Clinical impact of methicillin-resistant staphylococcus aureus on bacterial pneumonia: cultivation and 16S ribosomal RNA gene analysis of bronchoalveolar lavage fluid

BMC Infectious Diseases

Research Article

Kazumasa Fukuda¹  Hatsumi Taniguchi¹  Kentarou Akata²  Hiroshi Ishimoto²  Toshinori Kawanami²  Kei Yamasaki²  Takashi Kido²  Kazuhiro Yatera²  Shingo Noguchi²  Keisuke Naito²  Hiroshi Mukae² 

[1] Department of Microbiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, 807-8555, Kitakyushu city, Fukuoka, Japan;Department of Respiratory Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, 807-8555, Kitakyushu city, Fukuoka, Japan;

关键词: 16S rRNA gene;    Staphylococcus aureus,;    Clone library;    Contamination;    Pneumonia;    Bronchoalveolar lavage, BALF;    Pneumonia;   

DOI  :  10.1186/s12879-016-1493-3

 received in 2015-08-26, accepted in 2016-04-01,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundDetermining whether methicillin-resistant Staphylococcus aureus (MRSA) is a true causative pathogen or reflective of colonization when MRSA is cultured from the respiratory tract remains important in treating patients with pneumonia.MethodsWe evaluated the bacterial microbiota in bronchoalveolar lavage fluid (BALF) using the clone library method with a 16S ribosomal RNA (rRNA) gene analysis in 42 patients from a pneumonia registry who had MRSA cultured from their sputum or BALF samples. Patients were divided into two groups: those treated with (Group A) or without (Group B) anti-MRSA agents, and their clinical features were compared.ResultsAmong 248 patients with pneumonia, 42 patients who had MRSA cultured from the respiratory tract were analyzed (Group A: 13 patients, Group B: 29 patients). No clones of S. aureus were detected in the BALF of 20 out of 42 patients. Twenty-eight of 29 patients in Group B showed favorable clinical outcomes, indicating that these patients had non-MRSA pneumonia. Using a microflora analysis of the BALF, the S. aureus phylotype was predominant in 5 of 28 (17.9 %) patients among the detected bacterial phylotypes, but a minor population (the percentage of clones ≤ 10 %) in 19 (67.9 %) of 28 patients. A statistical analysis revealed no positive relationship between the percentage of clones of the S. aureus phylotype and risk factors of MRSA pneumonia.ConclusionsThe molecular method using BALF specimens suggests that conventional cultivation method results may mislead true causative pathogens, especially in patients with MRSA pneumonia. Further studies are necessary to elucidate these clinically important issues.

【 授权许可】

CC BY   
© Kawanami et al. 2016