Longitudinal Changes in Clonal Distribution and Fluoroquinolone Resistance of Ocular MRSA.

IF 6.3 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal Pub Date : 2026-08-13 DOI:10.1016/j.bj.2026.101033

Ching-Hsi Hsiao, Eugene Yu-Chuan Kang, Ya-Tung Liu, Hung-Chi Chen, Lung-Kun Yeh, David H K Ma, Kuo-Hsuan Hung, Yhu-Chering Huang

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引用次数: 0

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of ocular infections, with evolving molecular epidemiology observed in systemic infections in Taiwan. However, longitudinal data on clonal distribution and antibiotic susceptibility in ocular MRSA isolates remain limited.

Material and methods: Patients with culture-proven S. aureus ocular infection at Chang Gung Memorial Hospital between 2013 and 2022 were included. MRSA isolates were characterized by pulsed-field gel electrophoresis, multilocus sequence typing, and staphylococcal cassette chromosome mec typing, and Panton-Valentine leucocidin genes detection. Antibiotic susceptibility was examined using disk diffusion method and E-test. Temporal trends were analyzed using chi-square tests for trend.

Results: A total of 154 MRSA ocular isolates were identified. The predominant clone complex (CC) was CC59 (80/154, 52.0%), followed by CC8 (30/154, 19.5%) and CC45 (25/154, 16.2%). Over the decade, CC59 declined while CC8 increased significantly (P = 0.005 and P = 0.002, respectively), paralleling nationwide systemic MRSA trends. CC8 isolates were more frequently associated with eyelid disorders than CC59 (50.0% vs 28.8%; P = 0.045). CC59 isolates remained highly susceptible to fluoroquinolones (> 95%), while CC8 demonstrated marked resistance (≤ 11% susceptible; P < 0.0001). All isolates were susceptible to vancomycin and teicoplanin.

Conclusions: Ocular MRSA infections in Taiwan demonstrate longitudinal changes in clonal distribution, characterized by declining CC59 and increasing CC8, and a concurrent increase in fluoroquinolone-resistant CC8. This evolution may compromise fluoroquinolone-based empirical therapy, a cornerstone of first-line treatment for ocular infections, and highlights the importance of continued molecular surveillance.

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眼部MRSA克隆分布及氟喹诺酮类药物耐药性的纵向变化。

背景：耐甲氧西林金黄色葡萄球菌（MRSA）是眼部感染的主要原因，在台湾地区的全身感染中观察到分子流行病学的演变。然而，眼部MRSA分离株克隆分布和抗生素敏感性的纵向数据仍然有限。材料和方法：纳入2013 - 2022年在长庚纪念医院经培养证实的金黄色葡萄球菌眼部感染患者。采用脉冲场凝胶电泳、多位点序列分型、葡萄球菌盒式染色体mec分型和潘通-瓦伦丁嗜白细胞素基因检测对MRSA分离株进行鉴定。采用纸片扩散法和e -试验进行药敏试验。采用卡方检验分析时间趋势。结果：共检出眼部MRSA分离株154株。优势克隆复合体（CC）为CC59(80/154, 52.0%)，其次为CC8（30/154, 19.5%）和CC45（25/154, 16.2%）。近十年来，CC59下降，CC8显著上升（P = 0.005和P = 0.002），与全国系统性MRSA趋势一致。CC8分离株与眼睑疾病的相关性高于CC59 （50.0% vs 28.8%; P = 0.045）。CC59菌株对氟喹诺酮类药物高度敏感（bb0 95%），而CC8菌株表现出明显的耐药性（≤11%,P < 0.0001）。所有分离株均对万古霉素和替可普宁敏感。结论：台湾地区眼部MRSA感染克隆分布呈纵向变化，CC59下降，CC8升高，氟喹诺酮类药物耐药CC8同时升高。这种演变可能危及以氟喹诺酮为基础的经验性治疗，而氟喹诺酮是眼部感染一线治疗的基石，并突出了持续分子监测的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biomedical Journal Medicine-General Medicine

CiteScore

11.60

自引率

1.80%

发文量

128

审稿时长

42 days

期刊介绍： Biomedical Journal publishes 6 peer-reviewed issues per year in all fields of clinical and biomedical sciences for an internationally diverse authorship. Unlike most open access journals, which are free to readers but not authors, Biomedical Journal does not charge for subscription, submission, processing or publication of manuscripts, nor for color reproduction of photographs. Clinical studies, accounts of clinical trials, biomarker studies, and characterization of human pathogens are within the scope of the journal, as well as basic studies in model species such as Escherichia coli, Caenorhabditis elegans, Drosophila melanogaster, and Mus musculus revealing the function of molecules, cells, and tissues relevant for human health. However, articles on other species can be published if they contribute to our understanding of basic mechanisms of biology. A highly-cited international editorial board assures timely publication of manuscripts. Reviews on recent progress in biomedical sciences are commissioned by the editors.