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Andrews V, Hasman H, Midttun M, Feldthaus MB, Porsbo LJ, Holzknecht BJ, Scheutz F, Hess CE, Olesen B. A hospital outbreak of an NDM-producing ST167 Escherichia coli with a possible link to a toilet. J Hosp Infect 2021; 117:186-187. [PMID: 34481891 DOI: 10.1016/j.jhin.2021.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Affiliation(s)
- V Andrews
- Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
| | - H Hasman
- Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - M Midttun
- Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - M B Feldthaus
- Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - L J Porsbo
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - B J Holzknecht
- Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - F Scheutz
- Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - C E Hess
- Department of Nephrology and Endocrinology, Copenhagen University Hospital - North Zealand Hospital, Hillerød, Denmark
| | - B Olesen
- Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
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Bartels MD, Worning P, Andersen LP, Bes M, Enger H, Ås CG, Hansen TA, Holzknecht BJ, Larssen KW, Laurent F, Mäkitalo B, Pichon B, Svartström O, Westh H. Repeated introduction and spread of the MRSA clone t304/ST6 in northern Europe. Clin Microbiol Infect 2020; 27:284.e1-284.e5. [PMID: 32439595 DOI: 10.1016/j.cmi.2020.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/13/2020] [Accepted: 05/03/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES During the last decades several methicillin-resistant Staphylococcus aureus (MRSA) clones with the capability of global spread have emerged in the community. Here, we have investigated a large collection of clinical isolates belonging to MRSA clone t304/ST6, which has emerged in many European countries over the last years, in order to retrace its phylogeny and its spread. METHODS We characterized 466 ST6 isolates from Denmark (n = 354), France (n = 10), Norway (n = 24), Sweden (n = 27) and the UK (n = 51). All had spa-type t304 (n = 454) or t304-related spa-types (n = 12) and whole genome sequencing (WGS) was carried out on Illumina Miseq or Hiseq with 100-300 bp reads. cgMLST was performed using Ridom SeqSphere. RESULTS A minimum spanning tree (MST) of all 466 isolates showed one large cluster including 182 isolates collected only from Denmark and related to a long-term neonatal outbreak in Copenhagen. This cluster contrasted with numerous small clusters, including the remaining Danish isolates and isolates from the other countries that interspersed throughout the tree. Most isolates were Panton-Valentine leukocidin (PVL) negative (95%) and harboured SCCmec IVa. One genome was closed using Oxford Nanopore technology and Illumina MiSeq. It contained a plasmid of 19.769 bp including the blaZ gene. A similar plasmid was found in 78% of all isolates. DISCUSSION t304/ST6 is a successful emerging clone and the fact that isolates from five countries are interspersed throughout the MST indicates a common origin. This clone is commonly described in the Middle East and its emergence in Europe coincides with influx of refugees from the Syrian Civil War.
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Affiliation(s)
- M D Bartels
- Department of Clinical Microbiology, MRSA Knowledge Centre, Hvidovre Hospital, Denmark.
| | - P Worning
- Department of Clinical Microbiology, MRSA Knowledge Centre, Hvidovre Hospital, Denmark
| | - L P Andersen
- Department of Clinical Microbiology, Rigshospitalet, Denmark
| | - M Bes
- Institute for Infectious Agents - Department of Bacteriology, French National Reference Centre for Staphylococci, Lyon, France
| | - H Enger
- Norwegian MRSA Reference Laboratory, Department of Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - C G Ås
- Norwegian MRSA Reference Laboratory, Department of Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - T A Hansen
- Department of Clinical Microbiology, MRSA Knowledge Centre, Hvidovre Hospital, Denmark
| | - B J Holzknecht
- Department of Clinical Microbiology, Herlev Gentofte Hospital, Denmark
| | - K W Larssen
- Department of Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - F Laurent
- Institute for Infectious Agents - Department of Bacteriology, French National Reference Centre for Staphylococci, Lyon, France
| | - B Mäkitalo
- Public Health Agency of Sweden, Solna, Sweden
| | - B Pichon
- Public Health England, National Infection Service, London, UK
| | | | - H Westh
- Department of Clinical Microbiology, MRSA Knowledge Centre, Hvidovre Hospital, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Marbjerg LH, Holzknecht BJ, Dargis R, Dessau RB, Nielsen XC, Christensen JJ. Commercial bacterial and fungal broad-range PCR (Micro-Dx™) used on culture-negative specimens from normally sterile sites: diagnostic value and implications for antimicrobial treatment. Diagn Microbiol Infect Dis 2020; 97:115028. [PMID: 32278620 DOI: 10.1016/j.diagmicrobio.2020.115028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/09/2020] [Accepted: 02/20/2020] [Indexed: 10/24/2022]
Abstract
The aim of this study was to evaluate the clinical value of partial 16S/18S rRNA gene sequencing with the commercial kit Micro-Dx™ used with the SelectNA™plus instrument on culture-negative samples. A retrospective study of microbiological and clinical data from a 2.5-year period was performed. Assessment of the clinical relevance of the 16S/18S rRNA gene sequencing results was based on evaluation of the results in the clinical context and changes in antimicrobial therapy. Included were 529 samples from 223 patients, representing 251 episodes. In 191 samples (36.1%), bacterial/fungal DNA was detected. Positive results were judged clinically relevant in 79 (31.5%) episodes. Antimicrobial treatment was adjusted according to the 16S/18S rRNA gene sequence analysis result in 42 (16.7%) episodes. The results from 16S/18S rRNA gene sequence analysis were highly clinically relevant. These findings support the use of this analysis in a routine setting.
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Affiliation(s)
- L H Marbjerg
- Department of Clinical Microbiology, Slagelse Hospital, Region Zealand, Denmark; Department of Clinical microbiology, Odense University Hospital, Odense, Denmark; Department of Clinical microbiology, Vejle Hospital, Vejle, Denmark.
| | - B J Holzknecht
- Department of Clinical Microbiology, Slagelse Hospital, Region Zealand, Denmark; Department of Clinical Microbiology, Herlev and Gentofte Hospital, Herlev, Denmark
| | - R Dargis
- Department of Clinical Microbiology, Slagelse Hospital, Region Zealand, Denmark
| | - R B Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Region Zealand, Denmark; Department of Regional Health Research, University of Southern Denmark
| | - X C Nielsen
- Department of Clinical Microbiology, Slagelse Hospital, Region Zealand, Denmark
| | - J J Christensen
- Department of Clinical Microbiology, Slagelse Hospital, Region Zealand, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Holzknecht BJ, Dargis R, Pedersen M, Pinholt M, Christensen JJ. Typing of vancomycin-resistant enterococci with MALDI-TOF mass spectrometry in a nosocomial outbreak setting. Clin Microbiol Infect 2018; 24:1104.e1-1104.e4. [PMID: 29581054 DOI: 10.1016/j.cmi.2018.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/11/2018] [Accepted: 03/13/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To investigate the usefulness of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) typing as a first-line epidemiological tool in a nosocomial outbreak of vancomycin-resistant Enterococcus faecium (VREfm). METHODS Fifty-five VREfm isolates, previously characterized by whole-genome sequencing (WGS), were included and analysed by MALDI-TOF MS. To take peak reproducibility into account, ethanol/formic acid extraction and other steps of the protocol were conducted in triplicate. Twenty-seven spectra were generated per isolate, and spectra were visually inspected to determine discriminatory peaks. The presence or absence of these was recorded in a peak scheme. RESULTS Nine discriminatory peaks were identified. A characteristic pattern of these could distinguish between the three major WGS groups: WGS I, WGS II and WGS III. Only one of 38 isolates belonging to WGS I, WGS II or WGS III was misclassified. However, ten of the 17 isolates not belonging to WGS I, II or III displayed peak patterns indistinguishable from those of the outbreak strain. CONCLUSIONS Using visual inspection of spectra, MALDI-TOF MS typing proved to be useful in differentiating three VREfm outbreak clones from each other. However, as non-outbreak isolates could not be reliably differentiated from outbreak clones, the practical value of this typing method for VREfm outbreak management was limited in our setting.
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Affiliation(s)
- B J Holzknecht
- Department of Clinical Microbiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark.
| | - R Dargis
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - M Pedersen
- Department of Clinical Microbiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark; Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - M Pinholt
- Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - J J Christensen
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark; Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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