Abstract
Aims & Objectives: We aimed to evaluate the clonal and drug-resistance dynamics of (Methicillin-resistant Staphylococcus aureus) MRSA in Chinese children from 2010 to 2016. Methods Totally 170 MRSA isolates were recovered from Beijing Children’s hospital from 2010 to 2016. The genotypic characteristics of all strains were determined. Antimicrobial susceptibility testing was performed by agar dilution method except sulphamethoxazole/trimethoprim (E-test method). Panton-Valentine leukocidin (pvl) gene was detected by PCR assay. Results Eighty-four isolates were classified as Community-associated Methicillin-resistant Staphylococcus aureus (CA-MRSA). ST59-SCCmecIV-t437-agrI was the most prevalent both in CA-MRSA (47.6%) and healthcare-associated MRSA (HA-MRSA) (46.5%). ST239-SCCmecIII-t030-agrI accounted for 14.0% of total HA-MRSA isolates, which had not been determined in 2016. The prevalence of pvl was similar among CA- and HA- MRSA (p=0.0805). There were no changes in antibiotic resistance in CA-MRSA from 2010 to 2016. HA-MRSA demonstrated an overall trend of decreased resistant to tetracycline, gentamicin, ciprofloxacin, rifampin, and an increased resistant to chloramphenicol during the studied period, which were basically consistent with the difference of antibiotic resistance patterns between ST59-SCCmecIV and ST239-SCCmecIII isolates. The percentage of isolates with minimal inhibitory concentration (MIC) ≥1 mg/L increased from 45.0% in 2010–2013 to 87.1% in 2016, and meanwhile, the percentage of isolates with MIC=0.5 mg/L decreased from 55.0% (55/100) to 12.9 (p<0.0001). Conclusions ST59-SCCmecIV had spread to hospital and replaced the traditional hospital associated ST239-SCCmecIII clone, which were accompanied by changes in drug resistance. Furthermore, vancomycin MIC creep indicated that the rational use of antibiotics should be taken seriously.
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