保健相关耐甲氧西林金黄色葡萄球菌(HA-MRSA)和社区相关耐甲氧西林金黄色葡萄球菌(CA-MRSA)的特征、相关危险因素和可能的治疗

Rabeya Nahar Ferdous, Rashed Zaman, Shahedur Rahman, Oliullah Rafi, S. Dey, A. Khaleque, A. Parvez
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摘要

耐甲氧西林金黄色葡萄球菌(MRSA)长期以来一直是卫生保健设施中常见的病原体,但现在,它已成为社区环境中的一个问题病原体。医疗保健相关耐甲氧西林金黄色葡萄球菌(HA-MRSA)和社区相关耐甲氧西林金黄色葡萄球菌(CA-MRSA)菌株已成为医疗保健和社区相关环境中的重要病原体。CA-MRSA过去对大多数使用的抗生素敏感,但在过去的十年中,标准已经改变。虽然HA-MRSA最常见于尿液,但CA-MRSA负责引起尿路感染。因此聚合酶链反应(PCR)可作为鉴定金黄色葡萄球菌(nuc基因)、MRSA (mecA基因)、CA-MRSA (PVL基因)在SCCmec IV型中的金标准,而HA-MRSA可通过检测SCCmec I型、II型、III型来检测。而PVL基因的检测可以降低CA-MRSA和HA-MRSA的筛选成本和时间。确定靶基因后,可以进行测序,了解PVL基因可能发生的氨基酸变化或任何突变,从而改变CA-MRSA的特征。全基因组测序可以在塑造未来和确定MRSA在爆发或流行环境中的传播方面发挥重要作用。控制HA-MRSA和CA-MRSA相关感染的另一种方法是控制危险因素,在给感染者开处方之前确定抗生素很重要。虽然万古霉素对大多数MRSA有敏感性,但也发现了耐药模式。MRSA疫苗的开发可能会对HA-MRSA和CA-MRSA相关的一些感染引起的发病率和死亡率产生巨大影响。然而,需要进一步的工作来评估它们在控制MRSA相关感染方面的长期作用
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Characterization, Associated Risk Factors and Possible Treatment of Healthcare Associated Methicillin-Resistant Staphylococcus aureus (HA-MRSA) and Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA)
Methicillin-Resistant Staphylococcus aureus (MRSA) has long been a common pathogen in healthcare facilities, but now, it has emerged as a problematic pathogen in the community setting as well. Healthcare-Associated Methicillin- Resistant S. aureus (HA-MRSA) and Community-Associated Methicillin-Resistant S. aureus (CA-MRSA) strains have appeared as a significant pathogen in healthcare and community-associated settings. The CA-MRSA used to be susceptible to mostly used antibiotics, but the criteria have been changed for past decade. Although HA-MRSA most commonly found in urine but CA-MRSA responsible for causing UTI. So Polymerase Chain Reaction (PCR) can be used as gold standard to characterize S. aureus (nuc gene), MRSA (mecA gene), CA-MRSA (PVL gene in SCCmec types IV). On the other hand, HA-MRSA can be detected by the detection of SCCmec types I, II, or III. But detection of PVL gene may reduce cost and time to screen CA-MRSA and HA-MRSA. After identifying targeting gene, sequencing can be carried out to know amino acid changes or any mutation that may occur in PVL gene and may change the characteristics of CA-MRSA. Whole genome sequencing can play a vital role for shaping the future and identifying transmission of MRSA in outbreak or endemic settings. Another way to control infection associated with HA-MRSA and CA-MRSA is to control risk factors and important to identify the antibiotics before prescribing to the infected person. Though vancomycin has susceptibility to most of MRSA but resistant pattern has also been found. Development of vaccines against MRSA may have dramatic impacts upon morbidity and mortality caused by a number of infection associated with HA-MRSA and CA-MRSA. However, further work is required to assess their long-term roles in controlling infection associated with MRSA
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