Faber M, Rosdahl V T
Staphylococcus Laboratory, Statens Seruminstitut, Copenhagen, Denmark.
Scand J Infect Dis. 1993;25(5):647-53. doi: 10.3109/00365549309008555.
Changes in Staphylococcus aureus strains of phage group II were evaluated over a 30-year period. Strains of this group were previously known to be mainly community-acquired, to be rather sensitive to antibiotics and to occur in infections with better clinical outcome. During the period 1961 to 1990 a total of 551, 563 S. aureus strains was characterized according to antibiotic resistance, phage type and site of isolation. Clinical information was obtained on 16,781 bacteraemia cases. Strains of group II occurred until 1983 with a rather constant frequency around 16% of the S. aureus population. Since then, a constant increase in frequency has taken place and since 1990 they are the most frequently isolated phage pattern (22%). Bacteraemia caused by these strains occurs today with the same frequency in hospital and community as strains of other phage patterns. Moreover, these strains have changed from being highly susceptible, to being more resistant to penicillins and tetracycline than the rest of the population. Resistance to methicillin remained low in group II strains throughout the period (about 0.2%). Mortality rate and the proportion of patients with underlying diseases have been the same in recent years regarding group II strains as with other strains. This study indicates that the previous distinction between community-acquired and hospital-acquired S. aureus infections is no longer valid.
在30年的时间里对II组金黄色葡萄球菌菌株的变化进行了评估。此前已知该组菌株主要是社区获得性的，对抗生素相当敏感，且在感染中出现时临床结果较好。在1961年至1990年期间，根据抗生素耐药性、噬菌体类型和分离部位对总共551563株金黄色葡萄球菌菌株进行了鉴定。获得了16781例菌血症病例的临床信息。II组菌株在1983年之前出现的频率相当稳定，约占金黄色葡萄球菌群体的16%。从那时起，频率持续上升，自1990年以来，它们是最常分离出的噬菌体模式（22%）。如今，由这些菌株引起的菌血症在医院和社区中的发生频率与其他噬菌体模式的菌株相同。此外，这些菌株已从高度敏感转变为比其他群体对青霉素和四环素更具耐药性。在整个时期内，II组菌株对甲氧西林的耐药率仍然很低（约0.2%）。近年来，II组菌株的死亡率和有基础疾病的患者比例与其他菌株相同。这项研究表明，以前社区获得性和医院获得性金黄色葡萄球菌感染之间的区别不再有效。
