2023 Fiscal Year Final Research Report
Elucidation of virulence factors involved in the severity of Staphylococcus aureus pneumonia
| Project/Area Number |
19K18326
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 55060:Emergency medicine-related
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| Research Institution | Hiroshima University |
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Principal Investigator |
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| Project Period (FY) |
2019-04-01 – 2024-03-31
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| Keywords | S. aureus / MRSA / MSSA / DNAシークエンス / DNA解析 / 病原因子 |
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| Outline of Final Research Achievements |
We conducted a molecular epidemiological study of Staphylococcus aureus using whole-genome sequence data and clinical data of isolates from nasal swabs of patients admitted to ICU of Hiroshima University hospital. The nasal carriage rates of MRSA and MSSA in ICU patients were 7.0% and 20.1%, respectively. The carriage rate of CA-MRSA was 2.3%, accounting for 32.8% of all MRSA isolates. Most, including CA-MRSA and HA-MRSA, belonged to CC 8 (ST 8) and SCCmec type IV. Furthermore, results for disease foci and the assessment of virulence factor genes associated with disease conditions (bacteremia, ARDS, DIC, and septic shock) suggested that nasal colonization of S. aureus clones could represent a risk for patients within the ICU. Particularly, MRSA/J and MSSA/J may be more likely to cause deep abscess infection; ST764 may cause ventilation-associated pneumonia, hospital-acquired pneumonia and subsequent bacteremia, and ARDS, and tst-1-positive isolates may cause DIC onset.
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| Free Research Field |
救急集中治療
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| Academic Significance and Societal Importance of the Research Achievements |
ICUに入院している患者の鼻腔内でのMRSAの定着は、MRSA 感染の発症を予測する可能性があります。しかし、黄色ブドウ球菌感染症発症のリスク評価を行うための細菌学的データは存在しない。
この単一施設の2年間の遺伝子観察研究では、ICUに入院した患者の鼻腔から分離された黄色ブドウ球菌と、ICUで感染症を発症した入院患者の血液または病変から分離された黄色ブドウ球菌をすべて分析した。 さらに、ICUで感染症を引き起こす原因となっている毒性のクローンを特定した。
この情報は、毒性の強いMRSA株を特定して、選択的除菌を行い、ICUでの黄色ブドウ球菌の院内感染を減らす治療戦略につながる可能性がある。
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