黄金葡萄球菌 (Staphylococcus aureus) 小殖民地变种:在腹膜透析中可能被低估的微生物挑战
Markus Obermueller1, Ludwig Traby1, Matthias Weiss-Tessbach2
1Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria.
International journal of antimicrobial agents
|March 8, 2024
概括
腹膜透析液可以在体外诱导金黄色葡萄球菌的小殖民地变体 (SCVs). 这些SCV很难识别和测试,可能导致持久感染.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 腹膜炎是腹膜透析 (PD) 的一个主要并发症.
- 凝血酶阴性葡萄球菌在PD周周炎中很常见.
- 黄金葡萄球菌 (Staphylococcus aureus) 小殖民地变种 (SCVs) 可能解释了这种患病率.
研究的目的:
- 为了调查PD液是否会诱导金黄色细菌SCVs.
- 评估SCVs对微生物鉴定和抗微生物敏感性测试的影响.
- 评估不同识别方法对S. aureus SCVs的性能.
主要方法:
- 在体外,S. aureus暴露于PD液体 (PDFs).
- 确定最小抑制度 (MIC) 和生物膜形成.
- 全基因组测序以确定遗传改变.
- 测试各种微生物识别方法 (MALDI-TOF,PCR,API-Staph,VITEK-2). 这是一个非常好的方法.
主要成果:
- 含有葡萄糖的PDF诱导了稳定的金黄色细菌SCVs.
- SCVs显示增长减少,影响MIC读数 (44%较低的值).
- 大多数SCV具有非同义突变;很少有人表现出auxotrophy.
- MALDI-TOF,PCR和Pastorex Staph-Plus正确地识别了黄金色杆菌SCV,与API-Staph和VITEK-2不同.
结论:
- 商业上可用的PDF诱导S. aureusSCVs在体外.
- 在识别和抗微生物敏感性测试中,SCVs带来了挑战.
- 这些变异可能导致PD相关的感染复发或持续.
相关概念视频
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
953
Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
953
Peritoneal Dialysis I: Introduction and Procedure
7.1K
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
7.1K
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
1.8K
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
1.8K
Peritoneal Dialysis III: Nursing Management
1.5K
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
1.5K
Staphylococcal Skin Infections
89
Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...
89
Clinical Significance of Antibiotic Resistance
52
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within...
52


