Transmission of ST8-USA300 Latin American Variant Methicillin-Resistant <i>Staphylococcus aureus</i> on a Neonatal Intensive Care Unit: Recurrent Skin and Soft- Tissue Infections as a Marker for Epidemic Community-Associated-MRSA Colonization

Nurjadi, Dennis; Klein, Sabrina; Zimmermann, Stefan; Heeg, Klaus; Zanger, Philipp

doi:10.1017/ice.2017.88

Cited by 11 publications

(13 citation statements)

References 9 publications

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“…Our study also failed to find any significant association of a higher proportion of clinical diseases and mortality with USA300 strains in infants vulnerable to MRSA infection. Recurrent skin and SSTI due to vertically transmitted USA300 was reported in a NICU (Nurjadi et al, 2017). However, our study did not find any significant difference in the proportion of SSTI infections between USA300 and non-USA300 MRSA strains.…”

Section: Discussioncontrasting

confidence: 86%

Comparison of USA300 with non-USA300 methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit

Murai

Okazaki

Kinoshita

et al. 2019

International Journal of Infectious Diseases

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Section: Discussioncontrasting

confidence: 86%

Comparison of USA300 with non-USA300 methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit

Murai

Okazaki

Kinoshita

et al. 2019

International Journal of Infectious Diseases

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“…Although the prevalence of this MRSA clone in Europe is generally considered to be low 8,10 , we found a remarkably high proportion of USA300 MRSA clones circulating in the community 2 and USA300 is indeed the most commonly imported MRSA into the European continent through intercontinental travel 19 . Moreover, USA300 MRSA clones can be classified as epidemic, as demonstrated by their expansive properties and dominance on the American continents 20 and further highlighted by accumulating reports on nosocomial transmission events and outbreaks in Europe 5,12,13 .…”

Section: Discussionmentioning

confidence: 99%

“…PVL is regarded as one of the main features of CA-MRSA and a clinically relevant virulence marker for S. aureus 3 . In recent years, cases of nosocomial PVL-positive MRSA transmissions and outbreaks in Europe have been accumulating 5 , 12 , 13 thus suggesting that the barrier between community- and hospital-associated MRSA has already been penetrated. Although PVL is associated with the severity of infection 3 , the characterization of MRSA isolates in hospitalized patients in Germany in terms of PVL is not consequently pursued.…”

Section: Discussionmentioning

confidence: 99%

Entry of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus into the hospital: prevalence and population structure in Heidelberg, Germany 2015–2018

Klein

Hannesen

Zanger

et al. 2020

Sci Rep

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Staphylococcus aureus is one of the major pathogens causing community-and healthcare-acquired infections. the presence of the virulence factor panton-Valentine leukocidin (pVL) is associated with recurrent infection and clinical severity and generally regarded as a feature of community associatedmethicillin-resistant Staphylococcus aureus (MRSA). to date, the focus of pVL-positive MRSA in hospitalized patients has been on outbreaks. We aimed to investigate whether pVL-positive MRSA has penetrated the community-hospital barrier by determining the prevalence of pVL in MRSA of hospitalized patients. MRSA strains isolated from patients hospitalized > 48 h in Heidelberg University Hospital between 2015 and 2018 Isolates were analysed for the presence of PVL and subjected to spatyping. PVL-positive MRSA were then characterized by whole genome sequencing. We analysed 740 MRSA isolates in the study period and identified 6.2% (n = 46) PVL-positivity. 32.6% of PVL-positive MRSA met the criteria for nosocomial acquisition. the most frequent clones among the pVL-positive strains were ST80-t044 (21.7%, n = 10/46) and ST8-t008 (19.5%, n = 9/46). WGS identified three possible transmission clusters involving seven patients. in conclusion, we found successful epidemic pVL-positive MRSA clones entering the hospital and causing nosocomial infections. preventive measures and constant surveillance should be maintained to prevent transmissions and clonal outbreaks. Staphylococcus aureus is one of the major causes of community and hospital acquired infections. Methicillinresistance is an ongoing problem locally and globally. Although the overall prevalence of methicillin-resistant S. aureus (MRSA) in Germany is declining 1, MRSA strains harboring the pathogenic marker Panton-Valentine leukocidin (PVL) are isolated more frequently 2. The presence of PVL is relevant, as it is associated with a more severe clinical presentation, often with recurrences, deep and multiple lesions and frequent transmission to contact persons, irrespective of methicillin resistance 3-6. In addition, PVL-positive S. aureus often displays multiple resistances to commonly used antibiotics to treat S. aureus infections 3,7. PVL has been linked to community-associated (CA-) MRSA 6. Although the overall prevalence of PVL in Germany is considered low according to data acquired by Schaumburg et al. 8 , a study by Jappe et al. 9 revealed

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“…Of note, some authors [15, 16] also suggest to perform a screening of high-risk newborns for MRSA colonization or infection in order to promptly implement preventive measures.…”

Section: Discussionmentioning

confidence: 99%

Osteomyelitis of the pubic symphysis caused by methicillin-resistant Staphylococcus aureus after vaginal delivery: a case report and literature review

Cosma¹,

Borella²,

Carosso³

et al. 2019

BMC Infect Dis

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BackgroundOsteomyelitis of the pubic symphysis is a rare cause of pelvic pain after delivery, mainly caused by Staphylococcus aureus and Pseudomonas aeruginosa.The clinical context is the same as the more common diastasis of the pubic bone, but the presence of intense local pain in association with fever should prompt further clinical work-up based on blood chemistry, microbiology and diagnostic imaging. We report the first case of methicillin-resistant Staphylococcus aureus osteomyelitis of the pubic symphysis occuring after the delivery.Case presentationA 39-year-old woman developed pain over the pubic bone 12 h after the delivery. After 72 h fever rose and laboratory examination showed elevation of C-reactive protein and procalcitonin levels. Pelvic x-rays and magnetic resonance showed pubic diastasis, joint effusion, tiny irregularities of articular surfaces and, severe bone edema. The patient was started on broad spectrum intravenous (IV) antibiotics (piperacillin-tazobactam) and then replaced to IV vancomycin and oral levofloxacin based on antibiogram result. She was then discharged with oral antibiotic therapy and fully recovered.ConclusionsDue to the rarity of this disease, we compared our experience with the other cases of osteomyelitis of pubic symphysis occurring in peri-postpartum reported in the literature. The course of osteomyelitis was favourable in all patients, and only in one case an additional orthopedic procedure for symphysis fixation was necessary. Knowledge of this rare condition is important to enable prompt diagnosis and treatment.

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Transmission of ST8-USA300 Latin American Variant Methicillin-Resistant Staphylococcus aureus on a Neonatal Intensive Care Unit: Recurrent Skin and Soft- Tissue Infections as a Marker for Epidemic Community-Associated-MRSA Colonization

Cited by 11 publications

References 9 publications

Comparison of USA300 with non-USA300 methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit

Comparison of USA300 with non-USA300 methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit

Entry of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus into the hospital: prevalence and population structure in Heidelberg, Germany 2015–2018

Osteomyelitis of the pubic symphysis caused by methicillin-resistant Staphylococcus aureus after vaginal delivery: a case report and literature review

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