MRSA dynamic circulation between the community and the hospital setting: New insights from a cohort study

Barcudi, Danilo; Sosa, Ezequiel; Lamberghini, Ricardo; Garnero, Analía; Tosoroni, Dario; Decca, L; González, Liliana; Kuyuk, María A; López, Teresa; Herrero, I.; Cortes, Paulo R.; Figueroa, M; Egea, Ana L.; Gagetti, Paula; Porto, Darío Augusto Fernández Do; Corso, Alejandra; Turjanski, Adrián; Bocco, José Luis; Sola, Claudia

doi:10.1016/j.jinf.2019.10.001

Cited by 23 publications

(14 citation statements)

References 67 publications

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“…A study of Royal Marine [39] recruits in the UK showed very little carriage of PVL+ S. aureus, although there was a high prevalence of skin and soft tissue infections. However, other studies have shown high prevalence of carriage with PVL + strains [40][41][42][43]. A whole genome-based study to attempt to identify an S. aureus carrier causing paediatric infections in a hospital revealed a PVL+ strain was being carried and transmitted by a staff member [44].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal whole-genome based comparison of carriage and infection associated Staphylococcus aureus in northern Australian dialysis clinics

et al. 2021

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Background The study objective was to reveal reservoirs potentially leading to Staphylococcus aureus infections in haemodialysis clinic clients in the tropical north of the Australian Northern Territory (NT). This client population are primarily Aboriginal Australians who have a greater burden of ill health than other Australians. Reservoir identification will enhance infection control in this client group, including informing potential S. aureus decolonisation strategies. Methods and findings The study participants were 83 clients of four haemodialysis clinics in the Darwin region of the NT, and 46 clinical staff and researchers who had contact with the clinic clients. The study design was longitudinal, encompassing swabbing of anatomical sites at two month intervals to yield carriage isolates, and also progressive collection of infection isolates. Swab sampling was performed for all participants, and infection isolates collected for dialysis clients only. Analysis was based on the comparison of 139 carriage isolates and 27 infection isolates using whole genome sequencing. Genome comparisons were based on of 20,651 genome-wide orthologous SNPs, presence/absence of the mecA and pvl genes, and inferred multilocus sequence type and clonal complex. Pairs of genomes meeting the definition of “not discriminated” were classed as defining potential transmission events. The primary outcome was instances of potential transmission between a carriage site other than a skin lesion and an infection site, in the same individual. Three such instances were identified. Two involved ST762 (CC1) PVL- MRSA, and one instance ST121 PVL+ MSSA. Three additional instances were identified where the carriage strains were derived from skin lesions. Also identified were six instances of potential transmission of a carriage strains between participants, including transmission of strains between dialysis clients and staff/researchers, and one potential transmission of a clinical strain between participants. There were frequent occurrences of longitudinal persistence of carriage strains in individual participants, and two examples of the same strain causing infection in the same participants at different times. Strains associated with infections and skin lesions were enriched for PVL and mecA in comparison to strains associated with long term carriage. Conclusions This study indicated that strains differ with respect to propensity to stably colonise sites such as the nose, and cause skin infections. PVL+ strains were associated with infection and skin lesions and were almost absent from the carriage sites. PVL- MRSA (mainly CC1) strains were associated with infection and also with potential transmission events involving carriage sites, while PVL- MSSA were frequently observed to stably colonise individuals without causing infection, and to be rarely transmitted. Current clinical guidelines for dialysis patients suggest MRSA decolonisation. Implementation in this client group may impact infections by PVL- MRSA, but may have little effect on infection by PVL+ strains. In this study, the PVL+ strains were predominant causes of infection but rarely colonised typical carriage sites such as the nose, and in the case of ST121, were MSSA. The important reservoirs for infection by PVL+ strains appeared to be prior infections.

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Section: Discussionmentioning

confidence: 99%

Longitudinal whole-genome based comparison of carriage and infection associated Staphylococcus aureus in northern Australian dialysis clinics

et al. 2021

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“…Bangangté-Cameroon. 4 School of Medicine Higher Institute of Health Sciences, Université des Montagnes; Bangangté-Cameroon. 5 Cliniques Universitaires des Montagnes; Bangangté-Cameroon Higher Institute of Health Sciences, Université des Montagnes; Bangangté-Cameroon.…”

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“…Studies on bacterial resistance in hospitals, more specifically on methicillin-resistant Staphylococcus (MRS) strains, have highlighted the acquisition of multi-resistant bacteria during hospital stay and the harmful consequences of these multi-resistant bacteria on patient's lives [4][5][6]; thus justifying the inclusion of the fight against bacterial resistance to antibiotics in global programs (Global Health Security Agenda, One Health) [7,8]. Also, several studies carried out throughout the world, in west Cameroon and more specifically in the hospitals of the Ndé division have shown that the hospital environment (mainly in surgery) is an environment conducive to the selection and dissemination of multi-resistant bacteria on one hand and to the exchange of genetic material between the bacteria in this environment and those in the human body on the other hand [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Hospitalization and colonization by methicillin-resistant Staphylococcus in the surgical department in 03 health facilities of the Ndé division, west-Cameroon

Nguekap

Kwetche

Tazemda-Kuitsouc

et al. 2020

Preprint

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Background: Commensal flora colonization during hospitalization by bacteria is the first step for a nosocomial infections while antibiotic resistance reduces therapeutic options. In aim to control this phenomenon, we initiated this study to describe the impact of hospitalization on colonization by methicillin-resistant Staphylococcus in the surgical department in 03 health facilities of the Ndé division, west-Cameroon. Methods: This quasi-experimental study was carried out on patients admitted for surgery in 03 health facilities of the Ndé division, west-Cameroon (District Hospital of Bangangté, Protestant Hospital of Bangwa and Cliniques Universitaires des Montagnes). After obtaining ethical clearance and authorizations, nasal swabs were performed at admission and discharge, with the aim of isolating bacteria and performing their antibiotic susceptibility tests. Information on each participant's antibiotic therapy was recorded. Laboratory investigations were carried out according to standard protocols (CASFM, 2019). Results: The most commonly used antibiotics were β-lactam antibiotics. Of the 52 patients who agreed to participate in the study, 104 nasal swabs were performed. From the analysis, 110 (57 at admission versus 53 at discharge) Staphylococcus isolates were obtained. Overall, susceptibility testing showed that antibiotic resistance rates were higher at discharge than at admission; with significant differences between the susceptibility profiles obtained at admission and discharge for β-lactam antibiotics and not significant for fluoroquinolones and aminoglycosides. The nasal flora of 13 (25%) patients was colonized with methicillin-resistant Staphylococcus at admission versus 39 (75%) at discharge and 14 (24.56%) of the isolates obtained at admission were methicillin-resistant versus 37 (69.81%) at discharge. Of the variables studied, hospital stay remained the only variable significantly (p=0.0080) associated with colonization by methicillin-resistant Staphylococcus.Conclusion: This work must be considered as an alarm bell regarding the role of health structures in the colonization and spread of multi-resistant bacteria in Ndé division. As a result, further investigations aimed at investigating the factors favouring this phenomenon should be carried out with an approach similar to that of the ONE HEALTH concept. Pending these investigations, we recommend strict compliance with hygiene rules, personalized antibiotic therapy (performing antibiotic susceptibility tests) and an updated antibiotic prophylaxis and probabilistic antibiotic therapy according to the studies carried out in the locality.

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“…methicillin-resistant Staphylococccus aureus isolates can resist to almost all β-lactams [3]. Studies on bacterial resistance in hospitals, more specifically on methicillin-resistant Staphylococcus aureus (MRSA) isolates, have highlighted the acquisition of multi-resistant bacteria during hospital stay and the harmful consequences of colonization and infections by these multi-resistant bacteria on patient's lives [4][5][6]. Thus justifying the inclusion of the fight against bacterial resistance to antibiotics in global programs (Global Health Security Agenda, One Health) [7,8].…”

Section: Introductionmentioning

confidence: 99%

Hospitalization and colonization by methicillin-resistant Staphylococcus aureus in the surgical department of 03 health facilities in the Ndé division, West-Cameroon

Nankam

Kwetche

Tazemda-Kuitsouc

et al. 2021

Ann Clin Microbiol Antimicrob

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Background Commensal flora colonization during hospitalization by bacteria is the first step for nosocomial infections while antibiotic resistance reduces therapeutic options. In aim to control this phenomenon, we initiated this study to describe the impact of hospitalization on colonization by methicillin-resistant Staphylococcus aureus in the surgical department of 03 health facilities in the Ndé division, West-Cameroon. Methods This study was carried out on patients admitted for surgery in 03 health facilities of the Ndé division, West-Cameroon (District Hospital of Bangangté, Protestant Hospital of Bangwa and Cliniques Universitaires des Montagnes). After obtaining ethical clearance and authorizations, nasal swabs were performed at admission and discharge, with the aim of isolating bacteria and performing their antibiotic susceptibility tests. Informations on each participant's antibiotic therapy were recorded. Laboratory investigations were carried out according to standard protocols (CASFM, 2019). Results The most commonly used antibiotics were β-lactams. A total of 104 nasal swabs were performed on 52 patients who agreed to participate to the study. From the analysis, 110 (57 at admission versus 53 at discharge) Staphylococcus isolates were obtained. Overall, susceptibility testing showed that antibiotic resistance rates were higher at discharge than at admission; with significant differences between the susceptibility profiles obtained at admission and discharge for β-lactams and not significant for fluoroquinolones and aminoglycosides. Globally, frequency of nasal carriage of methicillin-resistant Staphylococcus aureus at discharge 16 (30.77%) was significantly higher than at admission 07 (13.46%) with Chi-2 = 4.52 and p = 0.0335. Conclusion The high rates of antibiotic resistance of bacteria isolated at discharge compared to those isolated at admission obtained in the present investigation, highlights the important role that hospitalization plays in the selection and dissemination of methicillin-resistant Staphylococcus aureus and colonization by these bacteria in health structures of Ndé division. As a result, further investigations to find the factors that promote this phenomenon should be carried out.

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MRSA dynamic circulation between the community and the hospital setting: New insights from a cohort study

Cited by 23 publications

References 67 publications

Longitudinal whole-genome based comparison of carriage and infection associated Staphylococcus aureus in northern Australian dialysis clinics

Longitudinal whole-genome based comparison of carriage and infection associated Staphylococcus aureus in northern Australian dialysis clinics

Hospitalization and colonization by methicillin-resistant Staphylococcus in the surgical department in 03 health facilities of the Ndé division, west-Cameroon

Hospitalization and colonization by methicillin-resistant Staphylococcus aureus in the surgical department of 03 health facilities in the Ndé division, West-Cameroon

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