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Title: Molecular epidemiology and change trend of methicillin-resistant Staphylococcus aureus from invasive infections of a hospital in Hangzhou from 2012 to 2018.
Author: Zhu YY, Wang Y, Xiao TT, Ji JR, Shen P, Xiao YH.
Journal: Yi Chuan; 2023 Nov 20; 45(11):1074-1084. PubMed ID: 38764272.
Abstract:
The disease caused by methicillin-resistant Staphylococcus aureus (MRSA) is a global public health challenge that threatens society and patients seriously. Therefore, the molecular epidemiology and change trend of MRSA is essential for the control and treatment of diseases caused by the pathogen in their regions. To explore molecular epidemiology of MRSA in Hangzhou, we collected 162 MRSA isolates from 2012 to 2018, conducted the antimicrobial susceptibility and used polymerase chain reaction(PCR) to test the molecular typing including multilocus sequence typing (MLST), staphylococcal chromosome cassette mec (SCCmec), staphylococcal protein A (spa A) and Panton-Valentine leucocidin (PVL). All the strains was divided into community-associated MRSA (CA-MRSA) or hospital-associated MRSA (HA-MRSA). 162 MRSA isolates were divided into 16 STs and 30 spa types. The major ST type was ST5 (96/162, 59.3%) and the predominant spa type was t311 (83/162, 51.2%). Five SCCmec types were found and the most common SCCmec type was type II (101/162, 61.7%). ST5-II-t311 was the predominant MRSA clone. And the prevalence of ST5 MRSA gradually declined from 2014 to 2018 but the prevalence of ST59 MRSA significantly increased. At the same time, livestock-associated methicillin-resistant Staphylococcus aureus(LA-MRSA) ST398 and ST9 were detected. Twenty-eight isolates were PVL gene positive (28/162, 17.3%). The most prevalent PVL-positive clone was ST59-IVa-t437. Comparing with HA-MRSA, CA-MRSA had a lower probability of ST5 (9.1% vs 67.1%, P=0.000) but a higher probability of ST59 (63.6% vs 11.4%, P=0.000), not only that, it was more likely to carrying PVL-positive gene (36.4% vs 14.3%, P=0.028). In summary, the molecular types of MRSA were getting complex over time. ST5-II-t311 was the predominant clone of MRSA isolate with a downward incidence from 2014 to 2018. ST59 MRSA strains, which is thought community related strain are spreading into hospitals and has an upward incidence from 2014 to 2018. 耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus，MRSA)是威胁全球的公共卫生问题，给社会和患者造成严重的安全威胁，因此明确MRSA耐药性和时空分布的多态性对于其感染的诊治和防控至关重要。本研究通过收集本院162株MRSA菌株，将所有菌株根据标准区分为社区获得性(community-associated) MRSA (CA-MRSA)和医院获得性(hospital-associated) MRSA (HA-MRSA)，利用聚合酶链式反应(polymerase chain reaction，PCR)测定MRSA菌株的多位点序列分型(multilocus sequence typing，MLST)，葡萄球菌盒式染色体序列(staphylococcal chromosome cassette mec，SCCmec)、葡萄球菌A蛋白(staphylococcal protein A，spa)基因多态性，以及杀白细胞毒素(Panton-Valentine leucocidin，PVL)，分析了杭州地区不同年份(2012~2018年) MRSA菌株的分子特征。结果共发现16种ST型和30种spa型。ST型以ST5型为主(96/162,59.3%)，spa分型以t311型为主(83/162,51.2%)。发现5种SCCmec分型，以SCCmec II型最为常见(101/162,61.7%)，ST5-II-t311是本地区的第一优势MRSA克隆。2014~2018年，ST5型MRSA的患病率逐渐下降，而ST59型MRSA的患病率上升。同时，本研究检出家畜相关耐甲氧西林金黄色葡萄球菌(livestock-associated methicillin-resistant Staphylococcus aureus，LA-MRSA) ST398和ST9。PVL基因阳性MRSA菌株共28株(28/162,17.3%)，最常见的PVL阳性克隆是ST59-IVa-t437。CA-MRSA与HA-MRSA相比，ST型为ST5的比例较低(9.1% vs 67.1%，P=0.000)，ST59的比例较高(63.6% vs 11.4%，P=0.000)，且CA-MRSA携带PVL阳性基因的可能性更高(36.4% vs 14.3%，P=0.028)。上述结果表明，MRSA的分子类型越来越多样化，ST5-II-t311是本地区MRSA的优势克隆，但在2014~ 2018年呈下降趋势，而社区相关性克隆菌株ST59型MRSA在2014~2018年呈逐年上升趋势。.

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