Streptococcus agalactiae carriage was evaluated by sampling four body sites in a group of 249 healthy individuals including both sexes and a wide range of ages; the aims were to study the population structure of colonizing strains by multilocus sequence typing (MLST) and to evaluate their diversity by serotyping, SmaI macrorestriction analysis, and PCR screening for genetic markers of highly virulent clones for neonates. The prevalences of carriage were 27% in women and 32% in men. The major positive body site was the genital tract (23% in women and 21% in men); skin, throats, and anal margins were also positive in 2%, 4%, and 14%, respectively. These human-colonizing strains belonged mostly to serotypes III (24%), Ia (21%), V (18%), and Ib (17%). Twenty-three sequence types ( Streptococcus agalactiae is the pathogen most commonly responsible for maternofetal and neonatal infections, and serogroup III sequence type (ST) 17 strains of this species have been identified as more likely to cause these infections (3,17,(24)(25)(26)28).S. agalactiae infections in nonpregnant adults have been reported increasingly since the 1970s (5,7,10,14,20,21,23,26,27). The major clinical forms consist of skin, soft tissue, and bone infections; bacteremia; urinary tract infections; pneumonia; and peritonitis. More rarely, S. agalactiae is responsible for septic arthritis, meningitis, and endocarditis. Risk factors have been identified (16) and include an age of over 60 years and diagnoses of diabetes, cancer, decubitus acutus, AIDS, longcourse corticotherapy, chronic renal disease, cirrhosis, and neurological vessel disorders. However, cases of invasive S. agalactiae infections in immunocompetent nonpregnant adults have recently been reported (7,20,21,23). The physiopathology of these infections is not well understood and may be linked in part to S. agalactiae strains with particular properties.Reports on the genetic characteristics of the strains associated with infections in adults showed that they are diverse and belong mostly to serotypes Ia, III, and V (5, 14) and clonal complexes 1, 9, 17, 19, and 23 (17).The portal of entry of these infections in adults is not often well documented. A better knowledge of the genetic characteristics of the S. agalactiae strains colonizing various body sites would contribute to a better understanding of the origin of infections in adults. Although the molecular features of S. agalactiae strains isolated during infectious diseases have been described in many cases, little is known about the molecular characteristics of human-colonizing strains. Therefore, we screened for S. agalactiae carriage in 249 healthy individuals of both sexes; the individuals were living at home and covered a range of ages, from the start of the teenage period until old age. Genital, skin, throat, and anal margin carriage was sampled by self-swabbing. The strains isolated were serotyped. The population structure of the strains was investigated by multilocus sequence typing (MLST). The genetic diversity of isolates was ev...

Legionella anisa is one of the most frequent species of Legionella other than Legionella pneumophila in the environment and may be hospital acquired in rare cases. We found that L. anisa may mask water contamination by L. pneumophila, suggesting that there is a risk of L. pneumophila infection in immunocompromised patients if water is found to be contaminated with Legionella species other than L. pneumophila.

Erythromycin resistance varied according to the clinical origin, serotype and molecular characteristics of S. agalactiae strains.

Skin and osteoarticular infections (SKI and OAI, respectively) account for almost one-third of Streptococcus agalactiae infections in nonpregnant adults. We evaluated the genetic diversity and phylogeny of 58 S. agalactiae strains responsible for adult SKI or OAI and of 61 S. agalactiae strains from cases of adult human colonization (HCol) by serotyping and multilocus sequence typing (MLST). We also assessed the prophage DNA content of the genomes of these strains by a PCR-based method. We found that 63% of SKI and 56% of OAI occurred in people aged 55 years and over. Overall, 71% of SKI strains were of serotype Ia or V, and 91% of OAI strains were of serotype Ia, III, or V. Strains of clonal complexes 1 and 23 (CC1 and CC23) were associated with 79% of SKI cases and 62% of OAI cases. Seven groups of strains, groups A, B, C, D, E, F, and G, were obtained by performing a hierarchical analysis on the basis of prophage DNA-PCR data. We found that 85% of CC1 strains clustered in DNA prophage group D, the group with the highest prophage DNA content (average, 4.4; average of absolute deviations [AVEDEV], 0.9). The CC23 strains displayed the greatest diversity in prophage DNA fragment content, but 47% of CC23 strains clustered in group B, which also had a high average prophage DNA content per strain (average, 2.3; AVEDEV, 0.6). Many (65%) of the OAI strains were in prophage DNA group D, whereas 83% of the SKI strains were in prophage DNA groups B and D. These data suggest that S. agalactiae strains from CC1 and CC23 may be subject to particular transduction mechanisms in gene recombination, rendering them particularly capable of invading the skin, bone, or joints in adults.

Methicillin-resistant S. aureus (MRSA) frequently causes disease outbreaks and has become endemic in many regions, adding to the morbidity, mortality, and cost of care associated with hospital-acquired infections. Enhanced surveillance and infection control measures have been adopted by healthcare institutions (HCIs) to address this unresolved problem (5). In particular, reporting of bloodstream infections (BSI) by MRSA is often mandatory and reduction of BSI rates is a performance target (5,12,21).In the Centre region of France, an extensive, prospective, longitudinal, region-wide survey of BSI has been under way since 2000. Data are collected for 3 months of each year in a large number of HCIs to establish a comprehensive picture of the epidemiology of severe hospital-acquired infections. MRSA BSI and methicillin-sensitive S. aureus (MSSA) BSI are extensively studied within this framework. All of the S. aureus strains isolated during successive study periods are sent to our central laboratory for susceptibility testing, molecular typing, and analysis of virulence genes with the aim of determining the spread and diversity of S. aureus strains in the region. The results obtained during the first 4 years of surveillance (2000 to 2003) of MRSA BSI have been reported previously (27).Here we report the data from 2004 to 2006. We looked for any major changes in the epidemiology of antibiotic resistance and of virulence genes in strains of S. aureus responsible for BSI. We identify a need to focus efforts on preventing both MRSA and MSSA BSI infections and raise the issue of whether the use of fluoroquinolones (FQs) has contributed to the acquisition of resistance and virulence genes by S. aureus strains. MATERIALS AND METHODSBSI epidemiological survey method. A BSI surveillance program in the Centre region of France (2.5 million inhabitants) and a microbiological study of S. aureus strains isolated from BSI cases have been conducted since 2000. Thirtytwo HCIs, comprising 6,027 short-stay beds, participated in this annual 3-month survey of all cases of BSI. Here, we report results for the years 2004 to 2006. The survey covered 2,007,681 patient days (PD). The methods, study design, and data for the years 2000 to 2003 have been reported elsewhere (27). Briefly, the variables studied included patient age and sex, portal of entry, community-or hospital-acquired BSI, occurrence of death within 7 days of BSI diagnosis, and duration of hospital stay. Data were analyzed with Epi Info v.6 software. Data were analyzed with a 2 test with five degrees of freedom. The incidences of community-acquired and nosocomial BSI were determined with respect to the number of PD.Microbiological methods. (i) Bacteriology. Three hundred fifty-eight BSIassociated S. aureus strains were collected during the three survey periods (2004, 2005, and 2006). The strains were sent to the reference laboratory of the Relais d'Hygiène du Centre. The isolates were identified as S. aureus according to previously described procedures (27).(ii) Antimicrobial ...