Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus strains isolated in a multicenter study of nursing home residents in Croatia

Budimir, Ana; Pal, Marina Payerl; Bošnjak, Zrinka; Mareković, Ivana; Vuković, Dubravka; Križan, Ivana Roksandić; Milas, Josip; Plečko, Vanda; Kalenić, Smilja

doi:10.1016/j.ajic.2014.07.032

Cited by 14 publications

(8 citation statements)

References 19 publications

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“…Results in region countries (e.g. Croatia) were in concordance with our results regarding antimicrobial susceptibility (19). General health decline with age, higher antibiotic regimens, lack of proper education, and less frequent visits to physicians are influential factors in the rapid evolution of antibiotic-resistant species.…”

Section: Discussionsupporting

confidence: 90%

Panton-Valentine leukocidin and staphylococcal cassette chromosome mec characterization of community acquired methicillin-resistant Staphylococcus aureus

Rebić

Budimir

Aljičević

et al. 2019

Cent Eur J Public Health

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Objectives: Staphylococcus aureus (SA) represents one of the most important microorganism that is part of the normal microflora of humans, but in certain conditions can cause very serious infections. Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for a wide spectrum of nosocomial and community associated infections worldwide. The aim of this study was to determine community acquired MRSA (CA-MRSA), as well as the frequency of Panton-Valentine leukocidin (PVL) genes and staphylococcal cassette chromosome mec (SCCmec) types in isolates obtained from outpatients in the region of 700,000 people (Canton Sarajevo, Bosnia and Herzegovina)Methods: Our investigation included phenotypic and genotypic markers such as antimicrobial resistance, pulsed-field gel electrophoresis (PFGE), SCC typing, and PVL detection.Results: Antimicrobial susceptibility: all MRSA isolates were resistant to the β-lactam antibiotics tested, and all isolates were susceptible to trimethoprim sulphamethoxazole, rifampicin, fusidic acid, linezolid, and vancomycin. After the PFGE analysis, the isolates were grouped into five similarity groups: A-E. The largest number of isolates belonged to one of two groups: C -60% and D -27%. In both groups C and D, SCCmec type IV was predominant (60% and 88.8%, respectively). A total of 24% of the isolates had positive expression of PVL genes, while 76% showed a statistically significantly greater negative expression of PVL genes.Conclusions: Using combination techniques, we were able to investigate the origin and genetic background of the strains. PFGE analysis revealed two large, genetically related groups of strains consisting of 87 isolates. Our results suggest failure to apply the screening policy, and a lack of knowledge about multiresistant MRSA strains. This study showed the local epidemiological situation which should be the basis of antimicrobial empiric therapy for non-hospitalized patients.

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Section: Discussionsupporting

confidence: 90%

Panton-Valentine leukocidin and staphylococcal cassette chromosome mec characterization of community acquired methicillin-resistant Staphylococcus aureus

Rebić

Budimir

Aljičević

et al. 2019

Cent Eur J Public Health

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“…aureus and MRSA colonization in this study are 22.2% and 10.6% respectively. As reported in other countries, the prevalence rate of MRSA in the resident population varies: 23.3% in Northern Ireland[ 3 ], 7.1% in Croatia[ 17 ], 4.7% in England[ 7 ], 10.1% in Ireland[ 18 ], 7.6% in Germany[ 19 ], 19.9% in Belgium[ 1 ], and 16% and 26% in the United States [ 2 ]. Another report in Italy has discovered that the MRSA strains isolated from long-term care facilities were resistant to ciprofloxacin and the majority was susceptible to most other non-betalactam antibiotics [ 20 ].…”

Section: Discussionmentioning

confidence: 93%

Prevalence and Molecular Epidemiology of Staphylococcus aureus among Residents of Seven Nursing Homes in Shanghai

Zhang

Zhao

et al. 2015

PLoS ONE

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BackgroundResidents in nursing homes (NHs) always represent potential reservoirs for Staphylococcus aureus and methicillin-resistant S. aureus (MRSA). To our knowledge, there is no epidemiological information up till now that describes the prevalence and molecular characteristics of S. aureus in nursing home residents in Shanghai, China.MethodsFour hundred and ninety-one unique residents from 7 NHs were enrolled in this study. Specimens were collected among these residents including 491 nasal swabs, 487 axillary swabs and 119 skin swabs. S. aureus isolated and identified from the swabs was characterized according to antimicrobial susceptibility profiling, toxin gene prevalence, and multilocus sequence typing (MLST), spa and SCCmec typing.ResultsAmong the 491 residents screened, S. aureus was isolated in 109 residents from 90 nasal swabs (90/491, 18.3%), 29 axillary swabs (29/487, 6.0%), and 22 skin swabs (22/119, 18.5%). Sixty-eight MRSA isolates were detected in 52 residents from 41 nasal carriers, 15 axillary carriers and 12 skin carriers. The overall prevalence rate of S. aureus and MRSA colonization was 22.2% and 10.6% respectively. Ten residents presented S. aureus in all three sample types and 12 residents presented S. aureus in two of the three sample types collected. Molecular analysis revealed CC1 (29.1%) to be the dominant clone in this study, followed by CC398 (19.9%), CC188 (13.5%) and CC5 (12.8%). The most common spa type was t127 (22.0%), followed by t14383 (12.8%) and t002 (10.6%).ConclusionsA high prevalence of S. aureus and MRSA colonization was revealed in nursing home residents in Shanghai. CC1 was the most common clonal complex and t127 was the most common spa type among NH residents. The data provides an important baseline for future surveillance of S. aureus in NHs in Shanghai and other highly urbanized regions in China. Implementation of infection control strategies must be given high priority in NHs to fight such high prevalence of both MRSA and methicillin-susceptible S. aureus (MSSA).

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“…For both HICs and JANIS, the age-specific incidence of MRSA patients showed a J-shaped curve and the incidence was lowest in the 5–9 years age group. MRSA colonization has been observed in healthy children [ 18 ] and the elderly living in retirement homes [ 19 ] or nursing homes [ 20 , 21 ]. Risk factors for mortality in patients with Staphylococcus aureus bacteraemia include malignancy, low serum albumin, high glucose, and methicillin resistance [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Estimation of the incidence of MRSA patients: evaluation of a surveillance system using health insurance claim data

Tanihara

Suzuki

2016

Epidemiol. Infect.

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SUMMARYBecause sentinel surveillance systems cannot obtain information about patients who visit non-sentinel medical facilities, the characteristics of patients identified by these systems may be biased. In this study, we evaluated the representativeness of a methicillin-resistant Staphylococcus aureus (MRSA) surveillance system using health insurance claim (HIC) data, which does not depend on physician notification. We calculated the age-specific incidence of MRSA patients using data from the Japan Nosocomial Infections Surveillance (JANIS) programme, which is based on sentinel surveillance systems, and inpatient HICs submitted to employee health insurance organizations in 2011, and then computed age-specific incidence ratios between the HIC and JANIS data. Age-specific MRSA incidence in both datasets followed J-shaped curves with similar shapes. For all age groups, the ratios between HIC and JANIS data were around 10. These findings indicate that JANIS notification of MRSA cases was not affected by patients’ age.

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Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus strains isolated in a multicenter study of nursing home residents in Croatia

Cited by 14 publications

References 19 publications

Panton-Valentine leukocidin and staphylococcal cassette chromosome mec characterization of community acquired methicillin-resistant Staphylococcus aureus

Panton-Valentine leukocidin and staphylococcal cassette chromosome mec characterization of community acquired methicillin-resistant Staphylococcus aureus

Prevalence and Molecular Epidemiology of Staphylococcus aureus among Residents of Seven Nursing Homes in Shanghai

Estimation of the incidence of MRSA patients: evaluation of a surveillance system using health insurance claim data

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