1887

Abstract

This study aimed to correlate the multidrug resistance (MDR) and sequence type (ST) clones of community-associated (CA) meticillin-resistant (MRSA) to identify the genes responsible for clindamycin and mupirocin resistance in isolates from paediatric hospitals in mainland China. A total of 435 isolates were collected. Compared with CA meticillin-susceptible (MSSA), the resistance rates of CA-MRSA to ciprofloxacin, chloramphenicol, gentamicin and tetracycline were higher (19.0 vs 2.6 %, <0.001; 14.7 vs 3.1 %, <0.001; 14.7 vs 3.1 %, <0.01; and 46.0 vs 13.3 %, <0.001, respectively). Compared with hospital-associated (HA)-MRSA, the resistance rates of CA-MRSA to ciprofloxacin, gentamicin, rifampicin, tetracycline and trimethoprim–sulfamethoxazole were lower (19 vs 94.8 %, <0.001; 14.7 vs 84.4 %, <0.001; 5.5 vs 88.3 %, <0.001; 46 vs 94.8 %, <0.001; and 1.8 vs 9.1 %, <0.01, respectively). The resistance rates of CA-MRSA, HA-MRSA and CA-MSSA to clindamycin (92.0, 77.9 and 64.1 %, respectively) and erythromycin (85.9, 77.9 and 63.1 %, respectively) were high. The MDR rates (resistance to three or more non-β-lactams) were 49.6, 100 and 14 % in the CA-MRSA, HA-MRSA and CA-MSSA isolates, respectively. Five of seven ST clones in the CA-MRSA isolates, namely ST59, ST338, ST45, ST910 and ST965, had MDR rates of >50 % (67.9, 87.5, 100, 50 and 83.3 %, respectively). The constitutive phenotype of macrolide–lincosamide–streptogramin B (MLS) resistance (69 %) and the gene (38.1 %) predominated among the MLS-resistant CA strains. The resistance rate to mupirocin was 2.3 % and plasmids carrying the gene varied in size between 23 and 54.2 kb in six strains with high-level resistance as determined by Southern blot analysis. The present study showed that resistance to non-β-lactams, especially to clindamycin, is high in CA-MRSA isolates from Chinese children and that the profile of resistance is related to clonal type. This study revealed distinctive patterns of MLS-resistant genes among CA isolates.

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2012-09-01
2019-10-17
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