[Molecular characterization of Staphylococcus aureus strains isolated from surgical site infections of patients in southern Poland].

Monika Pomorska-Wesolowska, Katarzyna Malyzek, Dorota Romaniszyn, Monika Pobiega, Anna Szczypta, Miroslawa Dzikowska, Agnieszka Chmielarczyk, Anna Różańska, Joanna Maciąg, Jadwiga Wójkowska-Mach
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Abstract

Introduction: The aim of the study was a molecular characterization of Staphylococcus aureus strains isolated from surgical site infections (SSIs) from patients in southern Poland, undergoing different surgical procedures, together with evaluation of the prevalence of antimicrobial resistance and the presence of virulence factors.

Materials and methods: In this laboratory-based, multicenter study, non-repetitive 162 samples from SSI were collected from hospitalized patients (12 hospitals, n=139) or outpatients (n=23) in southern Poland between January 1 and December 31, 2013. In all S. aureus isolates, we investigated antimicrobial susceptibility, the presence of selected virulence genes (lukE, pvl, tsst-l and eta), and also conducted spa typing.

Results: Patients with SSI had a median age of 61 years; 54.9% were male. Prevalence of MRSA (29 strains, 17.9%) SSI per surgery type was 8.7% in orthopaedic, 17.7% in general and 42.9% in vascular surgery. Over 20% of strains were resistant for erythromycin (27.2%), clindamycin (23.5%). No resistance was found for linezolid, glycopeptides or tigecycline. Gene of Leukocidin (lukE) was the most frequently found gene. Spa typing identified 10 spa types; the two dominant types were t003 (41.4%) and t138(17.2%).

Conclusions: The results show that after vascular surgery, there was an unexpectedly high prevalence of MRSA in SSIs in southern Poland. Conversely, the prevalence of MRSA was unexpectedly low following orthopaedics procedures. The surprisingly observation was the low virulence of the S. aureus strains among older patients.

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[波兰南部手术部位感染患者分离的金黄色葡萄球菌菌株的分子特征]。
本研究的目的是对波兰南部接受不同外科手术的患者手术部位感染(ssi)中分离的金黄色葡萄球菌菌株的分子特征进行分析,并评估其耐药性的流行程度和毒力因子的存在。材料和方法:在这项以实验室为基础的多中心研究中,从2013年1月1日至12月31日期间波兰南部住院患者(12家医院,n=139)或门诊患者(n=23)中收集了162份非重复性SSI样本。在所有金黄色葡萄球菌分离株中,我们研究了抗菌药物敏感性,选择的毒力基因(lukE, pvl, tsst- 1和eta)的存在,并进行了spa分型。结果:SSI患者中位年龄61岁;54.9%为男性。MRSA(29株,17.9%)各手术类型的SSI患病率分别为骨科8.7%、普通外科17.7%和血管外科42.9%。超过20%的菌株对红霉素(27.2%)和克林霉素(23.5%)耐药。利奈唑胺、糖肽类和替加环素均未发现耐药。白细胞抑制素(Leukocidin, lukE)基因是发现最多的基因。Spa分型识别出10种Spa类型;两种优势型分别为t003(41.4%)和t138(17.2%)。结论:结果显示,在血管手术后,MRSA在波兰南部ssi意外地高流行。相反,在骨科手术后,MRSA的患病率出乎意料地低。令人惊讶的观察结果是金黄色葡萄球菌菌株在老年患者中的毒性较低。
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