https://scholars.lib.ntu.edu.tw/handle/123456789/583915
標題: | Sequence type 8 as an emerging clone of methicillin-resistant Staphylococcus aureus causing bloodstream infections in Taiwan | 作者: | PAO-YU CHEN YU-CHUNG CHUANG JANN-TAY WANG WANG-HUEI SHENG YEE-CHUN CHEN SHAN-CHWEN CHANG |
關鍵字: | ACME; PVL; USA300; multilocus sequence typing; spa typing | 公開日期: | 十二月-2021 | 卷: | 10 | 期: | 1 | 來源出版物: | Emerging microbes & infections | 摘要: | Sequence type (ST) 8 has not been a common methicillin-resistant Staphylococcus aureus (MRSA) clone in Asia until recently. We aimed to determine the clinical significance and microbiological characteristics of MRSA bacteraemia (MRSAB) caused by ST8 and other endemic clones. A total of 281 non-duplicated MRSAB were identified in a medical centre between 2016 and 2018. Sequencing of target genes was performed to determine ST and to confirm ST8 belonging to USA300. Antimicrobial susceptibility testing was performing by using Sensititre standard panel. In total, ST8 accounted for 18.5% of MRSAB ranking after ST239 (31.0%) and ST59 (23.5%). However, it increased to become the most prevalent clone finally. All ST8 isolates belonged to spa clonal complex008, and carried SCCmec IV/IVa, PVL and ACME genes, indicating USA300. ST8/USA300 isolates were highly susceptible to non-β-lactams antibiotics, except fluoroquinolone and erythromycin. ST8/USA300 MRSAB is commonly developed in community settings with either healthcare risks or not (71.2%). Compared to other STs MRSAB, ST8/USA300 MRSAB patients had more diabetes mellitus (50.0%), more admitted from long-term care facility residents (25.0%), had more skin ad soft tissue infection as primary focus (25.0%), and had fewer vascular devices (26.9%) at MRSAB onset. On multivariable analysis, isolates with vancomycin MIC were significantly associated with mortality in the dose-response relationship, rather than STs. This report depicts the clinical features of ST8/USA300 MRSAB and clonal shift from prior endemic clones to ST8/USA300. Our data strongly support long-term surveillance to ascertain whether ST8/USA300 will successfully disseminate and demonstrate its pathogenicity on clinical outcomes. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/583915 | ISSN: | 2222-1751 | DOI: | 10.1080/22221751.2021.1981158 | SDG/關鍵字: | ciprofloxacin; clindamycin; cotrimoxazole; daptomycin; erythromycin; gentamicin; linezolid; oxacillin; rifampicin; tetracycline; vancomycin; antiinfective agent; bacterial DNA; adult; aged; antibiotic sensitivity; Article; bacterial gene; clone; controlled study; diabetes mellitus; erythromycin resistance; female; fluoroquinolone resistance; human; major clinical study; male; methicillin resistant Staphylococcus aureus infection; minimum inhibitory concentration; mortality; nonhuman; nursing home; skin infection; soft tissue infection; Taiwan; bacteremia; classification; drug effect; genetics; methicillin resistant Staphylococcus aureus; microbiology; middle aged; retrospective study; skin infection; soft tissue infection; Staphylococcus infection; very elderly; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; DNA, Bacterial; Female; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Retrospective Studies; Skin Diseases, Infectious; Soft Tissue Infections; Staphylococcal Infections; Taiwan |
顯示於: | 醫學系 |
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