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首页> 美国卫生研究院文献>Journal of Clinical Microbiology >Detection of an Archaic Clone of Staphylococcus aureus with Low-Level Resistance to Methicillin in a Pediatric Hospital in Portugal and in International Samples: Relics of a Formerly Widely Disseminated Strain?
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Detection of an Archaic Clone of Staphylococcus aureus with Low-Level Resistance to Methicillin in a Pediatric Hospital in Portugal and in International Samples: Relics of a Formerly Widely Disseminated Strain?

机译：在葡萄牙的一家儿科医院和国际样本中检测到对甲氧西林耐药程度低的金黄色葡萄球菌古克隆：以前广泛传播的菌株的文物？

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Close to half of the 878 methicillin-resistant Staphylococcus aureus (MRSA) strains recovered between 1992 and 1997 from the pediatric hospital in Lisbon were bacteria in which antibiotic resistance was limited to β-lactam antibiotics. The other half were multidrug resistant. The coexistence of MRSA with such unequal antibiotic resistance profiles prompted us to use molecular typing techniques for the characterization of the MRSA strains. Fifty-three strains chosen randomly were typed by a combination of genotypic methods. Over 90% of the MRSA strains belonged to two clones: the most frequent one, designated the “pediatric clone,” was reminiscent of historically “early” MRSA: most isolates of this clone were only resistant to β-lactam antimicrobials and remained susceptible to macrolides, quinolones, clindamycin, spectinomycin, and tetracycline. They showed heterogeneous and low-level resistance to methicillin (MIC, 1.5 to 6 μg/ml), carried the ClaI-mecA polymorph II, were free of the transposon Tn554, and showed macrorestriction pattern D (clonal type II::NH::D). The second major clone was the internationally spread and multiresistant “Iberian” MRSA with homogeneous and high-level resistance to methicillin (MIC, >200 μg/ml) and clonal type I::E::A. Surprisingly, the multidrug-resistant and highly epidemic Iberian MRSA did not replace the much less resistant pediatric clone during the 6 years of surveillance. The pediatric clone was also identified among contemporary MRSA isolates from Poland, Argentina, The United States, and Colombia, and the overwhelming majority of these were also associated with pediatric settings. We propose that the pediatric MRSA strain represents a formerly widely spread archaic clone which survived in some epidemiological settings with relatively limited antimicrobial pressure.
机译：在1992年至1997年之间从里斯本的儿科医院回收的878株耐甲氧西林的金黄色葡萄球菌（MRSA）菌株中，近一半是细菌，其耐药性仅限于β-内酰胺类抗生素。另一半是耐多药的。 MRSA与不平等的抗生素耐药性特征共存促使我们使用分子分型技术来表征MRSA菌株。通过基因型方法的组合，随机选择了53个菌株。超过90％的MRSA菌株属于两个克隆：最常见的一个称为“儿科克隆”，让人想起历史上的“早期” MRSA：该克隆的大多数分离株仅对β-内酰胺类抗生素具有抗性，并仍然易感大环内酯类，喹诺酮类，克林霉素，壮观霉素和四环素。它们显示出对甲氧西林的异质和低水平抗性（MIC，1.5至6μg/ ml），携带ClaI-mecA多晶型物II，不含转座子Tn554，并显示出宏观限制性图谱D（克隆类型II :: NH :: D）。第二个主要克隆是国际上广泛传播且具有多重耐药性的“伊比利亚” MRSA，对甲氧西林（MIC，> 200μg/ ml）具有同质和高水平耐药性，且克隆类型为I :: E :: A。令人惊讶的是，在监测的6年中，多药耐药性和高度流行的伊比利亚MRSA并未取代耐药性差得多的儿科克隆。在波兰，阿根廷，美国和哥伦比亚的当代MRSA分离株中也鉴定出了儿科克隆，其中绝大多数也与儿科环境有关。我们建议，小儿MRSA菌株代表一种以前广泛传播的古细菌克隆，它在某些流行病学环境中以相对有限的抗微生物压力存活下来。

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