Edslev Sofie M, Laurent Frederic, Månsson Emeli, Johannesen Thor Bech, Aarris Mia, Sönksen Ute Wolff, Kolenda Camille, Söderquist Bo, Stegger Marc
Department of Sequencing and Bioinformatics, Statens Serum Institut, Copenhagen, Denmark.
European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS), Basel, Switzerland.
J Antimicrob Chemother. 2025 Jul 1;80(7):2007-2015. doi: 10.1093/jac/dkaf166.
Staphylococcus epidermidis is a major cause of prosthetic joint infections (PJIs). Multidrug resistant (MDR), hospital-adapted clones constitute most cases globally, though regional differences in lineage dissemination likely exist. The aim was to explore the population structure of S. epidermidis from PJIs in Sweden and France, with a focus on the presence of antimicrobial resistance (AMR).
This study included genome sequence data from 191 clinical S. epidermidis isolates collected from patients with PJI in central Sweden (2007-16; n = 138) and the Lyon region in France (2015-20; n = 53).
Hospital-adapted lineages with a high burden of AMR dominated the cases in both countries. However, the ST2 lineage was significantly more prevalent in Sweden (43% versus 11% in France), while ST5 and ST87 were more common in France (55% versus 10% in Sweden). ST215 was only present in Sweden (25%). A significantly higher prevalence of streptogramin resistance genes [vat(B), vga(A), vga(B)] was found in French (26%) versus Swedish (2%) isolates. These genes were present in all ST87 isolates and in 20% of the French ST5 isolates. The erm(C) gene (resistance to streptogramin A, macrolides and lincosamides) was also more common in the French isolates (77% versus 55% of Swedish isolates), and so was the fusidic acid resistance gene fusB (France: 66%, Sweden: 39%).
This study highlights significant regional differences in S. epidermidis variants causing PJI. Despite similar MDR levels, certain AMR genes, particularly those related to streptogramin resistance, were significantly more prevalent among French isolates. This suggests that S. epidermidis undergoes local adaptation to region-specific antibiotic usage.
表皮葡萄球菌是人工关节感染（PJI）的主要病因。多药耐药（MDR）的医院适应克隆株在全球大多数病例中占主导地位，不过谱系传播可能存在地区差异。本研究旨在探索瑞典和法国PJI患者中分离出的表皮葡萄球菌的种群结构，重点关注抗菌药物耐药性（AMR）情况。
本研究纳入了从瑞典中部（2007 - 2016年；n = 138）和法国里昂地区（2015 - 2020年；n = 53）的PJI患者中收集的191株临床表皮葡萄球菌分离株的基因组序列数据。
两个国家的病例中均以具有高AMR负担的医院适应谱系为主。然而，ST2谱系在瑞典更为常见（43%，法国为11%），而ST5和ST87在法国更为常见（55%，瑞典为10%）。ST215仅在瑞典存在（25%）。在法国分离株（26%）中发现的链阳菌素耐药基因[vat(B)、vga(A)、vga(B)]的流行率显著高于瑞典分离株（2%）。这些基因存在于所有ST87分离株以及20%的法国ST5分离株中。erm(C)基因（对链阳菌素A、大环内酯类和林可酰胺类耐药）在法国分离株中也更为常见（77%，瑞典分离株为55%），夫西地酸耐药基因fusB也是如此（法国：66%，瑞典：39%）。
本研究突出了导致PJI的表皮葡萄球菌变体存在显著的地区差异。尽管MDR水平相似，但某些AMR基因，特别是与链阳菌素耐药相关的基因，在法国分离株中更为普遍。这表明表皮葡萄球菌会针对地区特异性抗生素使用情况进行局部适应。
