一地区MRSA长达八年的分子流行病学变化的监测统计（JCM Nov）

David

Journal of Clinical Microbiology, November 2007, p. 3729-3736, Vol. 45, No. 11
对一地区MRSA长达八年的分子流行病学变化的监测统计
Changing Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Small Geographic Area over an Eight-Year Period

D. S. Blanc,1* C. Petignat,1 A. Wenger,1 G. Kuhn,1 Y. Vallet,1 D. Fracheboud,2 S. Trachsel,3 M. Reymond,4 N. Troillet,5 H. H. Siegrist,6 S. Oeuvray,7 M. Bes,8 J. Etienne,8 J. Bille,1 P. Francioli,1 and G. Zanetti1
Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne,1 Microbiology Laboratory, Canton Hospital of Fribourg, Fribourg,2 Analysa Laboratory, Yverdon-les-Bains,3 Polyanalytic Laboratory, Lausanne,4 Central Institute of the Valais Hospitals, Sion,5 Institute of Microbiology of Neuchâtel, La Chaud-de-Fonds,6 Jura Hospital Laboratory, Porentruy, Switzerland,7 French National Reference Center for Staphylococci, University of Lyon, Lyon, France8

Received 7 March 2007/ Returned for modification 4 May 2007/ Accepted 5 September 2007

The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) at an international level shows that most MRSA strains belong to a few pandemic clones. At the local level, a predominance of one or two clones was generally reported. However, the situation is evolving and new clones are emerging worldwide, some of them with specific biological characteristics, such as the presence of Panton-Valentine leucocidin (PVL). Understanding these changes at the local and international levels is of great importance. Our objective was to analyze the evolution of MRSA epidemiology at multiple sites on a local level (Western Switzerland) over a period of 8 years. Data were based on MRSA reports from seven sentinel laboratories and infection control programs covering different areas. Pulsed-field gel electrophoresis was used to type MRSA isolates. From 1997 to 2004, a total of 2,256 patients with MRSA were reported. Results showed the presence of four predominant clones (accounting for 86% of patients), which could be related to known international clones (Berlin, New York/Japan, Southern Germany, and Iberian clones). Within the small geographic region, the 8-year follow-up period in the different areas showed spacio-temporal differences in the relative proportions of the four clones. Other international MRSA clones, as well as clones showing genetic characteristics identical to those of community-acquired MRSA (SCCmec type IV and the presence of PVL genes), were also identified but presumably did not disseminate. Despite the worldwide predominance of a few MRSA clones, our data showed that at a local level, the epidemiology of MRSA might be different from one hospital to another. Moreover, MRSA clones were replaced by other emerging clones, suggesting a rapid change.

右手心

国际水平的MRSA流行研究表明,一些MRSA菌株属于世界广泛性流行的繁殖.

绿茵场

谢谢David版的分享，:handshake 学习ing...:handshake
《美国医学会杂志》在今年刊登了一份政府调查报告，指有一种被称为“超级病菌”的耐甲氧西林金黄色葡萄球菌（MRSA）正在美国国内蔓延，每年预计有超过9万人严重感染这一病菌，被列为世界三大最难解决感染性疾患第一位。专家预计，这种“超级病菌”在美国每年致死的人数可能会超过艾滋病。
  我们国家形势更为严峻，形势逼人，不得不学！:victory:

绿茵场

现将David版的文献翻译下，本人水平有限，请大家多多指点哦。并且期待更专业的翻译出现...就算是抛砖引玉哈吧。:P

世界范围，MRSA的流行病学显示大多数的MRSA链属于几种主要克隆体。在当地，通常报道的是一种或者两种克隆体占主要。然而，这种状况正在发生变化，新的克隆体正在全世界范围内出现，其中一些出现特殊的生物学特征，例如Panton-Valentine杀白细胞素的出现。了解这些在当地和国际上发生的变化是很重要的。我们的目就是分析发生在瑞士西部地多数地区的长达8年MRSA流行病学变化。资料来源于7个监测实验室和覆盖不同地区的感染控制程序所报道的MRSA事件。应用脉冲凝胶电泳场来对MRSA分型。1997至2004年间，总共有2256例MRSA报道。结果显示，出现了四个主要的克隆体（占86％）， 且被认为与国际上的克隆体有联系（分别是柏林，纽约/日本，德国南部和伊伯利亚的克隆体）。在小区域内部，8年的随访结果显示，不同地区四种克隆体的构成比随空间改变而发生了相应的变化。尽管一些MRSA克隆体在全世界范围内占主要，但是我们的资料显示，在当地MRSA的流行病学特征因不同医院而有所区别。其他国际上的MRSA克隆体，显示与社区获得性MRSA同源，也被确认但可能不会传播开来。此外，MRSA克隆体被其他克隆体所取代，变化很快。

红樱桃

icchina确实有魄力，办SIFIC网上论坛的idea，把一件大家都想做但却无法做到的有意义的事情做到近乎完美。佩服！佩服！

David

如果计算死亡率，SARS在MRSA面前根本就是小弟弟:L

柳莹依

研究者的执着、Daivd的积极传播、绿茵场的热心，没啥说的了。

怡之秋

真诚感谢老师们无私的分享。。。问好各位老师。