西班牙不同养猪密度地区医院中耐甲氧西林金黄色葡萄球菌CC398的流行病学变化：一项2023年的多中心研究。

Changing epidemiology of MRSA-CC398 in Spanish hospitals located in areas with different pig farming densities: a 2023 multicentre study.

作者信息

Campaña-Burguet Allelen, Latorre-Fernández Javier, Eguizábal Paula, Bellés-Bellés Alba, Mormeneo-Bayo Saray, Alonso Carla Andrea, Arregui Irati, López-Calleja Ana Isabel, Rezusta Antonio, Seral Cristina, Castillo Francisco Javier, Vilamala Anna, Navarro María, Aspiroz Carmen, Cebollada Rocío, Cercenado Emilia, Zarazaga Myriam, Lozano Carmen, Torres Carmen

机构信息

Area de Bioquímica y Biología Molecular, Grupo de Investigación OneHealth-UR, Universidad de La Rioja, Logroño, Spain.

Laboratorio de Microbiología, Hospital Universitario Arnau Villanova, Lleida, Spain.

出版信息

J Antimicrob Chemother. 2025 Jun 3;80(6):1577-1586. doi: 10.1093/jac/dkaf104.

DOI:10.1093/jac/dkaf104

PMID:40246576

Abstract

BACKGROUND

Livestock-associated (LA)-MRSA of CC398 lineage is related to the pig environment, although it also colonizes/infects humans. Tetracycline resistance (TETR) is a phenotypic marker of LA-MRSA-CC398.

OBJECTIVES

To determine the prevalence and changing epidemiology of LA-MRSA-CC398 in seven Spanish hospitals (H1-H7) located in areas with different pig farming densities (PFDs) (extremely high, very high, medium, and very low: EH/VH/M/VL), and to identify other non-CC398-LA-MRSA clones.

METHODS

MRSA-TETR isolates (n = 165) obtained from hospitals H1-H7 over 6 months in 2023 were characterized with respect to genetic lineages/antimicrobial resistance and virulence/immune evasion cluster of CC398 and non-CC398. Results were compared with a previous multicentre study from 2016.

RESULTS

We identified 86/165 MRSA-TETR isolates (52.1%) as being MRSA-CC398. A significant difference in MRSA-CC398/MRSA prevalence was detected between hospitals located in EH-PFD areas (H1 and H2, > 25%) and the one in a VL-PFD area (H7, 0%). Prevalences in the range 6.4%-12.2% were found in hospitals in M- and VH-PFD areas (H3-H6). Fourteen spa-types were identified among MRSA-CC398 isolates, with t011/t034 predominating (68.3%), followed by t1451/t1255 (13%). All but two MRSA-CC398 isolates were scn-negative (human adaptation marker). Among the 79 non-CC398-MRSA-TETR isolates, CC5, CC1 and CC8 predominated (45.6%, scn-negative). The prevalences of the scn gene among non-CC398-MRSA-TETR isolates in hospitals of EH-, VH-, M- and VL-PFD areas were 77.8%, 50%, 18.75% and 0%, respectively (significant correlation, P < 0.05). This study shows that MRSA-CC398 isolates are prevalent in hospitals located in EH-PFD areas but absent in the hospital of the VL-PFD area. Moreover, an increase in both PFD and prevalence of MRSA-CC398/MRSA in hospitals H3-H6 was observed in the 2023 study compared with the 2016 study.

CONCLUSIONS

A significant increase and more genetic diversity of predominant lineages of CC398-MRSA-TETR were observed in hospitals located in M- to VH-PFD areas.

摘要

背景

CC398 谱系的家畜相关（LA）-耐甲氧西林金黄色葡萄球菌（MRSA）与猪的环境有关，尽管它也可定植于/感染人类。四环素耐药性（TETR）是 LA-MRSA-CC398 的一个表型标志物。

目的

确定位于不同养猪密度（PFD）（极高、非常高、中等和非常低：EH/VH/M/VL）地区的七家西班牙医院（H1-H7）中 LA-MRSA-CC398 的流行情况及其流行病学变化，并识别其他非 CC398-LA-MRSA 克隆株。

方法

对 2023 年 6 个月期间从 H1-H7 医院获得的 MRSA-TETR 分离株（n = 165）进行 CC398 和非 CC398 的遗传谱系/抗菌药物耐药性以及毒力/免疫逃避簇特征分析。将结果与 2016 年的一项多中心研究进行比较。

结果

我们鉴定出 86/165 株 MRSA-TETR 分离株（52.1%）为 MRSA-CC398。在位于 EH-PFD 地区的医院（H1 和 H2，>25%）与位于 VL-PFD 地区的医院（H7，0%）之间，检测到 MRSA-CC398/MRSA 流行率存在显著差异。在 M-和 VH-PFD 地区的医院（H3-H6）中，流行率在 6.4%-12.2%之间。在 MRSA-CC398 分离株中鉴定出 14 种 spa 型，其中 t011/t034 占主导（68.3%），其次是 t1451/t1255（13%）。除两株外，所有 MRSA-CC398 分离株均为 scn 阴性（人类适应性标志物）。在 79 株非 CC398-MRSA-TETR 分离株中，CC5、CC1 和 CC8 占主导（45.6%，scn 阴性）。在 EH-、VH-、M-和 VL-PFD 地区医院的非 CC398-MRSA-TETR 分离株中，scn 基因的流行率分别为 77.8%、50%、18.75%和 0%（显著相关，P<0.05）。本研究表明，MRSA-CC398 分离株在位于 EH-PFD 地区的医院中流行，但在 VL-PFD 地区的医院中不存在。此外，与 2016 年的研究相比，在 2023 年的研究中观察到 H3-H6 医院中 MRSA-CC398/MRSA 的 PFD 和流行率均有所增加。