Tenover F C, Arbeit R, Archer G, Biddle J, Byrne S, Goering R, Hancock G, Hébert G A, Hill B, Hollis R
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
J Clin Microbiol. 1994 Feb;32(2):407-15. doi: 10.1128/jcm.32.2.407-415.1994.
Fifty-nine Staphylococcus aureus isolates and 1 isolate of Staphylococcus intermedius were typed by investigators at eight institutions by using either antibiograms, bacteriophage typing, biotyping, immunoblotting, insertion sequence typing with IS257/431, multilocus enzyme electrophoresis, restriction analysis of plasmid DNA, pulsed-field or field inversion gel electrophoresis, restriction analysis of PCR-amplified coagulase gene sequences, restriction fragment length polymorphism typing by using four staphylococcal genes as probes, or ribotyping. Isolates from four well-characterized outbreaks (n = 29) and a collection of organisms from two nursing homes were mixed with epidemiologically unrelated stock strains from the Centers for Disease Control and Prevention. Several isolates were included multiple times either within or between the sets of isolates to analyze the reproducibilities of the typing systems. Overall, the DNA-based techniques and immunoblotting were most effective in grouping outbreak-related strains, recognizing 27 to 29 of the 29 outbreak-related strains; however, they also tended to include 3 to 8 epidemiologically unrelated isolates in the same strain type. Restriction fragment length polymorphism methods with mec gene-associated loci were less useful than other techniques for typing oxacillin-susceptible isolates. Phage typing, plasmid DNA restriction analysis, and antibiogram analysis, the techniques most readily available to clinical laboratories, identified 23 to 26 of 29 outbreak-related isolates and assigned 0 to 6 unrelated isolates to outbreak strain types. No single technique was clearly superior to the others; however, biotyping, because it produced so many subtypes, did not effectively group outbreak-related strains of S. aureus.
来自八个机构的研究人员使用抗菌谱、噬菌体分型、生物分型、免疫印迹、IS257/431插入序列分型、多位点酶电泳、质粒DNA限制性分析、脉冲场或场反转凝胶电泳、PCR扩增凝固酶基因序列的限制性分析、以四个葡萄球菌基因为探针的限制性片段长度多态性分型或核糖体分型，对59株金黄色葡萄球菌分离株和1株中间葡萄球菌分离株进行了分型。来自四个特征明确的暴发（n = 29）的分离株以及来自两家疗养院的一批菌株，与来自疾病控制和预防中心的流行病学无关的标准菌株混合在一起。在分离株组内或组间多次纳入了几个分离株，以分析分型系统的可重复性。总体而言，基于DNA的技术和免疫印迹在对与暴发相关的菌株进行分组方面最为有效，识别出了29株与暴发相关菌株中的27至29株；然而，它们也倾向于将3至8株流行病学无关的分离株归为同一菌株类型。与mec基因相关位点的限制性片段长度多态性方法在对苯唑西林敏感分离株进行分型时不如其他技术有用。噬菌体分型、质粒DNA限制性分析和抗菌谱分析是临床实验室最容易获得的技术，它们识别出了29株与暴发相关分离株中的23至26株，并将0至6株无关分离株归为暴发菌株类型。没有一种技术明显优于其他技术；然而，生物分型由于产生了太多亚型，未能有效地对金黄色葡萄球菌与暴发相关的菌株进行分组。
