A Multidrug-Resistant Staphylococcus epidermidis Clone (ST2) Is an Ongoing Cause of Hospital-Acquired Infection in a Western Australian Hospital

Abstract

Staphylococcus epidermidis is an important pathogen involved in health care-associated bloodstream infections and infections related to vascular catheters and prosthetic devices (17). Several investigations have demonstrated that certain multidrug-resistant S. epidermidis (MDRSE) genotypes become established as opportunistic pathogens in the health care setting as a novel ecological niche (8,10,12). In addition, recent studies identified several worldwide epidemic clonal lineages (9,12,13,18,21). Currently, little information is available on the molecular epidemiology of S. epidermidis in the health care setting in Australia (16,18).We have previously documented the occurrence and potential dissemination of two genotypes of MDRSE in 11 hospitals in northern Europe between 2001 and 2008. The aims of this study were to examine the molecular epidemiology of clinical isolates of MDRSE collected in a teaching hospital in Australia and determine the possible presence of previously described health careassociated MDRSE clones.

Comparative Epidemiology of Staphylococcus epidermidis Isolates from Patients with Catheter-Related Bacteremia and from Healthy Volunteers

“…The patients' clinical histories were also different in the two groups, as patients from the CRBSI-specific PFGE group were more often exposed to antibiotics within the month preceding the CRBSI episode, more often had a severe clinical presentation, and developed their CRBSI episode on a catheter 3 days "older" on average. ST2 isolates accounted for nearly 20% of all CRBSIs isolates and were thus not as frequently recovered as in other studies conducted in the United States, Australia, or Germany, where the majority of S. epidermidis isolates responsible for nosocomial infections belonged to ST2 (9,10,33). However, all of the ST2 isolates belonged to the CRBSIspecific PFGE group.…”

“…The most predominant of these lineages, clonal complex 2 (CC2), is composed of a large number of sequence types (STs), due to an unusually high rate of recombination within the lineage (8). One of these STs, ST2, was recognized as representing the majority of methicillin-resistant S. epidermidis (MRSE) clinical strains (9,10). ST2 isolates usually harbor the ica operon (11) and can carry different SCCmec types (12).…”

Genetic Analysis of Glycopeptide-Resistant Staphylococcus epidermidis Strains from Bone and Joint Infections

“…4). These findings show that the GRSE strains isolated from BJIs in the Paris area are representative of the populations of multidrugresistant strains circulating in hospitals worldwide (10,11,(29)(30)(31)(32)(33). Almost 95% of these strains belong to the STs of the main clonal complex, principally ST2, ST5, and ST23, and most of these strains are resistant to numerous antibiotics, such as oxacillin, macro- lides, quinolones, and fucidic acid.…”

Commentary: Significance of Staphylococcus epidermidis in Health Care-Associated Infections, from Contaminant to Clinically Relevant Pathogen: This Is a Wake-Up Call!

“…Over a period of several decades, CoNS and particularly Staphylococcus epidermidis have evolved as important opportunistic pathogens, primarily causing health care-associated infections in patients with indwelling medical devices (2,3). These infections were previously predominantly regarded as being of endogenous origin, but considerable evidence has been accumulated confirming that nosocomial genotypes of S. epidermidis colonize patients and health care personnel and cause a substantial proportion of health care-associated infections (4)(5)(6)(7)(8)(9)(10)(11). S. epidermidis is currently the main pathogen in catheter-related bloodstream infections and early-onset neonatal sepsis and is also a frequent cause of prosthetic joint infections, prosthetic valve endocarditis, and other biomedical device-related infections (12)(13)(14)(15).…”