Molecular Epidemiological Analysis of Methicillin-Resistant Staphylococci in a Neonatal Intensive Care Unit

Takei, Yasushi; Yokoyama, Kumi; Katano, Hideki; Tsukiji, Mami; Ezaki, Takayuki

doi:10.4265/bio.15.129

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…Furthermore, the isolation of ST5-V-t002 from a mother, her baby and nine other babies in the same unit in 2008 is suggestive of an outbreak with the mother as the likely source of the organism [53]. Likewise, the detection of ST22-IV-t852 from a baby’s cot and five different babies in the same unit suggests that the environment also contributed to the nosocomial transmission [54]. Therefore, multiple sources including colonized mothers, adult patients, healthcare workers and the environment contributed to the MRSA population in the Maternity hospital.…”

Section: Discussionmentioning

confidence: 99%

Dominance of community-associated methicillin-resistant Staphylococcus aureus clones in a maternity hospital

Udo

Al‐Sweih

2017

PLoS ONE

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BackgroundMethicillin- resistant Staphylococcus aureus (MRSA) is a major pathogen causing healthcare- and community- acquired infections. The purpose of this study was to characterize MRSA isolated at the Maternity Hospital between 2006 and 2011 for their genetic relatedness.Materials and methodsThe MRSA isolates were investigated using a combination of antibiogram, Staphylococcal chromosome cassette mec (SCCmec) and spa typing to determine their relatedness to MRSA isolated in other Kuwait hospitals. The isolates were also investigated for the carriage of genes for Pantone valentine Leukocidin (PVL).ResultsA total of 103 MRSA obtained from 64 neonates, 17 adult patients and 12 healthcare workers. The isolates were resistant to Kanamycin (46.6%), gentamicin (40.8%), trimethoprim (32%), ciprofloxacin (22.3%), fusidic acid (16.5%), tetracycline (19.4%), erythromycin (15.5%), clindamycin (15.5%), streptomycin (11.6%) high-level mupirocin (2.9%) and chloramphenicol (0.9%). Twenty (19.4%) of the isolates were multiresistant. Thirty-one (30.0%) isolates were positive for PVL. Molecular typing revealed the presence of 11 clonal complexes and 23 clones with ST5-V-t002, (N = 22), ST22-IV-t223 (N = 18), ST22-IV-t852 (N = 10), ST80-IV-t044 (N = 7), ST5-V-t688 (N = 5), ST772-V-t657 (N = 5) and ST239-III-t860 (N = 4) constituting 66.9% of the isolates. Other clones were isolated sporadically. The number of MRSA isolates increased from two in 2006 to 22 in 2011 with a peak of 43 in 2008.ConclusionThe study revealed a high prevalence of community-associated MRSA Maternity hospital. The MRSA population consisted of known strains, such as ST239-III-t680, ST22-IV-t223/t852 and ST80-IV-t044, that were reported previously in Kuwait and novel strains such as ST5-V-t002, and several sporadic strains obtained for the first time in the Maternity hospital. This study has provided an initial data which will serve as a platform for future comparative studies on the distribution of MRSA clones in the Maternity hospital in Kuwait.

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Section: Discussionmentioning

confidence: 99%

Dominance of community-associated methicillin-resistant Staphylococcus aureus clones in a maternity hospital

Udo

Al‐Sweih

2017

PLoS ONE

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“…These findings correlate with Raimundo et al who add to the increasing evidence that Citation: Brzychczy-Wloch M, Wojkowska-Mach J, Gadzinowski J, Opala T, Szumala-Kakol A, et al 2013 [4] suggested that clonal spread of CoNS may occur within and even between wards. Similarly, Takei et al [24] showed the transmission of MRSA/MRCNS in the old NICU of Hospital A and the relocated NICU (new NICU). A homology study of MRSA/MRCNS strains by PFGE DNA restriction patterns identified genotypes that showed similar patterns in the nurses' palms, towels, infant incubators, and room air.…”

Section: Discussionmentioning

confidence: 90%

Outbreak Intervention for Bloodstream Infections Caused by Methicillin Resistant Coagulase-Negative Staphylococci in Neonatal Intensive Care Unit

Brzychczy-Włoch¹,

Wójkowska‐Mach²,

Gadzinowski³

et al. 2012

Clin Microbial

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Coagulase-negative staphylococci (CoNS) may cause severe infections in newborns hospitalised in Neonatal Intensive Care Units (NICU). The present study aimed to investigate the outbreak of bloodstream infections (BSI) caused by CoNS among 18 neonates in Polish NICU, including the implementation of preventive strategies. The outbreak period was observed from June to September 2009 in a group of 1016 newborns. To terminate the outbreak, an independent audit was performed in October 2009 by a team of experts. The post-intervention time lasted from January to March 2010. The genotype characteristics of CoNS derived from the blood samples and strains isolated from the NICU environment and staff hands were analysed by PCR (Polymerase Chain Reaction) and PFGE (Pulsed Field Gel Electrophoresis). In the outbreak period, the incidence density of BSI was 4.5/1000 patient days (pds), whereas that of CoNS BSI was 3.3/1000 pds. Generally, in the outbreak period, 18 cases of BSI caused by CoNS were registered with a large number of new cases in the 34 th week of 2009, associated with a four-day-long public holiday. Both monomicrobial infections, as well as polymicrobial ones caused by multi-drug resistant Staphylococcus haemolyticus and Staphylococcus epidermidis, were noted. The result indicated high epidemic level of resistance genes among the CNS strains as well as horizontal spread of selected clones. After the intervention, when the preventive procedures had been standardized, a twofold decrease was recorded in the incidence rate of BSI from 4.5/1000 pds in the outbreak time comparing to 2.4/1000 pds in the post-intervention time. Our data support the view that CoNS are significant nosocomial pathogens in NICU and that some clones are transmitted between babies, through the hands of the staff. The research shows a failure to prepare Polish Infection Control Teams for crisis situations, such as an epidemic, and, at the same time, cautions against a similar occurrence in the future. Materials and Methods Ethical considerations The study was approved by Jagiellonian University Bioethical Committee decision no. KBET/94/B/2009. Hospital setting The Gynecological and Obstetrics Clinical Hospital facility with 410 beds located in a big city in the west of Poland was studied. There are approximately 4800 to 6300 live births per year in the centre and the admitted neonates are either born there or brought from nearby hospitals (about 5%). The NICU in this hospital consists of 3 parts that surround a common storage and medicine dispensing area.

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Microbial contamination of hospital reusable cleaning towels

Sifuentes

Gerba

Weart

et al. 2013

American Journal of Infection Control

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Molecular Epidemiological Analysis of Methicillin-Resistant Staphylococci in a Neonatal Intensive Care Unit

Cited by 6 publications

References 16 publications

Dominance of community-associated methicillin-resistant Staphylococcus aureus clones in a maternity hospital

Dominance of community-associated methicillin-resistant Staphylococcus aureus clones in a maternity hospital

Outbreak Intervention for Bloodstream Infections Caused by Methicillin Resistant Coagulase-Negative Staphylococci in Neonatal Intensive Care Unit

Microbial contamination of hospital reusable cleaning towels

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