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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Detection and Characterisation of Heteroresistant Vancomycin Intermediate Staphylococcus aureus (hVISA) using Phenotypic and Genotypic Methods
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Detection and Characterisation of Heteroresistant Vancomycin Intermediate Staphylococcus aureus (hVISA) using Phenotypic and Genotypic Methods

机译：表型和基因型方法对耐万古霉素中间金黄色葡萄球菌（hVISA）的检测和表征

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Vancomycin remains the drug of choice to treat infections caused by Methicillin Resistant Staphylococcus aureus (MRSA). Frequent therapeutic failures arise due to the emergence of strains with reduced susceptibility to vancomycin and difficulty in detecting these isolates. Therefore, improvements in screening and confirmatory tests to detect these isolates are required.Aim: To detect heteroresistant Vancomycin Intermediate Staphylococcus aureus (hVISA) isolates among Methicillin Resistant Staphylococcus aureus (MRSA) and Methicillin Sensitive Staphylococcus aureus (MSSA) obtained from various clinical samples and to study the phenotypic and genotypic charecteristics of these strains.Materials and Methods: This study was carried out in the Department of Microbiology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India. A total of 468 non-duplicate S.aureus strains obtained from various clinical samples during a period of two years from September 2014 to November 2016 were included in the study. MRSA isolates and hVISA/VISA isolates were detected by screening and confirmatory methods (MRSA screen by cefoxitin disc, hVISA/VISA screen by brain heart infusion agar with 6 μg vancomycin and hVISA/VISA confirmation by PAP-AUC method). Agr polymorphism in hVISA/VISA was analysed by duplex PCR. Accessory gene regulator (Agr) dysfunction in these strains was studied by their colony spreading property in soft agar and autolytic property by Triton X-100 induced lysis. The results were analysed using IBM SPSS (version 21.0) software.Results: Out of 468 S.aureus strains, 114 (24%) strains were detected as MRSA and 33 (7.0%) were hVISA/VISA strains. Among MRSA detected, 11 (9.5%) strains were confirmed as hVISA/VISA. All hVISA/VISA isolates showed reduction in autolytic activity. Colony spreading property was appreciated in 13 (39%) of these isolates. Out of the 33 hVISA/VISA strains, majority belonged to agr I, III and II and the least number of isolates belonged to agr IV.Conclusion: It was concluded that hVISA/VISA strains have diverse virulence properties and are detected in both MRSA and MSSA strains. Therefore, surveillance of these strains among S.aureus isolates having vancomycin MIC?s =1.5 μg/mL in laboratory settings is needed.
机译：万古霉素仍然是治疗由耐甲氧西林金黄色葡萄球菌（MRSA）引起的感染的首选药物。由于出现了对万古霉素敏感性降低且难以检测到这些分离株的菌株，因此出现了频繁的治疗失败。因此，需要改进筛选和确证试验以检测这些分离株。目的：在耐甲氧西林的金黄色葡萄球菌（MRSA）和对甲氧西林敏感的金黄色葡萄球菌中检测耐异万古霉素中间金黄色葡萄球菌（hVISA）分离株（MSSA）来自各种临床样品，并研究这些菌株的表型和基因型特征。材料与方法：这项研究是在金奈州泰勒纳德邦钦奈Kelambakkam的切蒂纳德医院和研究所微生物学系进行的，印度。在2014年9月至2016年11月的两年中，从各种临床样品中获得的总共468株非重复性金黄色葡萄球菌菌株被纳入研究。通过筛选和确认方法检测MRSA分离物和hVISA / VISA分离物（通过头孢西丁片进行MRSA筛选，通过脑心琼脂加6μg万古霉素进行hVISA / VISA筛选，通过PAP-AUC方法确认hVISA / VISA）。通过双重PCR分析hVISA / VISA中的Agr多态性。通过在软琼脂中的菌落扩散特性和通过Triton X-100诱导的自溶特性研究了这些菌株中辅助基因调节剂（Agr）的功能障碍。结果使用IBM SPSS（版本21.0）软件进行了分析。结果：在468株金黄色葡萄球菌中，检测到114株（24％）为MRSA，33株（7.0％）为hVISA / VISA菌株。 。在检测到的MRSA中，确认有11株（9.5％）为hVISA / VISA。所有hVISA / VISA分离物均显示自溶活性降低。在这些分离物中的13个（39％）中，菌落的传播特性得到了赞赏。在33株hVISA / VISA菌株中，大多数属于agr I，III和II，最少的分离株属于agr IV。结论：结论：hVISA / VISA菌株具有多种毒力特性，并在MRSA和MSSA菌株。因此，需要在实验室环境中对万古霉素MIC≥1.5μg/ mL的金黄色葡萄球菌分离株中的这些菌株进行监测。

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