Epidemiological and Biological Characteristics of Methicillin-Resistant Staphylococcal Infections in a Mexican Hospital

Urdez-Hernández, Elena; Sifuentes–Osornio, José; Calva, Juan J.; Villalobos-Zapata, Yvonne

doi:10.1016/s0188-0128(99)00031-7

Cited by 10 publications

(7 citation statements)

References 61 publications

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“…In this study, we isolated several staphylococcal strains from different clinical samples. The staphylococcal clinical species most commonly isolated were S. aureus, S. epidermidis, and S. hominis, a distribution similar to those found by other authors (Ammendolia et al 1999, Urdez-Hernandez et al 1999. S. lugdunensis, S. capitis, S. warnerii, and S. cohnii subsp.…”

Section: Discussionsupporting

confidence: 86%

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Slime production and antibiotic susceptibility in staphylococci isolated from clinical samples

Arslan

Özkardeş

2007

Mem. Inst. Oswaldo Cruz

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Slime production is considered to be a significant virulence factor for some strains of staphylococci (Christensen et al. 1982, Davenport et al. 1986, Kleeman et al. 1993, Ammendolia et al. 1999, Mack et al. 2000. In coagulase-negative staphylococci (CNS), a loosely bound exopolysaccharides layer (slime) has been found in addition to capsule, and it has been associated with sepsis, including intravenous-catheter-related bacteremia and other prosthetic device infections (Ishak et al. 1985, Diaz-Mitoma et al. 1987, Etienne et al. 1988, Rupp & Archer 1994.Similarly, Staphylococcus aureus strains have bacterial capsules, which are closely associated with the bacterial cell wall. These strains may also have an extracapsular and labile extrapolysaccharidic structure (Caputy & Costerton 1982). Formerly slime production of S. aureus has never been considered as a virulence factor. Recently, some investigators reported that slimeproducing S. aureus strains had a higher colonization capacity than its non-slime-producing variants did. Therefore, S. aureus slime may play a role in the establishment of infection (Baselga et al. 1993, Ammendolia et al. 1999.The importance of the role played by slime is further increased by its frequent association to reduced antibiotic susceptibility (Kloos & Bannerman 1994). The difficulty in eradicating a chronic infection associated with slime formation has been reported, and slime-producing bacteria has been shown to resist higher antibiotic concentrations than non-slime-producing bacteria (Gristina et al. 1987). Moreover, detection of resistance to oxacillin in staphylococci is important to guide the therapy and prevent the patient from being unnecessarily treated with vancomycin, which is an antimicrobial agent that presents therapeutic complications, high costs, and may lead to the selection of resistant mutants (Marshall et al. 1999).In this study, we wanted to evaluate the occurrence of slime production among clinical isolates of both CNS and S. aureus by comparing different methods. To assess the relationship between slime and pathogenicity, we investigated the susceptibility to certain antimicrobial agents, particularly oxacillin. MATERIALS AND METHODSBacterial isolates -One hundred eighty seven staphylococcal isolates, provided by hospital laboratory, were obtained from culture of several specimens; 117 isolated from throat and nasal swabs, 32 from wounds, 21 from urine, 9 from blood, and 8 from catheters. Table I shows distribution of species and clinical samples in the 187 staphylococcal strains. These staphylococcal strains, specifically 115 S. aureus strains, 34 S. epidermidis strains, eight S. chromogenes strains, eight S. hominis strains, three S. saprophyticus strains, one S. lugdunensis strain, one S. capitis strain, one S. haemolyticus strain, one S. warneri strain, one S. cohnii subsp. cohnii strain, isolated from diverse clinical sources were studied. Isolates were characterized at the species level by the API Staph system (Biomerieux, France) according to the instruc...

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Section: Discussionsupporting

confidence: 86%

“…S. lugdunensis, S. capitis, S. warnerii, and S. cohnii subsp. cohnii were less frequent although these strains have also been isolated from several clinical specimens (Kleeman et al 1993, Urdez-Hernandez et al 1999. S. epidermidis was the most prevalent species isolated among clinical strains of CNS.…”

Section: Discussionmentioning

confidence: 99%

Slime production and antibiotic susceptibility in staphylococci isolated from clinical samples

Arslan

Özkardeş

2007

Mem. Inst. Oswaldo Cruz

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“…Methicillin resistance was detected in 73% of CoNS isolates from these episodes and in 88% of isolates from nosocomially acquired infections. Independent risk factors for MRCoNS bacteremia at hospital admission were similar to those identified for nosocomial MR-CoNS bacteremia [8][9][10], including the presence of a CVC, admission from long-term care facilities or nursing homes, receipt of antibiotic therapy within the previous 30 days, and previous MRSA infection or colonization. The strongest predictor was the presence of a CVC, which increased the risk for MR-CoNS bacteremia by 15-fold.…”

Section: Discussionmentioning

confidence: 62%

“…In contrast, the epidemiology of nosocomial CoNS bacteremia has been well defined. The independent risk factors associated with nosocomial CoNS bacteremia include intravenous access, acute leukemia, previous documentation of CoNS colonization, malignancies, neutropenia, and previous receipt of antibiotic therapy [1,[8][9][10].…”

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confidence: 99%

Epidemiological Comparison of True Methicillin-Resistant and Methicillin-Susceptible Coagulase-Negative Staphylococcal Bacteremia at Hospital Admission

Tacconelli

D’Agata

Karchmer

2003

Clinical Infectious Diseases

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We performed 2 case-control studies among 108 patients with true coagulase-negative staphylococcal (CoNS) bacteremia diagnosed within 48 h of hospital admission. Seventy-nine patients (73%) with methicillin-resistant (MR) CoNS bacteremia and 29 patients (27%) with methicillin-susceptible (MS) CoNS bacteremia were compared with 79 randomly selected control patients without CoNS bacteremia. The presence of a central venous catheter was an independent risk factor for both MR- and MS-CoNS bacteremia (P<.001). Patients with MR-CoNS bacteremia were more frequently admitted from health care facilities (P=.02), more likely to have had previous MR Staphylococcus aureus infection or colonization (P=.02), and more likely to have received antibiotics in the previous 30 days (P=.02). The probability that bacteremia was caused by an MR strain, rather than an MS strain, was 62% among patients admitted from the community and 84% among patients admitted from health care facilities. This study identified epidemiological characteristics that can be used to distinguish between MR- and MS-CoNS bacteremia and found high rates of methicillin resistance among CoNS isolates recovered from patients admitted from the community, as well as from health care facilities.

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“…Recently, it has been demonstrated that the proportion of patients for whom death is attributable to MRSA is significantly higher than that for methicillin‐susceptible S. aureus (MSSA), with a strong statistical trend for death associated with nosocomial MRSA infection and bacteraemia compared with MSSA [5]. In Mexico, MRSA was an uncommon nosocomial pathogen until the 1990s [6–8]. Surveillance studies performed in several Latin American countries, including Mexico, have now reported a high occurrence of MRSA in commonly observed infections, and a marked geographical variation in multiresistance patterns [6,8].…”

Section: Introductionmentioning

confidence: 99%

Molecular characterisation of a dominant methicillin-resistant Staphylococcus aureus (MRSA) clone in a Mexican hospital (1999–2003)

Echániz-Avilés

Velázquez-Meza

Aires-de-Sousa

et al. 2006

Clinical Microbiology and Infection

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Methicillin-resistant Staphylococcus aureus (MRSA) isolates (n = 216), collected between January 1999 and May 2003 in a tertiary-care university hospital in Guadalajara, Mexico, were characterised by antibiotype, pulsed-field gel electrophoresis (PFGE) of SmaI macrorestriction fragments, and hybridisation of ClaI digests with mecA- and Tn554-specific DNA probes. Representatives of the single clonal type found were analysed by spa typing, multilocus sequence typing and staphylococcal chromosomal cassette mec (SCCmec) typing, and were tested for the presence of 22 virulence determinants and agr type. A single PFGE pattern was identified, with minor variations over time, with spa type 2, sequence type 5, SCCmec type II, agr type 2 and the presence of the enterotoxin genes seg and sei, the gamma-haemolysin variant gene hlg-v and the leukocidin lukE-lukD genes. In addition, the isolates showed antimicrobial resistance to beta-lactams, macrolides, chloramphenicol and imipenem, and susceptibility to gentamicin, rifampicin, trimethoprim-sulphamethoxazole and vancomycin. Following its appearance in 1997, this clone spread within the hospital, and is now present in most of the hospital units and wards.

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Epidemiological and Biological Characteristics of Methicillin-Resistant Staphylococcal Infections in a Mexican Hospital

Cited by 10 publications

References 61 publications

Slime production and antibiotic susceptibility in staphylococci isolated from clinical samples

Slime production and antibiotic susceptibility in staphylococci isolated from clinical samples

Epidemiological Comparison of True Methicillin-Resistant and Methicillin-Susceptible Coagulase-Negative Staphylococcal Bacteremia at Hospital Admission

Molecular characterisation of a dominant methicillin-resistant Staphylococcus aureus (MRSA) clone in a Mexican hospital (1999–2003)

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