北部某區域醫院門診乳腺炎個案抗耐甲氧西林金黃色葡萄球菌之分子流行病學分析

Epidemiological Analysis of Methicillin-Resistant Staphylococcus aureus Causing Mastitis at a Regional Hospital in Northern Taiwan

目的：耐甲氧西林金黃色葡萄球菌（MRSA）常引起乳腺炎患者治療的問題。我們以台灣北部某區域醫院門診中MRSA乳腺炎檢體進行研究，以了解細菌株之分子特性與流行趨勢。方法：共收集40名門診患者檢體，以聚合酶反應進行金黃色葡萄球菌殺白血球殺傷素（PVL）、葡萄球菌蛋白A（SPA）和抗藥之移動式卡式基因複合體（SCCmec）基因進行分析。結果：總體而言，SCCmec分型中可發現了四種抗藥型別，包括了25株（62.5％）的SCCmec V_T，9株（22.5％）的SCCmec III，5株（12.5％）的SCCmec IV，僅有1株（2.5％）為SCCmecV。MRSA分離株均含有與社區相關的PVL基因（100％）。主要的SPA型別為t437共38株（95.0％），只有2個分離株（5.0％）為t019型。結論：乳腺炎可能造成母親和寶寶的不適，延遲或不適當的治療會導致乳房組織損傷和復發感染，這些對母親和嬰兒健康是非常重要的。建議未來能進行更多實驗研究並提供適宜的藥物治療。 Purposes Methicillin-resistant Staphylococcus aureus (MRSA) often causes treatment problems in mastitis patients. We studied MRSA mastitis isolates from the outpatient clinic of a regional hospital in northern Taiwan to understand the molecular characteristics and epidemiological trends of these strains. Methods A total of 40 outpatient samples were collected. Polymerase chain reaction was used for genetic analysis of the Panton-Valentine leukocidin (PVL) gene, staphylococcal protein A (SPA), and staphylococcal cassette chromosome (SCCmec). Results Overall, SCCmec typing revealed 4 types, including 25 strains (62.5%) of SCCmec VT, 9 (22.5%) of SCCmec III, 5 (12.5%) of SCCmec IV and only 1 (2.5%) of SCCmec V. All of the community-associated MRSA isolates harbored the PVL gene (100%). The major SPA types included 38 strains (95.0%) of t437, with only 2 strains (5.0%) of t019. Conclusions Mastitis can cause substantial discomfort for the affected mother and her baby. Delayed, inappropriate, or inadequate treatment may result in breast tissue damage and recurrence. These factors are also important in terms of maternal and child health. It is recommended that more laboratory studies be conducted in the future and appropriate drug treatment be provided.

Purposes Methicillin-resistant Staphylococcus aureus (MRSA) often causes treatment problems in mastitis patients. We studied MRSA mastitis isolates from the outpatient clinic of a regional hospital in northern Taiwan to understand the molecular characteristics and epidemiological trends of these strains. Methods A total of 40 outpatient samples were collected. Polymerase chain reaction was used for genetic analysis of the Panton-Valentine leukocidin (PVL) gene, staphylococcal protein A (SPA), and staphylococcal cassette chromosome (SCCmec). Results Overall, SCCmec typing revealed 4 types, including 25 strains (62.5%) of SCCmec VT, 9 (22.5%) of SCCmec III, 5 (12.5%) of SCCmec IV and only 1 (2.5%) of SCCmec V. All of the community-associated MRSA isolates harbored the PVL gene (100%). The major SPA types included 38 strains (95.0%) of t437, with only 2 strains (5.0%) of t019. Conclusions Mastitis can cause substantial discomfort for the affected mother and her baby. Delayed, inappropriate, or inadequate treatment may result in breast tissue damage and recurrence. These factors are also important in terms of maternal and child health. It is recommended that more laboratory studies be conducted in the future and appropriate drug treatment be provided.