BACKGROUND To analyze the molecular epidemiology and to compare between the major methicillin resistant Staphylococcus aureus biotypes for association with patient characteristics who had an implant for closed fracture and developed early post-operative wound infections (POWI) in a tertiary care hospital of India. METHODS Pulsed-field gel electrophoresis (PFGE), antimicrobial resistance, accessory gene regulator (agr) and staphylococcal cassette chromosome mec (SCCmec) types, Paton-Valentine leukocidin (PVL) gene, toxin gene profiling, biofilm formation and patient demographics were correlated with MLST clonal complexes (CC). FINDINGS Overall eight different sequence types (STs) were detected with a predominance of ST239 (66%), ST22 (18%) and some minor types ST772, ST30 (4% each) ST1, ST642, ST6, ST107 (2% each). All ST239 isolates belong to CC239 and SCCmec III whereas ST22 isolates belong to CC22 and SCCmec IV. The isolates varied in the distribution of various toxin genes. With 63.63% biofilm formers ST239 were all multidrug resistant with frequent resistance to erythromycin, clindamycin, gentamicin, cefuroxime, amoxyclav and ciprofloxacin indicating doxycycline, amikacin, vancomycin and linezolid can be the drug of choice. CONCLUSION This study shows that ST239 MRSA is still most prevalent strain with new emergence of ST642 and ST107 isolates in association with orthopedic implant based POWI. As compare to other ST types ST239 strain was associated with adverse treatment outcomes. This highlights the importance of improving nosocomial infection control measures in this unit.

中文翻译：

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从术后早期骨科植入物感染患者中分离出的耐甲氧西林金黄色葡萄球菌的克隆谱特征。


背景 分析分子流行病学并比较主要耐甲氧西林金黄色葡萄球菌生物型与印度三级护理医院因闭合性骨折植入物并发生早期术后伤口感染 (POWI) 的患者特征的关系。方法将脉冲场凝胶电泳 (PFGE)、抗菌药物耐药性、辅助基因调节因子 (agr) 和葡萄球菌盒式染色体 mec (SCCmec) 类型、Paton-Valentine 杀白细胞素 (PVL) 基因、毒素基因谱、生物膜形成和患者人口统计数据与MLST 克隆复合物 (CC)。结果 总共检测到八种不同的序列类型 (ST)，其中主要是 ST239 (66%)、ST22 (18%) 和一些次要类型 ST772、ST30（各 4%） ST1、ST642、ST6、ST107（各 2%） 。所有 ST239 分离株属于 CC239 和 SCCmec III，而 ST22 分离株属于 CC22 和 SCCmec IV。分离株的各种毒素基因的分布各不相同。 ST239具有63.63%的生物膜形成物，均具有多重耐药性，其中对红霉素、克林霉素、庆大霉素、头孢呋辛、阿莫克拉和环丙沙星频繁耐药，表明多西环素、阿米卡星、万古霉素和利奈唑胺可以作为首选药物。结论 这项研究表明，ST239 MRSA 仍然是最流行的菌株，新出现的 ST642 和 ST107 分离株与基于 POWI 的骨科植入物相关。与其他 ST 类型相比，ST239 菌株与不良治疗结果相关。这凸显了改善本单位院内感染控制措施的重要性。