Lack of methicillin-resistant Staphylococcus aureus nasal carriage among patients at a primary-healthcare unit in Porto Alegre, Brazil

Scribel, Mariana Vale; Barth, A. L.; Zavascki, Alexandre Prehn

doi:10.1590/s0036-46652011000400004

“…Although MRSA is more frequently studied, the mecA gene, responsible for its resistance to methicillin, can also be found in strains of methicillin-resistant coagulase-negative Staphylococcus (MR-CoNS). (7,8,14,15) The results of present study are in agreement with others (4,11,16) in which S. aureus was not the most prevalent. The nasal vestibules of about 20% of the healthy population were colonized by S. aureus, (4,5) an important pathogen that can spread throughout the community and has a high resistance potential.…”

Section: Discussionsupporting

confidence: 93%

Colonização nasal por Staphylococcus sp. em pacientes internados

Almeida

¹

,

Lima

²

,

Santos

³

et al. 2014

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Objective: To analyze nasal colonization by Staphylococcus sp. its resistance to methicillin, and associated factors in inpatients. Methods: Nasal sample collection, antimicrobial susceptibility tests, and analysis of medical records of inpatients (n=71) were performed, and a questionnaire was applied. Data were analyzed by descriptive and inferential statistics using the chi-square, Student's t, and Mann-Whitney tests (α=5%). Results: Nearly half (44.4%) of the patients who were significantly associated with prolonged antibiotic treatment (p=0.02) was infected with methicillin-resistant Staphylococcus sp.. A significant association was observed between patients with sensitive strains and absence of antibiotic treatment prior to sample collection (p=0.02) or absence of wounds (p=0.003). Conclusion: Strains of methicillin-resistant Staphylococcus sp. were found, and there was no significant difference between the S. aureus species and the coagulase-negative Staphylococci groups, which indicates the degree of spread of methicillin resistance among different species of Staphylococcus. ResumoObjetivo: Analisar a colonização nasal por Staphylococcus sp., sua resistência à meticilina e fatores associados em pacientes internados. Métodos: Foram realizados coleta de amostra nasal, testes de susceptibilidade antimicrobiana e análise de prontuários médicos de pacientes internados (n=71), e foi aplicado um questionário. Os dados foram analisados por meio de estatística descritiva e inferencial usando os testes c 2 , t de Student e Mann-Whitney (α=5%). Resultados: Cerca de metade (44,4%) dos pacientes, significativamente associados ao tratamento antibiótico prolongado (p=0,02) estavam infectados por Staphylococcus sp resistentes à meticilina. Observou-se uma associação significativa entre pacientes com cepas sensíveis e ausência de tratamento com antibiótico antes da coleta (p=0,02) ou ausência de feridas (p=0,003). Conclusão: Foram encontradas cepas de Staphylococcus sp. resistentes à meticilina e não houve diferença significativa entre a espécie S. aureus e os grupos de estafilococos coagulase negativos, o que indica o grau de disseminação da resistência à meticilina entre diferentes espécies de Staphylococcus.

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“…Another Brazilian study that investigated the rate of nasal S . aureus carriers among adults from a primary-healthcare unit found a rate of 11.5% [33]. A Portuguese study on S .…”

Section: Discussionmentioning

confidence: 99%

Nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in a Brazilian elderly cohort

Zanella

¹

,

Brandileone

²

,

Almeida

³

et al. 2019

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We aimed to investigate the nasopharyngeal colonization (NPC) by Streptococcus pneumoniae , Haemophilus influenzae , and Staphylococcus aureus in the elderly population and to assess the demographic factors associated with NPC. This was an observational cohort study in which outpatients aged ≥60 years were enrolled from April to August 2017, with a follow-up visit from September through December 2017. Nasopharyngeal (NP) swabs were collected, bacteria were detected and isolated, and isolates were subjected to phenotypic and molecular characterization using standard microbiological techniques. At enrolment, the rates of S . aureus , methicillin-resistant S . aureus (MRSA), H . influenzae , and S . pneumoniae among 776 elderly outpatients were 15.9%, 2.3%, 2.5%, and 2.2%, respectively. Toxin production was detected in 21.1% of methicillin-susceptible S . aureus , and three SCC mec types were identified: II/IIb, IVa, and VI. At the follow-up visit, all carriage rates were similar (p > 0.05) to the rates at enrolment. Most of S . pneumoniae serotypes were not included in pneumococcal conjugate vaccines (PCVs), except for 7F, 3, and 19A. All strains of H . influenzae were non-typeable. Previous use of antibiotics and 23-valent pneumococcal polysaccharide vaccination (p < 0.05) were risk factors for S . aureus and MRSA carriage; S . aureus colonization was also associated with chronic kidney disease (p = 0.021). S . pneumoniae carriage was associated with male gender (p = 0.032) and an absence of diabetes (p = 0.034), while not receiving an influenza vaccine (p = 0.049) and chronic obstructive pulmonary disease (p = 0.031) were risk factors for H . influenzae colonization. The frailty of study participants was not associated with colonization status. We found a higher S . aureus carriage rate compared with the S . pneumoniae - and H . influenzae -carriage rates in a well-attended population in a geriatric outpatient clinic. This is one of the few studies conducted in Brazil that can support future colonization studies among elderly individuals.

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“…A large number of studies have been done all over the world. Scribel et al [16] from Brasil found no MRSA from the patients at a primary healthcare unit. Sfeir et al [17] found 1.5% cefoxitin, gentamycin; 21.4% erythromycin;…”

Section: Discussionmentioning

confidence: 95%