1887

Abstract

, including meticillin-sensitive and -resistant (MSSA and MRSA, respectively), is associated with severe nosocomial human infections. This study aimed to investigate the molecular profile, including the dynamic changes and genotype/phenotype correlation, of isolates recovered from different clinical specimens of inpatients with infection over a 6-year span at a teaching hospital in Shanghai, China. Between 2005 and 2010, a random sample of 610 unique isolates was collected from different clinical samples of inpatients with infection for molecular and antibiotic susceptibility analysis. The results showed that, among the 610 isolates, 20 sequence types (STs) determined by multi-locus sequence typing (primarily ST239, ST5, ST7, ST188 and ST398) and 52 types (primarily t002, t037, t030 and t601) were found. In total, 444 isolates (72.8 %) were MRSA and 166 (27.2 %) were MSSA. ST239-MRSA-III- t037 and ST5-MRSA-II- t002 were the predominant MRSA clones. From 2005 to 2010, t002, t037 and their corresponding STs (ST5 and ST239) were the most frequent clones among all of the isolates and showed the most resistant phenotypes to various antibiotics. Generally, the different genotypes showed different drug resistance rates, but no isolates were resistant to vancomycin, teicoplanin or linezolid. The profiles of virulence and resistance genes differed by genetic background, with the ST239 and ST5 strains showing higher resistance rates to gentamicin, cefoxitin, ampicillin, cefazolin, erythromycin, clindamycin and levofloxacin than strains of other types. Moreover, the antiseptic resistance genes were generally associated with these two types. The prevalence of STs was different among different clinical specimens and also changed by year. Recently (2009–2010), the distribution of predominant MRSA clones decreased, whilst the prevalence of non-predominant MSSA clones increased, especially for the isolates causing bacteraemia. Continual monitoring of clinical isolates is necessary to develop and maintain an effective strategy against infection in the hospital setting.

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2013-02-01
2024-12-03
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