Elimination of Epidemic Methicillin-Resistant<i>Staphylococcus aureus</i>from a University Hospital and District Institutions, Finland

Kotilainen, Pirkko; Routamaa, Marianne; Peltonen, R; Oksi, Jarmo; Rintala, Esa; Meurman, Olli; Lehtonen, Olli‐Pekka; Eerola, Erkki; Salmenlinna, Saara; Vuopio‐Varkila, Jaana; Rossi, T

doi:10.3201/eid0902.020233

Cited by 82 publications

(50 citation statements)

References 32 publications

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“…Infections with MRSA are known to be associated with considerable morbidity and mortality (8). Many studies have shown that effective control measures, including the systematic screening of persons exposed to MRSA, can confine or even eliminate the nosocomial spread of MRSA (31,36,41,43,50). However, standard culture methods for the identification of S. aureus and the determination of oxacillin susceptibility are time-consuming, usually requiring 2 to 4 days.…”

Section: Discussionmentioning

confidence: 99%

New Real-Time PCR Assay for Rapid Detection of Methicillin- ResistantStaphylococcus aureusDirectly from Specimens Containing a Mixture of Staphylococci

et al. 2004

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Molecular methods for the rapid identification of methicillin-resistant Staphylococcus aureus (MRSA) are generally based on the detection of an S. aureus-specific gene target and the mecA gene. However, such methods cannot be applied for the direct detection of MRSA from nonsterile specimens such as nasal samples without the previous isolation, capture, or enrichment of MRSA because these samples often contain both coagulasenegative staphylococci (CoNS) and S. aureus, either of which can carry mecA. In this study, we describe a real-time multiplex PCR assay which allows the detection of MRSA directly from clinical specimens containing a mixture of staphylococci in <1 h. Five primers specific to the different staphylococcal cassette chromosome mec (SCCmec) right extremity sequences, including three new sequences, were used in combination with a primer and three molecular beacon probes specific to the S. aureus chromosomal orfX gene sequences located to the right of the SCCmec integration site. Of the 1,657 MRSA isolates tested, 1,636 (98.7%) were detected with the PCR assay, whereas 26 of 569 (4.6%) methicillin-susceptible S. aureus (MSSA) strains were misidentified as MRSA. None of the 62 nonstaphylococcal bacterial species or the 212 methicillin-resistant or 74 methicillinsusceptible CoNS strains (MRCoNS and MSCoNS, respectively) were detected by the assay. The amplification of MRSA was not inhibited in the presence of high copy numbers of MSSA, MRCoNS, or MSCoNS. The analytical sensitivity of the PCR assay, as evaluated with MRSA-negative nasal specimens containing a mixture of MSSA, MRCoNS, and MSCoNS spiked with MRSA, was ϳ25 CFU per nasal sample. This real-time PCR assay represents a rapid and powerful method which can be used for the detection of MRSA directly from specimens containing a mixture of staphylococci.

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Section: Discussionmentioning

confidence: 99%

New Real-Time PCR Assay for Rapid Detection of Methicillin- ResistantStaphylococcus aureusDirectly from Specimens Containing a Mixture of Staphylococci

et al. 2004

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“…Methicillin-resistant and methicillin-sensitive strains were included as controls [14]. Methicillin resistance was further confirmed by the detection of the mecA gene by the PCR method.…”

Section: Identification and Antibiogram Of S Aureusmentioning

confidence: 99%

Phenotypic and molecular characterization of HA-MRSA in Taif hospitals, Saudi Arabia

Eed

Ghonaim

Hussein

et al. 2015

J Infect Dev Ctries

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Introduction: Methicillin-resistant S. aureus (MRSA) is one of the most important organisms causing hospital-acquired infections worldwide. Molecular analysis of MRSA strains from Taif, Saudi Arabia, had not been previously done. Phenotypic and molecular characteristics of MRSA isolated from Taif hospitals were investigated. Methodology: This study involved S. aureus strains isolated from different clinical samples from Taif hospitals. MRSA strains were identified and antimicrobial susceptibility profiles were determined. Multiplex polymerase chain reaction (PCR) was used to identify S. aureus-specific sequence, mecA genes, and type of staphylococcal cassette chromosome mec (SCCmec). MRSA strains were typed using coagulase gene polymorphism. Results: In total, 390 strains of S. aureus were isolated, and 58 MRSA strains -40 hospital-acquired MRSA (HA-MRSA) and 18 community-acquired MRSA (CA-MRSA) -were detected. HA-MRSA strains included three SCCmec types, while CA-MRSA strains included two SCCmec types. PCR amplification and restriction of the coagulase gene of the 58 MRSA isolates showed nine different patterns, while three strains were non-typable. HA-MRSA strains showed seven distinct restriction fragment length polymorphism (RFLP) patterns; the most frequent was pattern 2 (15 isolates), followed by patterns 1 and 4 (5 isolates each). CA-MRSA showed five RFLP patterns; the most frequent was pattern 3 (7 isolates) followed by pattern 8 (6 isolates). Conclusions: HA-MRSA strains were more common than CA-MRSA strains. SCCmec typing and coagulase gene polymorphism analysis may be useful methods for studying clonal relatedness of isolates and for discriminating between HA-MRSA and CA-MRSA.

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“…About 30% of the S. aureus causing bloodstream infections is methicillin resistant in the United Kingdom, whereas that proportion is ∼1% in The Netherlands and Scandinavian countries (7). Among countries with high endemic MRSA infection rates, the proportion is highest in large teaching hospitals (6,8), where the highest frequency of new emerging MRSA clones has also been reported (9)(10)(11)(12). The proposed reasons include increased antibiotic use and increased prevalence of medical procedures and serious medical conditions associated with MRSA acquisition and disease (13).…”

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confidence: 99%

Patient sharing and population genetic structure of methicillin-resistant Staphylococcus aureus

Ke¹,

Huang

Hudson

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

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Rates of hospital-acquired infections, specifically methicillin-resistant Staphylococcus aureus (MRSA), are increasingly being used as indicators for quality of hospital hygiene. There has been much effort on understanding the transmission process at the hospital level; however, interhospital population-based transmission remains poorly defined. We evaluated whether the proportion of shared patients between hospitals was correlated with genetic similarity of MRSA strains from those hospitals. Using data collected from 30 of 32 hospitals in Orange County, California, multivariate linear regression showed that for each twofold increase in the proportion of patients shared between 2 hospitals, there was a 7.7% reduction in genetic heterogeneity between the hospitals’ MRSA populations (permutation P value = 0.0356). Pairs of hospitals that both served adults had more similar MRSA populations than pairs including a pediatric hospital. These findings suggest that concerted efforts among hospitals that share large numbers of patients may be synergistic to prevent MRSA transmission.

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Elimination of Epidemic Methicillin-ResistantStaphylococcus aureusfrom a University Hospital and District Institutions, Finland

Cited by 82 publications

References 32 publications

New Real-Time PCR Assay for Rapid Detection of Methicillin- ResistantStaphylococcus aureusDirectly from Specimens Containing a Mixture of Staphylococci

New Real-Time PCR Assay for Rapid Detection of Methicillin- ResistantStaphylococcus aureusDirectly from Specimens Containing a Mixture of Staphylococci

Phenotypic and molecular characterization of HA-MRSA in Taif hospitals, Saudi Arabia

Patient sharing and population genetic structure of methicillin-resistant Staphylococcus aureus

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