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[阿尔及尔社区获得性和医院获得性含杀白细胞素基因的耐甲氧西林金黄色葡萄球菌感染的高患病率]

[High prevalence of community- and hospital-acquired infections of methicillin-resistant Staphylococcus aureus containing Panton-Valentine leukocidin gene in Algiers].

作者信息

Antri K, Rouzic N, Boubekri I, Dauwalder O, Beloufa A, Ziane H, Djennane F, Neggazi M, Benhabyles B, Bes M, Tazir M, Etienne J, Ramdani-Bouguessa N

机构信息

Service de microbiologie, centre hospitalo-universitaire Mustapha-Bacha, place du Premier-Mai, 16000 Alger, Algérie.

出版信息

Pathol Biol (Paris). 2010 Apr;58(2):e15-20. doi: 10.1016/j.patbio.2009.07.017. Epub 2009 Oct 28.

Abstract

OBJECTIVES

To determine the prevalence of community acquired and hospital methicillin-resistant Staphylococcus aureus (S. aureus) infections and the Panton-Valentine leukocidin.

PATIENTS AND METHODS

Seven hundred S. aureus strains were collected during 21 months period in Mustapha Bacha hospital. Bacterial identification was based on standard methods and susceptibilities were tested by disk diffusion method. Molecular study (toxins, mecA gene and agr alleles) were determined for 221 S. aureus isolates by multiplex PCR.

RESULTS

The global MRSA prevalence was 42 %, 35 % in the community and 49 % in hospital setting. The frequency of strains containing PVL genes (PVL+) was 36 %, their molecular profile was: agr3, mecA+, etd, edin, which correspond to the C-MRSA major ST80 clone in Europe and the Maghreb. The H-MRSA-PVL+ were multidrug resistant. Among the MSSA, 13 strains contained the tst gene and five contained the exfoliatine genes ETA and ETB.

CONCLUSION

Our results show a high rate of MRSA-PVL+ in the community and the hospital setting. The H-MRSA-PVL+ were multidrug resistant complicating their antibiotic treatment options.

摘要

目的

确定社区获得性和医院内耐甲氧西林金黄色葡萄球菌(S. aureus)感染及杀白细胞素(Panton-Valentine leukocidin)的流行情况。

患者与方法

在穆斯塔法·巴查医院21个月期间收集了700株金黄色葡萄球菌菌株。细菌鉴定基于标准方法,药敏试验采用纸片扩散法。通过多重聚合酶链反应(multiplex PCR)对221株金黄色葡萄球菌分离株进行分子研究(毒素、mecA基因和agr等位基因)。

结果

耐甲氧西林金黄色葡萄球菌(MRSA)总体流行率为42%,社区为35%,医院为49%。含杀白细胞素基因(PVL+)菌株的频率为36%,其分子特征为:agr3、mecA+、etd、edin,这与欧洲和马格里布地区社区获得性耐甲氧西林金黄色葡萄球菌(C-MRSA)的主要ST80克隆相对应。医院获得性耐甲氧西林金黄色葡萄球菌(H-MRSA)-PVL+具有多重耐药性。在甲氧西林敏感金黄色葡萄球菌(MSSA)中,13株含有中毒性休克综合征毒素基因(tst基因),5株含有表皮剥脱毒素基因ETA和ETB。

结论

我们的结果显示社区和医院环境中MRSA-PVL+的发生率较高。H-MRSA-PVL+具有多重耐药性,使其抗生素治疗选择变得复杂。

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