。采用多位点序列分型来鉴定ST72分离株。在感染SAB的患者中，比较了ST72 MSSA和ST72 MRSA的临床和微生物学特征。
在442例ST72的SAB患者中，157例（35.5%）感染了MSSA，285例（64.5%）感染了MRSA。社区和医院环境中ST72 MSSA的比例均显著增加。与ST72 MRSA相比，ST72 MSSA分离株产生多重耐药的可能性较小。两组之间的主要感染部位、感染严重程度和菌血症持续时间没有显著差异。MSSA组的90天复发率显著较低（2.5%对8.4%，P=0.03），而90天死亡率相当（28.0%对23.9%，P=0.40）。
ST72 MSSA在感染部位、严重程度和90天死亡率方面与ST72 MRSA具有相似的临床特征。尽管ST72 MSSA的抗生素耐药水平较低，但在医院环境中其与ST72 MRSA同时增加。
