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降低了黄金葡萄球菌 (Staphylococcus aureus) 临床分离物中的万科胺素敏感性:一系列不太研究的不确定性

Christine E Tawfeek¹, Sally Khattab¹, Nermine Elmaraghy¹

¹Medical Microbiology and Immunology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

BMC infectious diseases

|October 30, 2024

概括

该研究发现,在临床隔离物中,抗万素黄金葡萄球菌 (VRSA) 的流行率较低,但异质的万素中间体黄金葡萄球菌 (hVISA) 的发病率显著. 这凸显了检测耐药性的潜在挑战,并强调了需要谨慎使用万科米辛的必要性.

科学领域:

临床微生物学临床微生物学
传染性疾病传染性疾病
抗微生物耐药性抗微生物耐药性

背景情况:

黄金葡萄球菌分离物与万科米MIC为2μg/ml与治疗失败和异质的万科米中间体黄金葡萄球菌 (hVISA) 现型有关.
旺科米辛耐药性基因 (van genes) 通常表明MIC较高,但异种耐药性往往被低估.
目前用于测试香草素敏感性的方法显示性能变化,使医院的治疗决策复杂化.

研究的目的:

调查临床黄金葡萄球菌 (Staphylococcus aureus) 隔离物中万科米辛耐药性和异种耐药性的流行情况.
评估不同的方法来检测减少的万科米辛敏感性和hVISA表型.
评估vanA和vanB基因的存在与万科米辛敏感性有关.

主要方法:

选了195个临床样本的金黄色细菌,确定了100个分离物.
使用赛福西盘和mecA基因检测抗甲素黄金色杆菌 (MRSA).
通过PCR对vanA和vanB基因进行查;使用vancomycin agar查,微稀释 (BMD) 和VITEK2.2评估降低的香草素敏感性.
使用PBP-AUC方法在血液中分离的hVISA查.

主要成果:

范菌素亚格查发现了16/96个具有降低敏感性的MRSA分离物;进一步测试证实7个是范菌素中间体S. aureus (VISA) 和1个是VRSA.
使用PAP-AUC方法检测到hVISA表型在16.7% (4/24) 的血液隔离物中.
通过PCR检测到5% (5/100) 的S. aureus分离物中发现了vanA基因,其中两个是VISA.

结论:

该研究报告了VRSA的低患病率 (1%),但在S. aureus血液分离物中,hVISA表型 (16.7%) 的显着存在.
百分之五十的分离物在阿加屏幕上显示敏感性降低,对BMD和VITEK2敏感,这表明潜在的检测限制.
在VSSA和VISA分离物 (5%) 中vanA的无声携带表明未被识别的因素有助于旺科米辛治疗失败,需要谨慎的处方.

关键词:

黄金葡萄球菌黄金葡萄球菌埃及埃及埃及埃及在MRSA中,MRSA可能是MRSA.减少了万科米辛的敏感性.签证签证是一个签证.这就是VRSA VRSA.这是VSA VSSA.范科米辛是一种药物.这是一个hVISASA.

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