Molecular Epidemiology of Methicillin-Resistant
 Staphylococcus aureus
 in Zürich, Switzerland (2003): Prevalence of Type IV SCC
 mec
 and a New SCC
 mec
 Element Associated with Isolates from Intravenous Drug Users

Wei, Qi; Ender, Miriam; O’Brien, Frances; Imhof, Alexander; Ruef, C.; McCallum, Nadine; Berger‐Bächi, Brigitte

doi:10.1128/jcm.43.10.5164-5170.2005

Cited by 65 publications

(46 citation statements)

References 41 publications

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“…These isolates belong to the dominant Taiwan C-MRSA clones (CC59:SCCmec V:pvl-positive and spa CC t437). Since CC59:SCCmec V isolates have now been reported in other countries (7,10,13,15,19) and since other C-MRSA lineages have also been found to have low-level ␤-lactam resistance (23,28,30), the findings and implications of our study may be relevant to predominant C-MRSA lineages on other continents. Our results indicate that as more clinical laboratories switch to using automated susceptibility testing instruments for determining antimicrobial susceptibility, there is a need for careful evaluation of the performance of these methods for the detection of mecA-positive S. aureus with a low-level oxacillin resistance to prevent their further spread in health care and community settings.…”

Section: Discussionmentioning

confidence: 62%

“…However, low-level and heterogeneous oxacillin resistance has been reported as a main characteristic of C-MRSA (23,28,30). The present study found a high rate of mecA-positive strains in S. aureus isolates with oxacillin MIC in the susceptible range of the CLSI breakpoint (Ͻ2 g/ml), including those with oxacillin MICs of 1 g/ml (3.3%, 6/180), and especially in those with oxacillin MICs of 2 g/ml (57.1%, 52/91).…”

Section: Discussionmentioning

confidence: 99%

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mecA -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan

et al. 2012

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Although the presence of mecA is the genotypic determinant of methicillin-resistant Staphylococcus aureus (MRSA), certain MRSA strains, especially community-associated MRSA (C-MRSA), can display an oxacillin MIC in the Clinical and Laboratory Standards Institute susceptible breakpoint range (<2 g/ml). Among 91 and 180 isolates thought to be methicillin-susceptible S. aureus (MSSA) with oxacillin MICs of 2 and 1 g/ml as determined by the Sensititre broth microdilution test initially, 52 (57.1%) and 6 (3.3%), respectively, were mecA positive. These mecA-positive low-oxacillin-MIC isolates belong to the dominant Taiwan C-MRSA clone (clonal complex [CC] 59), 56 of which carried SCCmec type V and were pvl positive, and 43 of which belonged to spa CC t437. All 271 isolates were retested by Sensititre, as well as by Vitek II and disk diffusion (DD). Based on the oxacillin results, the sensitivities of the Sensititre, Vitek II, and DD methods were 48.3% (28/58), 46.6% (27/58), and 89.6% (52/ 58), respectively. Although cefoxitin was better at detecting these isolates, 12.1, 10.4, and 5.2% of these isolates were still misidentified as MSSA by Sensititre, Vitek II, and DD, respectively. These results highlight the difficulty in the accurate identification of MRSA with borderline oxacillin MICs in the CC59:SCCmec V clone, which likely has contributed to its spread in the health care and community settings. Since this clone has now been detected in other countries, and since other C-MRSA lineages have also been found to have low-level ␤-lactam resistance, the findings of the present study may be relevant to other regions. Further studies are warranted to determine the extent and clinical impact of such misidentification.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

mecA -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan

et al. 2012

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“…SCCmec typing is a polymerase chain reaction (PCR)-based method, which is essential for characterization of MRSA clones in epidemiological studies and provides important information about the mobile genetic elements of methicillin resistance (8,9). SCCmec is an element involved in the horizontal transfer of resistant genes among Staphylococcus strains.…”

Section: Introductionmentioning

confidence: 99%

StaphylococcalCassette Chromosomemec(SCCmec) Typing of Methicillin-ResistantStaphylococcus aureusStrains Isolated from Community- and Hospital-Acquired Infections

Ghanbari¹,

Saberianpour²,

Zarkesh-Esfahani³

et al. 2017

Avicenna J Clin Microbiol Infect

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“…MRSA was found in the wound of another patient, who also was previously known to be colonized with MRSA (case 5). PFGE typing of the MRSA isolates revealed two different common endemic types: four isolates were identified as the Zurich IDU clone [14] and one as the Grison clone [13] (Table II, Figure 1). Fisher's exact test revealed no statistical differences between MRSA positive persons and MRSA negative persons concerning age, sex, presence of wounds, and consumption of antibiotics, or hospitalization.…”

Section: Mrsamentioning

confidence: 99%

“…The transregional dissemination of this single clone indicated the capacity for spreading and colonizing other drug-use networks [13]. This clone belongs to the sequence type ST45 (Berlin-clone) and has a novel SCCmec cassette [14,15]. Based on the high prevalence of this particular clone among IDUs in Zurich and its epidemic circulation in several hospitals in Zurich, infection control measures were preemptively taken upon admission of persons with a history of intravenous drug use.…”

Section: Introductionmentioning

confidence: 99%

Clearance of an epidemic clone of methicillin-resistant Staphylococcus aureus in a drug-use network: A follow-up study in Switzerland

Colombo

Senn

Bürgel

et al. 2012

Scandinavian Journal of Infectious Diseases

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Background: A single clone of methicillin-resistant Staphylococcus aureus (MRSA) was observed in a drug-use network starting in 1994, and was found to persist throughout 2001, with up to 19% MRSA colonization of intravenous drug users (IDUs). Recent clinical observations have shown low prevalences of this endemic drug clone among MRSA isolates. The goal of this study was to assess the evolution of MRSA carriage among IDUs. Methods: The survey took place from November 2008 to September 2009. Ten drug dispensary facilities took part. Demographic and clinical data including sex, history of MRSA, past hospitalization, use of antibiotics, and presence of wounds were collected. Screening of the nares, throat, and wounds was done. Results: Five hundred and fourteen swab specimens were obtained; 497 of them were nose/throat samples and 17 were wound swabs. MRSA was identified in 5 samples (1%). Four MRSA were found in nose/throat samples and 1 in a wound swab. Pulsed-field gel electrophoresis typing of the MRSA isolates revealed 2 different common endemic types: 4 were identified as the Zurich IDU clone and 1 as the Grison clone. Conclusions: The study shows a significant decline of MRSA colonization among IDUs. The underlying causes for this decline could not be determined fully, but we hypothesize a bundle of interventions as contributing: enhanced medical care, better wound management, isolation management, teaching IDUs basic hygiene techniques, and the national 'Four Pillars' policy. Hospital epidemiological policies such as pre-emptive isolation, length of isolation time, and screening procedures were adapted accordingly.

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Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Zürich, Switzerland (2003): Prevalence of Type IV SCC mec and a New SCC mec Element Associated with Isolates from Intravenous Drug Users

Abstract: The majority of methicillin-resistant

Cited by 65 publications

References 41 publications

mecA -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan

mecA -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan

StaphylococcalCassette Chromosomemec(SCCmec) Typing of Methicillin-ResistantStaphylococcus aureusStrains Isolated from Community- and Hospital-Acquired Infections

Clearance of an epidemic clone of methicillin-resistant Staphylococcus aureus in a drug-use network: A follow-up study in Switzerland

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