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Romero LC, de Souza da Cunha MLR. Insights into the epidemiology of community-associated methicillin-resistant Staphylococcus aureus in special populations and at the community-healthcare interface. Braz J Infect Dis 2021; 25:101636. [PMID: 34672988 DOI: 10.1016/j.bjid.2021.101636] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/15/2021] [Indexed: 02/07/2023] Open
Abstract
The current epidemic proportions of infections caused by Staphylococcus aureus strains and especially by methicillin-resistant S. aureus (MRSA) are one of today's many threats to global public health, particularly in underdeveloped countries where significant gaps on the subject exist. The rapid spread and diversification of pandemic clones that exhibit remarkably increasing virulence and antimicrobial resistance pose a risk to the effective prevention and treatment of a wide range of infections. Undoubtedly, the remarkable versatility involving the pathogenesis and resistance of these bacteria is perpetuated through geographic and temporal factors inherent to clonal evolution and is reflected in the dramatic epidemiological changes of MRSA which, after decades prevailing in healthcare settings, have emerged in the community. Denominated community-associated [CA]-MRSA, these strains are particularly prevalent in some population groups, facilitating the spread of successful clones that are potentially capable of triggering severe community-acquired infections. Therefore, a broad approach to local epidemiological aspects in less studied regions, but nonetheless at latent risk of endemic spread that may reach global proportions, is necessary. In Brazil, despite limited molecular epidemiology data, CA-MRSA strains predominantly characterized as SCCmec IV, often classified as CC30-ST30, CC5-ST5 and CC8-ST8, seem to be spreading across different population groups in different regions of the country. Another important fact addressed in this review is the identification of the ST398-MRSA-IV/V clone and methicillin-susceptible S. aureus (MSSA) in healthy individuals from the community. Although susceptible to methicillin, the ST398 clone is associated with severe infections in humans and animals, denominated livestock-associated MRSA. It is therefore important to encourage assertive actions by all government sectors and by society, with a reassessment of current public health measures in light of the new perspectives arising from the scientific and epidemiological data on MRSA.
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da Silva LS, Andrade YM, Oliveira AC, Cunha BC, Oliveira EG, Cunha TS, Mafra SS, Almeida JB, Carvalho SP, Nascimento FS, Santos Junior MN, Chamon RC, Santos KR, Campos GB, Marques LM. Prevalence of methicillin-resistant Staphylococcus aureus colonization among healthcare workers at a tertiary care hospital in northeastern Brazil. Infect Prev Pract 2020; 2:100084. [PMID: 34368723 PMCID: PMC8336055 DOI: 10.1016/j.infpip.2020.100084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Staphylococcus aureus is a human pathogen of clinical importance related to a variety of infections. AIM The objective of this study was to analyze the molecular and epidemiological characteristics of S. aureus obtained from healthcare professionals (HCP) of a hospital in southwestern Bahia, Brazil. METHODS Samples were collected from hands, nasal cavity, and laboratory coats of 80 HCP. The bacterial isolates recovered from 240 samples were identified as S. aureus, and then analyzed for their antimicrobial resistance profile, genotypic characterization, and pathogenicity. FINDINGS 178 isolates were identified as S. aureus, being mostly isolated from the nasal cavity. Thirty isolates (16.8%) were characterized as MRSA. The virulence gene frequency varied according to isolate source. All virulence genes were identified in at least one hand isolate. Isolates from laboratory coats did not show seb and pvl. Isolates from the nasal cavity did not exhibit pvl. The SCCmec type I was identified in 56.7% of MRSA isolates. Among MRSA isolates, 14 PFGE pulsotypes were characterized, with profile A being predominant (nine isolates). Clonal complexes CC5, CC45, and CC398 were found. MRSA isolates induced cytokine gene expression in macrophages, with IL-10 and IL-17 being expressed more often. CONCLUSION We found a high colonization rate for S. aureus among HCP. Moreover, we observed that MRSA strains presented different virulence factors and could induce cytokine gene expression, indicating an urgent need to control colonization rates of HCP by MRSA isolates in order to protect hospital patients and the general public.
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Affiliation(s)
- Lucas S.C. da Silva
- State University of Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Ilhéus, Brazil
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Yasmin M.F.S. Andrade
- State University of Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Ilhéus, Brazil
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Arianne C. Oliveira
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Beatriz C. Cunha
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Eliana G. Oliveira
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Tamara S. Cunha
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Suzelle S. Mafra
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Jéssica B. Almeida
- State University of Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Ilhéus, Brazil
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Suzi P. Carvalho
- State University of Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Ilhéus, Brazil
| | - Flávia S. Nascimento
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Manoel Neres Santos Junior
- State University of Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Ilhéus, Brazil
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Raiane C. Chamon
- Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Pathology Department, Medicine Faculty, Fluminense Federal University (UFF), Niterói, Brazil
| | - Kátia R.N. Santos
- Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Guilherme B. Campos
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - Lucas M. Marques
- State University of Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Ilhéus, Brazil
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
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Andrade MM, Luiz WB, da Silva Oliveira Souza R, Amorim JH. The History of Methicillin-Resistant Staphylococcus aureus in Brazil. ACTA ACUST UNITED AC 2020; 2020:1721936. [PMID: 33082892 DOI: 10.1155/2020/1721936] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/21/2020] [Accepted: 09/24/2020] [Indexed: 12/20/2022]
Abstract
Since the emergence of MRSA in the 1960s, a gradual increase in infections by resistant bacteria has been observed. Clinical manifestations may vary from brand to critical condition due to host risk factors, as well as pathogen virulence and resistance. The high adaptability and pathogenic profile of MRSA clones contributed to its spread in hospital and community settings. In Brazil, the first MRSA isolates were reported in the late 1980s, and since then different genetic profiles, such as the Brazilian epidemic clone (BEC) and other clones considered a pandemic, became endemic in the Brazilian population. Additionally, Brazil's MRSA clones were shown to be able to transfer genes involved in multidrug resistance and enhanced pathogenic properties. These events contributed to the rise of highly resistant and pathogenic MRSA. In this review, we present the main events which compose the history of MRSA in Brazil, including numbers and locations of isolation, as well as types of staphylococcal cassette chromosome mec (SCCmec) found in the Brazilian territory.
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Pereira-Franchi EPL, Barreira MRN, da Costa NDSLM, Riboli DFM, Abraão LM, Martins KB, Victória C, Cunha MDLRDSD. Molecular epidemiology of methicillin-resistant Staphylococcus aureus in the Brazilian primary health care system. Trop Med Int Health 2019; 24:339-347. [PMID: 30549385 DOI: 10.1111/tmi.13192] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate the molecular epidemiology and to georeference Staphylococcus aureus isolated from wounds and nares of patients seen at Basic Health Units (BHUs) of a Brazilian city. METHODS Observational, cross-sectional study conducted from 2010 to 2013. A total of 119 S. aureus strains isolated from the wounds and nares of 88 patients were studied. The isolates were characterised by identifying virulence genes encoding enterotoxins A-E, haemolysins α, β and δ, exfoliatins A, B and D, biofilm production, Panton-Valentine Leukocidin and toxic shock syndrome toxin 1, and by pulsed-field gel electrophoresis (PFGE), multilocus sequence and spa typing. RESULTS Eighteen methicillin-resistant Staphylococcus aureus (MRSA) (6 SCCmec type II and 12 SCCmec type IV) and 101 (85%) MSSA were identified. PFGE typing resulted in the formation of eight clusters, with STs 1, 5, 8, 30, 188, 1176 and 1635 and spa type t002 being the predominant types among MSSA. The 18 MRSA belonged to STs 5, 8 and 1176 and spa types t002 and t062. CONCLUSION The results demonstrate widespread dissemination of MSSA and MRSA clones carrying haemolysin, biofilm and toxin genes. Kernel density estimation revealed the highest density of S. aureus in the 4, 5 and 8 BHUs.
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Affiliation(s)
- Eliane Patricia Lino Pereira-Franchi
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil
| | - Maria Rachel Nogueira Barreira
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil
| | - Natália de Sousa Lima Moreira da Costa
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil
| | - Danilo Flávio Moraes Riboli
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil
| | - Ligia Maria Abraão
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil.,Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil
| | - Katheryne Benini Martins
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil
| | - Cassiano Victória
- Departamento de Higiene Veterinária e Saúde Pública, Faculdade de Medicina Veterinaria e Zootecnia, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, Brazil
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Bonesso MF, Marques SA, Camargo CH, Fortaleza CMCB, da Cunha MDLRDS. Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections. Braz J Microbiol 2015; 45:1401-7. [PMID: 25763047 PMCID: PMC4323316 DOI: 10.1590/s1517-83822014000400034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 04/17/2014] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to determine the prevalence of Staphylococcus aureus and risk factors for the acquisition of MRSA (Methicillin Resistant Staphylococcus aureus) as the main cause of skin and soft tissue infections. S. aureus were characterized for the presence of PVL, TSST-1 and mecA genes. SCCmec typing was carried out in mecA positive strains and PFGE was performed only in these strains. During the study period, 127 outpatients attending a dermatology clinical the Botucatu Medical School, a regional tertiary hospital in Botucatu, Sao Paulo, Brazil, were diagnosed with active skin infections. A total 66 (56.9%) S. aureus strains were isolated. The methicillin resistance gene mecA was detected in seven (10.6%) S. aureus strains. The SCCmec types detected in the seven mecA-positive S. aureus strains were type Ia in one, type II in three, and type IV in three. The PVL gene was detected in 10 (15.1%) in sensitive strains. Pulsed field gel electrophoresis revealed non-clonal diversity among the isolates. The risk factors associated with MRSA acquisition in this study were previous ciprofloxacin use and working in a healthcare environment. The risk factors indicate plausible routes of CA-MRSA transmission among the subjects studied.
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Affiliation(s)
- Mariana Fávero Bonesso
- Departamento de Microbiologia e Imunologia Instituto de Biociencias de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Microbiologia e Imunologia, Instituto de Biociencias de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil. ; Departamento de Doenças Tropicais Faculdade de Medicina de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
| | - Silvio Alencar Marques
- Departamento de Dermatologia e Radiologia Faculdade de Medicina de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Dermatologia e Radiologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
| | - Carlos Henrique Camargo
- Departamento de Microbiologia e Imunologia Instituto de Biociencias de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Microbiologia e Imunologia, Instituto de Biociencias de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
| | - Carlos Magno Castelo Branco Fortaleza
- Departamento de Doenças Tropicais Faculdade de Medicina de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
| | - Maria de Lourdes Ribeiro de Souza da Cunha
- Departamento de Microbiologia e Imunologia Instituto de Biociencias de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Microbiologia e Imunologia, Instituto de Biociencias de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
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Pires FV, da Cunha MDLRDS, Abraão LM, Martins PYF, Camargo CH, Fortaleza CMCB. Nasal carriage of Staphylococcus aureus in Botucatu, Brazil: a population-based survey. PLoS One 2014; 9:e92537. [PMID: 24663818 PMCID: PMC3963891 DOI: 10.1371/journal.pone.0092537] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 02/23/2014] [Indexed: 11/29/2022] Open
Abstract
Recent increases in the incidence and severity of staphylococcal infections renewed interest in studies that assess the burden of asymptomatic carriage of Staphylococcus aureus in the community setting. We conducted a population-based survey in the city of Botucatu, Brazil (122,000 inhabitants), in order to identify the prevalence of nasal carriage of Staphylococcus aureus (including methicillin-resistant strains). Nasal swabs were obtained from 686 persons over one year of age. Resistance to methicillin was assessed through phenotypic methods, identification of the mecA gene and typing of the Staphylococcal Chromosome Cassette mec (SCCmec). Methicillin-resistant S. aureus (MRSA) isolates were characterized using Pulsed-Field Gel Electrophoresis (PFGE), Multilocus Sequence Typing (MLST) and spa typing. Polymerase chain reaction was applied to identify genes coding for Panton-Valentine Leukocidin (PVL) in isolates. The prevalence of overall S. aureus carriage was 32.7% (95%CI, 29.2%–36.2%). Carriers were significantly younger (mean age, 28.1 versus 36.3 for non-carriers; OR for age, 0.98; 95%CI, 0.97–0.99) and likely to report recent skin infection (OR, 1.85; 95%CI, 1.03–3.34). Carriage of methicillin-resistant S. aureus (MRSA) was found in 0.9% of study subjects (95%CI, 0.4%–1.8%). All MRSA isolates harbored SCCmec type IV, and belonged to spa types t002 or t021, but none among them harbored genes coding for PLV. In MLST, most isolates belonged to clones ST5 or ST1776. However, we found one subject who carried a novel clone, ST2594. Two out of six MRSA carriers had household contacts colonized with isolates similar to theirs. Our study pointed to dissemination of community-associated MRSA among the Brazilian population.
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Affiliation(s)
- Fabiana Venegas Pires
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | | | - Lígia Maria Abraão
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | - Patrícia Y. F. Martins
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | - Carlos Henrique Camargo
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
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Roberts MC, Soge OO, No D. Comparison of Multi-Drug Resistant Environmental Methicillin-Resistant Staphylococcus aureus Isolated from Recreational Beaches and High Touch Surfaces in Built Environments. Front Microbiol 2013; 4:74. [PMID: 23577006 PMCID: PMC3616243 DOI: 10.3389/fmicb.2013.00074] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 03/14/2013] [Indexed: 11/13/2022] Open
Abstract
Over the last decade community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major cause of disease in the general population with no health care exposure or known classical risk factors for MRSA infections. The potential community reservoirs have not been well defined though certain strains such as ST398 and USA300 have been well studied in some settings. MRSA has been isolated from recreational beaches, high-touch surfaces in homes, universities, and other community environmental surfaces. However, in most cases the strains were not characterized to determine if they are related to community-acquired or hospital-acquired clinical strains. We compared 55 environmental MRSA from 805 samples including sand, fresh, and marine water samples from local marine and fresh water recreational beaches (n = 296), high touch surfaces on the University of Washington campus (n = 294), surfaces in UW undergraduate housing (n = 85), and the local community (n = 130). Eleven USA300, representing 20% of the isolates, were found on the UW campus surfaces, student housing surfaces, and on the community surfaces but not in the recreational beach samples from the Northwest USA. Similarly, the predominant animal ST133 was found in the recreational beach samples but not in the high touch surface samples. All USA300 isolates were multi-drug resistant carrying two to six different antibiotic resistance genes coding for kanamycin, macrolides and/or macrolides-lincosamides-streptogramin B, and tetracycline, with the majority (72%) carrying four to six different antibiotic resistance genes. A surprising 98% of the 55 MRSA isolates were resistant to other classes of antibiotics and most likely represent reservoirs for these genes in the environment.
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Affiliation(s)
- Marilyn C Roberts
- Department of Environmental and Occupational Health Sciences, University of Washington Seattle, WA, USA
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Espadinha D, Faria NA, Miragaia M, Lito LM, Melo-Cristino J, de Lencastre H; Médicos Sentinela Network. Extensive dissemination of methicillin-resistant Staphylococcus aureus (MRSA) between the hospital and the community in a country with a high prevalence of nosocomial MRSA. PLoS One 2013; 8:e59960. [PMID: 23593155 DOI: 10.1371/journal.pone.0059960] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 02/20/2013] [Indexed: 11/19/2022] Open
Abstract
According to the EARS-Net surveillance data, Portugal has the highest prevalence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) in Europe, but the information on MRSA in the community is very scarce and the links between the hospital and community are not known. In this study we aimed to understand the events associated to the recent sharp increase in MRSA frequency in Portugal and to evaluate how this has shaped MRSA epidemiology in the community. With this purpose, 180 nosocomial MRSA isolates recovered from infection in two time periods and 14 MRSA isolates recovered from 89 samples of skin and soft tissue infections (SSTI) were analyzed by pulsed-field gel electrophoresis (PFGE), staphylococcal chromosome cassette mec (SCCmec) typing, spa typing and multilocus sequence typing (MLST). All isolates were also screened for the presence of Panton Valentine leukocidin (PVL) and arginine catabolic mobile element (ACME) by PCR. The results showed that ST22-IVh, accounting for 72% of the nosocomial isolates, was the major clone circulating in the hospital in 2010, having replaced two previous dominant clones in 1993, the Iberian (ST247-I) and Portuguese (ST239-III variant) clones. Moreover in 2010, three clones belonging to CC5 (ST105-II, ST125-IVc and ST5-IVc) accounted for 20% of the isolates and may represent the beginning of new waves of MRSA in this hospital. Interestingly, more than half of the MRSA isolates (8/14) causing SSTI in people attending healthcare centers in Portugal belonged to the most predominant clones found in the hospital, namely ST22-IVh (n = 4), ST5-IVc (n = 2) and ST105-II (n = 1). Other clones found included ST5-V (n = 6) and ST8-VI (n = 1). None of the MRSA isolates carried PVL and only five isolates (ST5-V-t179) carried ACME type II. The emergence and spread of EMRSA-15 may be associated to the observed increase in MRSA frequency in the hospital and the consequent spillover of MRSA into the community.
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Teixeira MM, Araújo MC, Silva-Carvalho MC, Beltrame CO, Oliveira CCHB, Figueiredo AMS, Oliveira AG. Emergence of clonal complex 5 (CC5) methicillin-resistant Staphylococcus aureus (MRSA) isolates susceptible to trimethoprim-sulfamethoxazole in a Brazilian hospital. Braz J Med Biol Res 2012; 45:637-43. [PMID: 22527128 PMCID: PMC3854277 DOI: 10.1590/s0100-879x2012007500065] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 04/09/2012] [Indexed: 12/03/2022] Open
Abstract
In this study, genotyping techniques including staphylococcal chromosomal cassette mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and restriction-modification tests were used to compare the molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered at two times within a 10-year interval (1998 and 2008) from a tertiary Brazilian hospital. In addition, the antimicrobial susceptibility profiles were analyzed. All 48 MRSA isolates from 1998 and 85.7% from 2008 (48/56 isolates) displayed multidrug-resistance phenotypes and SCCmec III. All but one of the 13 representative SCCmec III isolates belonged to CC8 and had PFGE patterns similar to that of the BMB9393 strain (Brazilian epidemic clone of MRSA; BEC). In 2008, we found an increased susceptibility to rifampicin and chloramphenicol among the SCCmec III isolates. In addition, we detected the entrance of diverse international MRSA lineages susceptible to trimethoprim-sulfamethoxazole (SXT), almost all belonging to CC5. These non-SCCmec III isolates were related to the USA300 (ST8-SCCmec IV; PFGE-type B), USA800 (ST5-SCCmec IV; subtype D1), USA100 (ST5-SCCmec II; subtype D2), and EMRSA-3/Cordobes (ST5-SCCmec I, type C) clones. To the best of our knowledge, this is the first report of the emergence of isolates genetically related to the EMRSA-3/Cordobes clone in southeast Brazil. In this regard, these isolates were the most common non-SCCmec III MRSA in our institution, accounting for 8.9% of all isolates recovered in 2008. Thus, despite the supremacy of BEC isolates in our country, significant changes may occur in local MRSA epidemiology, with possible consequences for the rationality of MRSA empiric therapy.
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Affiliation(s)
- M M Teixeira
- Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
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Bádue Pereira MF, Mimica MJ, de Lima Bigelli Carvalho R, Scheffer DK, Berezin EN. High rate of Staphylococcus aureus oropharyngeal colonization in children. J Infect 2011; 64:338-40. [PMID: 22155659 DOI: 10.1016/j.jinf.2011.11.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 11/26/2011] [Accepted: 11/28/2011] [Indexed: 11/17/2022]
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