呼吸道与非呼吸道标本分离MRSA临床株耐药性比较及其分子流行病学特征

doi:10.13481/j.1671-587X.20240215

Abstract

Abstract:

Objective To discuss the differences in drug resistance， molecular typing， and biofilm-forming abilities of methicillin-resistant Staphylococcus aureus （MRSA） isolated from respiratory and non-respiratory tract specimens. Methods A total of 100 MRSA strains were selected from clinical specimens of the hospitalized patients， and 50 MRSA strains were isolated from the respiratory specimens and another 50 MRSA strains were isolated from non-respiratory tract specimens. These 100 MRSA strains underwent an in vitro susceptibility test for 14 kinds of antimicrobial drugs， molecular typing was performed through multilocus sequence typing （MLST） and Staphylococcus aureus protein A （Spa） typing， and their biofilm-forming abilities were detected by crystal violet staining assay. Results The in vitro susceptibility tests results showed that all the 100 MRSA strains had high overall resistance rates of over 60.0% to penicillin， erythromycin， clindamycin， levofloxacin， ciprofloxacin， moxifloxacin， and tetracycline， while only 9.0% exhibited resistance to trimethoprim-sulfamethoxazole， and all the strains were susceptible to vancomycin， linezolid， tigecycline， and quinupristin/dalfopristin. Compared with those isolated from non-respiratory tract specimens，the MRSA strains isolated from respiratory tract specimens showed significantly higher resistance rates to moxifloxacin， levofloxacin， ciprofloxacin， tetracycline， and gentamicin （P<0.05）. Among the 100 MRSA strains， 17 genotypes were identified， and the dominant types weve ST5-t2460 （26.0%）， ST239-t030 （23.0%）， and ST59-t437 （20.0%）. In the MRSA from the respiratory tract specimens， the dominant types were ST5-t2460 （20.0%） and ST239-t030 （13.0%）， followed by ST59-t437 （7.0%）； in the non-respiratory tract specimens， 13 genotypes were found， and the dominant types were ST59-t437 （13.0%） and ST239-t030 （10.0%）. All 100 MRSA strains were biofilm producers， among them the strong biofilm formers， moderate biofilm formers， and weak biofilm formers accounted for 2.0% （2/100）， 24.0% （24/100）， and 74.0% （74/100）， respectively. The ST59-t437 clones had overall strong biofilm-forming abilities， and 60.0% （12/20） stains were moderate to strong biofilm formers. Conclusion The MRSA strains isolated from the respiratory tract specimens have a significantly higher overall resistance rate than those isolated from the non-respiratory tract specimens. The ST59-t437 and ST239-t030 genotypes are dominant clones common to both types of specimens， and ST59-t437 strains show strong biofilm-forming abilities， and ST239-t030 strains exhibit the strongest resistance.

Key words: Methicillin-resistant Staphylococcus aureus, Drug resistance, Molecular typing, Biofilm

CLC Number:

R378.1

ERDEMUTU,Yanyan WANG,Yutong LI,Guilin CHEN,Junrui WANG. Comparison of drug resistance of MRSA clinical strains from respiratory tract and non-respiratory tract specimens and their molecular epidemiological characteristics[J].Journal of Jilin University(Medicine Edition), 2024, 50(2): 422-430.

Figures/Tables 4

Tab. 1

Tab. 2

Fig. 1

Tab. 3

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Antimicrobial drug	MRSA （n=100）	MRSA from respiratory tract specimen（n=50）		MRSA from non-respiratory tract specimen（n=50）		χ²	P
Antimicrobial drug	MRSA （n=100）	No.of drug-resistant strain(n)	Resistant rate(η/%)	No.of drug-resistant strain(n)	Resistant rate(η/%)	χ²	P
Vancomycin	0	0	0.0	0	0.	－	－
Tetracycline	0	0	0	0	0.	－	－
Rifampicin	25	15	30.0	10	20.0	0.853	0.356
Penicillin	100	50	100.0	50	100.0	－	－
Erythromycin	87	44	88.0	43	86.0	－	－
Clindamycin	73	38	76.0	34	68.0	0.446	0.504
Quinuptin / dafuptin	0	0	0.	0	0.	－	－
Tigecycline	0	0	0.	0	0.	－	－
Trimethoprim and sulphame-thoxazole	9	2	4.0	7	14.0	1.954	0.162
Moxifloxacin	62	40	80.0	22	44.0	12.270	0.001
Levofloxcin	70	43	86.0	27	54.0	10.710	0.001
Ciprofloxacin	70	43	86.0	27	54.0	10.710	0.001
Gentamycin	46	29	58.0	17	34.0	4.871	0.027
Tetracycline	70	44	88.0	26	52.0	13.760	<0.01

Antimicrobial resistance drug	ST5-t2460			ST239-t030			ST59-t437
Antimicrobial resistance drug	Total MRSA （n=26）	MRSA from respiratory tract （n=20）	MRSA from non-respiratory tract （n=6）	Total MRSA （n=23）	MRSA from respiratory tract （n=13）	MRSA from non-respiratory tract （n=10）	Total MRSA （n=20）	MRSA from respiratory tract （n=7）	MRSA from non-respiratory tract (n=13）
Levofloxcin	100.0	100.0	100.0	95.7	100.0	90.0	10.0	28.6	0.
Ciprofloxacin	100.0	100.0	100.0	95.7	100.0	90.0	10.0	28.6	0.
Moxifloxacin	100.0	100.0	100.0	95.7	100.0	90.0	10.0	28.6	0.
Erythromycin	100.0	100.0	100.0	78.3	69.2	90.0	95.0	100.0	92.3
Clindamycin	88.5	85.0	100.0	69.6	69.2	70.0	90.0	85.7	92.3
Tetracycline	100.0	100.0	100.0	95.7	100.0	90.0	55.0	71.4	46.2
Gentamycin	53.8	55.0	50.0	87.0	100.0	70.0	15.0	28.6	7.7
Rifampicin	3.9	5.0	0.	87.0	84.6	90.0	5.0	14.3	0.

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Comparison of drug resistance of MRSA clinical strains from respiratory tract and non-respiratory tract specimens and their molecular epidemiological characteristics

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Molecular charateristic				Source of sample		Biofilm-forming ability
STs	n	Spa	n	Respiratory tract	Non-respiratory tract	Respiratory tract			Non-respiratory tract
STs	n	Spa	n	Respiratory tract	Non-respiratory tract	+	?	?	+	?	?
ST5	26	t2460	26	20	6	15	5	0	4	2	0
ST239	25	t030	23	13	10	13	0	0	10	0	0
		t1493	1	1	0	1	0	0	0	0	0
		t4239	1	1	0	1	0	0	0	0	0
ST59	25	t437	20	7	13	2	4	1	6	6	1
		t2460	2	1	1	1	0	0	1	0	0
		t3590	1	0	1	0	0	0	1	0	0
		t441	1	0	1	0	0	0	1	0	0
		t7496	1	0	1	0	0	0	1	0	0
ST22	12	t005	9	1	8	0	1	0	6	2	0
		t309	2	0	2	0	0	0	1	1	0
		t2460	1	0	1	0	0	0	0	1	0
ST25	6	t078	5	2	3	2	0	0	2	1	0
ST25	6	t258	1	0	1	0	0	0	1	0	0
ST5939	2	t2460	2	2	0	2	0	0	0	0	0
ST398	1	t034	1	1	0	1	0	0	0	0	0
ST5637	1	t3622	1	0	1	0	0	0	0	1	0
ST5662	1	t2460	1	0	1	0	0	0	1	0	0
ST1	1	t127	1	1	0	1	0	0	0	0	0
Total	100		100	50	50	39	10	1	35	14	1