耐甲氧西林金黄色葡萄球菌的基因型分布及在不同遗传基因背景下的耐药谱分析

doi:10.13481/j.1671-587X.20240223

Abstract

Abstract:

Objective To discuss the genotype distribution of methicillin-resistant Staphylococcus aureus （MRSA） in a tertiary hospital and to discuss the correlation among different molecular types of the strains， and to construct the resistance profile model under different genetic backgrounds. Methods A total of 204 strains of Staphylococcus aureus （S. aureus）from 25 departments of the hospital were selected. The automatic VITEK 2 Compact system and E-test strips were used to detect the antimicrobial susceptibility of the strains. The detection of mecA gene by the polymerase chain reaction （PCR） method was used as the confirmatory experiment， the abilities of cefoxitin （FOX） and（or） oxacillin （OXA） were compared as phenotypic detection methods to screen MRSA. The molecular typing of MRSA strains was carried out by PCR method， including Staphylococcal proteinA gene （spa） determination， accessory gene regulator （agr） typing， multilocus sequence typing （MLST）， and staphylococcal chromosomal cassettes mec （SCCmec） typing. The resistance profile was constructed combing with antimicrobial susceptibility tests results and molecular typing results. Results A total of 39 MRSA strains were obtained by detecting the mecA gene. A total of 51 phenotypic MRSA strains were identified by testing FOX and OXA. In spa typing， 57 different types were identified， including 5 new types （t20226， t20227， t20228， t20229， and t20230）， with the main types being t309 （30.9%）， t078 （11.8%）， and t437 （11.8%）. In agr typing， 94.9% of MRSA belonged to agr Ⅰ. The MLST analysis results of MRSA populations showed that ST59 clone （61.5%） was the most prevalent， followed by ST72 （20.5%）. A total of 87.2% of MRSA carried type Ⅳ SCCmec， with subtypes Ⅳa accounting for 24 strains and subtype ⅣF accounting for 10 strains. Conclusion The main genotype of MRSA is ST59-t437-agr Ⅰ-Ⅳa and its resistance profile is primarily characterized by resistance to FOX-OXA-penicillin （PEN）-erythromycin （ERY）-clindamycin （CLI）.

Key words: Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus, Cefoxitin, Oxacillin, Resistance profile

CLC Number:

R446.5

Jin LIANG,Mingxia FU,Na LI,Fengxia WANG,Yujia CHEN,Yuanfang HU,Bing JI. Genotype distribution of methicillin-resistant Staphylococcus aureus and analysis on resistance pattern under different genetic backgrounds[J].Journal of Jilin University(Medicine Edition), 2024, 50(2): 489-497.

Figures/Tables 7

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References 29

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Method	Sensitivity（η/%）	Specificity（η/%）	PPV（η/%）	NPV（η/%）	YI
FOX	97.4	93.3	77.6	99.4	0.907
OXA	94.9	96.4	86.0	98.8	0.913
FOX+OXA	94.9	97.0	88.1	98.8	0.919

Group	n	CC/ST	Spa	SCCmec	Agr
MRSA	39	CC59/ST59	t437, t172,t3736	Ⅳa	Ⅰ
			t3527	Ⅲ	Ⅰ
		CC59/ST7437	t437	Ⅳa	Ⅰ
		ST965	t062	ⅣF	Ⅱ
		ST9	t899	－	Ⅱ
		ST22	t309	Ⅲ	Ⅰ
		ST72	t2431, t20226	ⅣF	Ⅰ
		ST1232	t034	Ⅴ	Ⅰ
		ST7196	t5155	ⅣF	Ⅰ
MSSA	165		t309, t078, t571, t701, t034, t437, t081,t148, t163, t258, t287, t796, t1751,t091, t167, t280,t349, t377, t385, t441, t1350, t1451, t2257, t2883, t5335, t8099, t8100, t13300, t15234, t19224, t20227		Ⅰ



			t002, t084, t14014, t062,t085, t105, t954		Ⅱ
			t002, t084, t14014, t062,t085, t105, t954		Ⅱ
			t127, t1504, t20228		Ⅲ
			t2092, t1425,t2019,t159, t2086, t6832, t7320, t20229, t20230		Ⅳ

Antibiotic	MRSA (n=39)		MSSA (n=165)		χ²	P
Antibiotic	Number	Rate ( η/% )	Number	Rate (η/%)	χ²	P
FOX	38	97.44	11	6.67	142.406	<0.01
PEN	38	97.44	159	96.36	0	1
OXA	37	94.87	6	3.64	157.838	<0.01
CPT	0	0	0	0	－	－
GEN	1	2.56	12	7.27	0.516	0.473
LVX	3	7.69	7	4.24	0.235	0.628
MFX	2	5.13	5	3.03	0.025	0.874
ERY	35	89.74	127	76.97	3.148	0.076
CLI	34	87.18	126	76.36	2.181	0.140
LZD	0	0	0	0	－	－
DAP	0	0	0	0	－	－
TEC	0	0	0	0	－	－
VAN	0	0	0	0	－	－
RIF	0	0	2	1.21	－	1
SXT	1	2.56	43	26.06	10.295	<0.01
AMK	2	5.13	0	0	－	0.036
MNO	0	0	0	0	－	－
CHL	3	7.69	2	1.21	－	0.049

Genotype	Percentage of genotype (η/%)	Resistance profile (Number of strain)
ST59-t437-agrⅠ-Ⅳa	53.8	FOX-OXA-PEN (1)
		FOX-OXA-PEN-ERY (1)
		FOX-OXA-PEN-ERY-CLI-AMK (1)
		FOX-OXA-PEN-ERY-CLI (15)
		FOX-OXA-PEN-ERY-CLI-CHL (2)
		FOX-OXA-PEN-LVX-MFX-ERY-CLI (1)
ST72-t2431-agrⅠ-ⅣF	15.4	FOX-OXA-PEN-AMK (1)
		FOX-OXA-PEN-ERY-CLI (4)
		FOX-PEN-ERY-CLI-CHL (1)
ST72-t20226-agrⅠ-ⅣF	5.1	FOX-OXA-PEN-ERY-CLI (2)
ST22-t309-agrⅠ-Ⅲ	5.1	FOX-OXA-PEN-ERY-CLI (2)
ST59-t172-agrⅠⅣa	2.6	FOX-OXA-PEN-ERY-CLI (1)
ST59-t3736-agrⅠ-Ⅳa	2.6	FOX-OXA-PEN-ERY-CLI (1)
ST59-t3527-agrⅠ-Ⅲ	2.6	FOX-OXA-PEN-ERY-CLI (1)
ST1232-t034-agrⅠ-Ⅴ	2.6	FOX-OXA-PEN-ERY-CLI (1)
ST7196-t5155-agrⅠ-ⅣF	2.6	FOX-OXA-PEN-ERY-CLI (1)
ST7437-t437-agrⅠ-Ⅳa	2.6	FOX-OXA-PEN (1)
ST965-t062-agrⅡ-ⅣF	2.6	LVX-MFX (1)
^aST9-t899-agrⅡ-NT	2.6	^bFOX-OXA-PEN-GEN-LVX-ERY-CLI-SXT⁽¹⁾

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Genotype distribution of methicillin-resistant Staphylococcus aureus and analysis on resistance pattern under different genetic backgrounds

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