对比临床,微生物学和遗传学定义的复发在患者的后续发作MRSA骨关节感染的病例
Kevin Bouiller1, Eleonora Cella2, Natasia F Jacko3
1Université Marie et Louis Pasteur, CHU Besançon, UMR-CNRS 6249 Chrono-environnement, Department of infectious and tropical diseases, F 25000 Besançon, France.
概括
区分复发性骨或关节感染 (BJIs) 是很困难的. 基因组分析优于临床或微生物学方法,用于识别耐甲基黄金葡萄球菌 (MRSA) BJI复发与新感染.
科学领域:
- 传染性疾病 传染性疾病
- 基因组学就是基因组学.
- 微生物学 微生物学
背景情况:
- 在复发性骨或关节感染 (BJIs) 中,区分复发和新感染是一个临床挑战.
- 甲素耐药黄金葡萄球菌 (MRSA) 是BJIs中常见的病原体,使治疗和复发管理复杂化.
研究的目的:
- 为了比较临床,微生物学和基因组定义的准确性,在患有复发性MRSA BJIs的患者中区分复发和新感染.
- 为了确定与复发性BJIs相关的因素,这些因素是由不同的甲基耐药黄金葡萄球菌血统引起的.
主要方法:
- 全基因组测序是在多次BJI发作患者的MRSA分离物上进行的.
- 通过基因组差异 (<100个单核酸多态) 定义了明显的内科基因系 (ISL).
- 临床,微生物学和多部位序列类型 (MLST) 定义与基因组黄金标准之间的一致性被使用科恩的卡帕评估.
主要成果:
- 在80名受试者中,有29名 (36%) 患有MRSA.的多个明显的人体内血统 (ISL).
- 临床标准显示,与复发的基因组定义的一致性较差 (kappa = -0.16).
- 微生物学和MLST标准显示出相应的公平 (kappa = 0.29) 和实质性 (kappa = 0.63) 协议.
结论:
- 临床和微生物学标准不足以准确区分BJI复发和新感染.
- 基因组定义,特别是识别不同的内基因系,提供了一种更可靠的方法来评估MRSA BJIs中的复发.
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