三级医院医护人员MRSA分离株的表型和基因型特征

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology Pub Date : 2025-05-17 DOI:10.1016/j.ijmmb.2025.100871

Kavita Sisodia , Anupam Kr Anveshi , Dabet Ranga , Dharmender Kumar , Rajni Gaind

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引用次数: 0

摘要

背景：耐甲氧西林金黄色葡萄球菌（MRSA）是一个重要的公共卫生问题，特别是在卫生保健机构中，卫生保健工作者（HCWs）作为宿主。本研究的目的是评估各种表型方法检测MRSA在医护人员和研究MRSA分离分子流行病学的SCCmec分型。方法：收集368例医护人员鼻拭子，研究MRSA携带情况。样品在5%羊血琼脂和CHROMagar™MRSA上培养。采用盘片扩散法测定抗菌药物敏感性，并根据CLSI指南测定所选抗生素的MIC。采用PCR检测mecA、mecc和SCCmec分型。表型试验性能：评价奥西林、头孢西丁（MICμg/ml）和头孢西丁圆盘扩散（DD）检测MRSA的效果。结果：65例（17.7%）HCWs检出金黄色葡萄球菌，27例（7.3%）MRSA检出mecA阳性。CHROMagar™MRSA正确鉴定出24 /27株mecA基因阳性。MRSA分离株中耐多药发生率较高。未发现对莫匹罗星的高水平耐药。头孢西丁DD是一种可靠的MRSA检测表型试验，具有100%的敏感性和特异性。使用甲氧西林MIC时出现了非常严重的错误（25.9%）。以SCCmectypeV型（66.6%）最为常见，其次为SCCmecIV型。未检测到与医院获得性MRSA （HA-MRSA）相关的SCCmectype I-III。结论：在医护人员中MRSA携带率显著（7.3%），强调对医护人员进行筛查的必要性。CHROMagar™MRSA可用于HCWs和患者的快速筛选，以实施早期去菌落和感染控制实践。表型试验结果表明头孢西丁片是一种可靠的MRSA检测方法。与传统的HA-MRSA相比，asCA-MRSA菌株往往毒性更强，更容易传播。

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Phenotypic and genotypic characterization of MRSA isolated from health care workers in tertiary care hospital

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant public health concern, particularly in healthcare settings where healthcare workers (HCWs) act as reservoirs. The aim of this study was to evaluate various phenotypic methods for detection of MRSA among HCWs and study molecular epidemiology of the MRSA isolates by SCCmec typing.

Methods

A total of 368 nasal swabs were collected from HCWs to study MRSA carriage. Samples were cultured on 5 % sheep blood agar and CHROMagar™ MRSA. Antimicrobial susceptibility was performed using disc diffusion and MIC was determined for select antibiotics as per CLSI guidelines. PCR was performed for detection of mecA, mecC and SCCmec typing. Performance of phenotypic test: oxacillin, cefoxitin (MIC μg/ml) and cefoxitin disc diffusion (DD) was evaluated for detection of MRSA.

Results

Colonization with S. aureus and MRSA (mecA positive) was detected among 65 (17.7 %) and 27 (7.3 %) HCWs respectively. CHROMagar™ MRSA correctly identified 24/27 isolates positive for mecA gene. Among MRSA isolates MDR was high. High level resistance to mupirocin was not detected. Cefoxitin DD was a reliable phenotypic test for MRSA detection showing 100 % sensitivity and specificity. Very major errors (25.9 %) were observed with oxacillin MIC. SCCmec typeV (66.6 %) was the most prevalent, followed by SCCmec IV. SCCmec type I-III, associated with hospital-acquired MRSA (HA-MRSA) were not detected.

Conclusion

The significant MRSA carriage rate (7.3 %) among HCWs underscores the need for screening HCWs. CHROMagar^TM MRSA can be used for rapid screening of HCWs and patients for implementing early decolonization and infection control practices. Results from phenotypic test indicate that cefoxitin disc is a reliable method for detection of MRSA. The high prevalence of SCCmec type V in hospital settings is a concern as CA-MRSA strains tend to be more virulent and easily transmissible compared to traditional HA-MRSA.

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来源期刊

Indian Journal of Medical Microbiology IMMUNOLOGY-

CiteScore

2.20

自引率

0.00%

发文量

154

审稿时长

73 days

期刊介绍： Manuscripts of high standard in the form of original research, multicentric studies, meta analysis, are accepted. Current reports can be submitted as brief communications. Case reports must include review of current literature, clinical details, outcome and follow up. Letters to the editor must be a comment on or pertain to a manuscript already published in the IJMM or in relation to preliminary communication of a larger study. Review articles, Special Articles or Guest Editorials are accepted on invitation.