Reduced susceptibility to vancomycin and biofilm formation in methicillin-resistant Staphylococcus epidermidis isolated from blood cultures

This study aimed to correlate the presence of ica genes, biofilm formation and antimicrobial resistance in 107 strains of Staphylococcus epidermidis isolated from blood cultures. The isolates were analysed to determine their methicillin resistance, staphylococcal cassette chromosome mec (SCCmec) type, ica genes and biofilm formation and the vancomycin minimum inhibitory concentration (MIC) was measured for isolates and subpopulations growing on vancomycin screen agar. The mecA gene was detected in 81.3% of the S. epidermidis isolated and 48.2% carried SCCmec type III. The complete icaADBC operon was observed in 38.3% of the isolates; of these, 58.5% produced a biofilm. Furthermore, 47.7% of the isolates grew on vancomycin screen agar, with an increase in the MIC in 75.9% of the isolates. Determination of the MIC of subpopulations revealed that 64.7% had an MIC ≥ 4 μg mL^-1, including 15.7% with an MIC of 8 μg mL^-1 and 2% with an MIC of 16 μg mL^-1. The presence of the icaADBC operon, biofilm production and reduced susceptibility to vancomycin were associated with methicillin resistance. This study reveals a high level of methicillin resistance, biofilm formation and reduced susceptibility to vancomycin in subpopulations of S. epidermidis. These findings may explain the selection of multidrug-resistant isolates in hospital settings and the consequent failure of antimicrobial treatment.     

表皮葡萄球菌生物膜形成分子机制的研究进展

细菌感染性疾病已成为了各临床科室关注的重要问题。其中条件致病感染菌具有耐药性 ,难以治疗 ,尤为棘手。表皮葡萄球菌 (Staphylococcusepidermidis)是重要的条件致病菌。近来 ,随多种插管、透析技术、人工心瓣膜、人工关节和人工晶体等医疗材料的广泛应用 ,人口老年化及免疫低下人群的出现等 ,生物膜感染上升为医院细菌感染的前 4位 ,并且感染后果日趋严重。表皮葡萄球菌作为存在于健康人皮肤表面的正常菌群并不致病 ,但可伴随“异物”(高分子材料如塑料等 )进入人体 ,并通过粘附形成生物膜 (Biofilm) ,入侵血循环而致败血症等。在生物膜…