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首页> 外文期刊>Journal of Clinical Microbiology >Predominance and Emergence of Clones of Hospital-Acquired Methicillin-Resistant Staphylococcus aureus in Malaysia
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Predominance and Emergence of Clones of Hospital-Acquired Methicillin-Resistant Staphylococcus aureus in Malaysia

机译：马来西亚医院获得的耐甲氧西林金黄色葡萄球菌克隆的优势和出现

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We define the epidemiology of predominant and sporadic methicillin-resistant Staphylococcus aureus (MRSA) strains in a central teaching and referral hospital in Kuala Lumpur, Malaysia. This is done on the basis of spa sequencing, multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec) typing, and virulence gene profiling. During the period of study, the MRSA prevalence was 44.1%, and 389 MRSA strains were included. The prevalence of MRSA was found to be significantly higher in the patients of Indian ethnicity (P < 0.001). The majority (92.5%) of the isolates belonged to ST-239, spa type t037, and possessed the type III or IIIA SCCmec. The arginine catabolic mobile element (ACME) arcA gene was detected in three (1.05%) ST-239 isolates. We report the first identification of ACME arcA gene-positive ST-239. Apart from this predominant clone, six (1.5%) isolates of ST-22, with two related spa types (t032 and t4184) and a singleton (t3213), carrying type IVh SCCmec, were detected for the first time in Asia. A limited number of community-acquired (CA) MRSA strains were also detected. These included ST-188/t189 (2.1%), ST-1/t127 (2.3%), and ST-7/t091 (1%). Panton-Valentin leukocidin (PVL) was detected in all ST-1 and ST-188 strains and in 0.7% of the ST-239 isolates. The majority of the isolates carried agr I, except that ST-1 strains were agr III positive. Virulence genes seg and sei were seen only among ST-22 isolates. In conclusion, current results revealed the predominance of ST-239-SCCmec III/IIIA and the penetration of ST-22 with different virulence gene profiles. The emergence in Malaysia of novel clones of known epidemic and pathogenic potential should be taken seriously.
机译：我们在马来西亚吉隆坡的一家中央教学和转诊医院定义了主要和偶发性耐甲氧西林金黄色葡萄球菌（MRSA）菌株的流行病学。这是基于 spa 测序，多基因座序列分型（MLST），葡萄球菌盒式染色体 mec （SCC mec ）分型和毒力完成的基因分析。在研究期间，MRSA患病率为44.1％，其中包括389株MRSA菌株。发现印度裔患者中MRSA的患病率明显更高（ P <0.001）。分离株的大部分（92.5％）属于ST-239，t037型是 spa ，具有III型或IIIA型SCC mec 。在三个（1.05％）ST-239分离物中检测到了精氨酸分解代谢移动元件（ACME） arcA 基因。我们报告的第一个鉴定ACME arcA 基因阳性的ST-239。除此主要克隆外，还有六个（1.5％）ST-22分离株，带有两个相关的 spa 类型（t032和t4184）和一个单例（t3213），携带IVh SCC mec < / em>，这是在亚洲首次检测到。还检测到有限数量的社区获得性（CA）MRSA菌株。其中包括ST-188 / t189（2.1％），ST-1 / t127（2.3％）和ST-7 / t091（1％）。在所有ST-1和ST-188菌株以及0.7％的ST-239分离物中都检测到Panton-Valentin白细胞抑制素（PVL）。除ST-1菌株 agr III阳性外，大多数分离株均携带 agr I。仅在ST-22分离株中发现了毒力基因 seg 和 sei 。总之，目前的结果显示出ST-239-SCC mec III / IIIA的优势以及ST-22在不同毒力基因谱下的渗透。在马来西亚出现具有流行和致病潜力的新型克隆应引起重视。

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