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Antibiotic resistance and typing of the methicillin-resistant Staphylococcus aureus clones in Kuwait hospitals, 2016–2017
BMC Microbiology ( IF 4.0 ) Pub Date : 2020-10-16 , DOI: 10.1186/s12866-020-02009-w
Samar S Boswihi 1 , Edet E Udo 1 , Wadha AlFouzan 1
Affiliation  

Methicillin-resistant Staphylococcus aureus (MRSA) belong to diverse genetic backgrounds that differ in antibiotic resistance. Knowledge of the local clonal composition of MRSA strains is important for patients’ management and for designing effective control and eradication methods. The aim of this study was to compare the antibiotic resistance patterns and genotypic characteristics of MRSA isolates obtained in public hospitals in Kuwait in 2016 and 2017 for changes in their resistance patterns and clonal composition. A total of 4726 MRSA isolates obtained in 2016–2017 from clinical specimens in Kuwait public hospitals were characterized using antibiogram, SCCmec typing, spa typing and DNA microarray. The isolates expressed resistance to fusidic acid (52.9%), kanamycin (41.6%), gentamicin (32.5%) and erythromycin (36.2%). The prevalence of high-level mupirocin resistance decreased from 3.7% in 2016 to 2.4% in 2017, while the proportion of resistance to other antibiotics remained relatively stable. A total of 382 spa types were detected with eight spa types, t688 (N = 547), t304 (N = 428), t860 (N = 394), t127 (N = 306), t044 (N = 230), t311 (N = 243), t223 (N = 184) and t002 (N = 181) constituting 53.1% of the MRSA isolates in 2016–2017. Of the 3004 MRSA isolates obtained in 2016 (N = 1327) and 2017 (N = 1677) selected for DNA microarray analysis, 26 clonal complexes (CCs) were identified. Most of the isolates belonged to CC1 (N = 248), CC5 (N = 833), CC6 (N = 241), CC8 (N = 292), CC22 (N = 421), CC30 (N = 177), CC80 (N = 177) and CC97 (N = 171). The prevalence of CC5 isolates has significantly (p ≤ 0.05) increased from 294 isolates in 2016 to 539 isolates in 2017. Although CC22 increased from 196 isolates in 2016 to 225 isolates in 2017, CC1 increased from 112 isolates in 2016 to 136 isolates in 2017, CC6 increased from 103 isolates in 2016 to 138 isolates in 2017, these changes were not significant (p ≥ 0.05). These results revealed the diversity in the genetic backgrounds of MRSA isolates and the stable maintenance of the dominant MRSA clones in Kuwait hospitals in 2016 and 2017 suggesting an on-going transmission of these clones. Novel and creative infection prevention and control measures are required to curtail further transmission.

中文翻译:

2016-2017年科威特医院耐甲氧西林金黄色葡萄球菌克隆的抗生素耐药性和分型

耐甲氧西林金黄色葡萄球菌 (MRSA) 属于不同的遗传背景,在抗生素耐药性方面存在差异。了解 MRSA 菌株的局部克隆组成对于患者的管理和设计有效的控制和根除方法很重要。本研究的目的是比较 2016 年和 2017 年在科威特公立医院获得的 MRSA 分离株的抗生素耐药模式和基因型特征,以了解其耐药模式和克隆组成的变化。使用抗菌谱、SCCmec 分型、spa 分型和 DNA 微阵列对 2016-2017 年从科威特公立医院临床标本中获得的 4726 株 MRSA 分离株进行了表征。分离株对夫西地酸 (52.9%)、卡那霉素 (41.6%)、庆大霉素 (32.5%) 和红霉素 (36.2%) 表现出耐药性。莫匹罗星高水平耐药发生率从2016年的3.7%下降到2017年的2.4%,其他抗生素耐药比例保持相对稳定。共检测到 382 种 spa 类型,其中 t688 (N = 547)、t304 (N = 428)、t860 (N = 394)、t127 (N = 306)、t044 (N = 230)、t311 ( N = 243)、t223 (N = 184) 和 t002 (N = 181) 占 2016-2017 年 MRSA 分离株的 53.1%。在选择用于 DNA 微阵列分析的 2016 年(N = 1327)和 2017 年(N = 1677)获得的 3004 株 MRSA 分离株中,鉴定出 26 个克隆复合体 (CC)。大多数分离株属于CC1 (N = 248)、CC5 (N = 833)、CC6 (N = 241)、CC8 (N = 292)、CC22 (N = 421)、CC30 (N = 177)、CC80 ( N = 177) 和 CC97 (N = 171)。CC5 分离株的流行率从 2016 年的 294 株显着增加(p ≤ 0.05)到 2017 年的 539 株。尽管CC22从2016年的196株增加到2017年的225株,但CC1从2016年的112株增加到2017年的136株,CC6从2016年的103株增加到2017年的138株,这些变化不显着(≥05)。 . 这些结果揭示了 MRSA 分离株遗传背景的多样性以及 2016 年和 2017 年科威特医院中优势 MRSA 克隆的稳定维持,表明这些克隆的持续传播。需要新的和创造性的感染预防和控制措施来减少进一步的传播。这些结果揭示了 MRSA 分离株遗传背景的多样性以及 2016 年和 2017 年科威特医院中优势 MRSA 克隆的稳定维持,表明这些克隆的持续传播。需要新的和创造性的感染预防和控制措施来减少进一步的传播。这些结果揭示了 MRSA 分离株遗传背景的多样性以及 2016 年和 2017 年科威特医院中优势 MRSA 克隆的稳定维持,表明这些克隆的持续传播。需要新的和创造性的感染预防和控制措施来减少进一步的传播。
更新日期:2020-10-19
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