Genotyping of methicillin-resistant Staphylococcus aureus isolates obtained in the Northeast region of Brazil

Sousa-Junior, F.C. de; Silva-Carvalho, Maria Cícera; Fernandes, Mariana Lima; Maurício, Vieira,; Pellegrino, Flávia Lúcia Piffano Costa; Figueiredo, Agnes Marie Sá; Melo, Maria Celeste Nunes de; Milan, Eveline Pı́polo

doi:10.1590/s0100-879x2009005000018

Cited by 18 publications

(12 citation statements)

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“…Similarly, we observed extensive variability of PFGE patterns for BEC isolates, suggesting clonal divergence over time. This observation reinforces the report of [ 11 ] that these genetic changes may have some significance in a particular epidemiological scenario and might correspond to an important instrument of clonal divergence.…”

Section: Discussionsupporting

confidence: 91%

“…BEC isolates are known to be dispersed throughout Brazil, with a major clonal type being responsible for 70–80 % of BEC strains [ 30 , 31 ]. More recently, increased variability in PFGE patterns for BEC isolates in Brazil has been described [ 11 ]. Similarly, we observed extensive variability of PFGE patterns for BEC isolates, suggesting clonal divergence over time.…”

Section: Discussionmentioning

confidence: 99%

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Clonal diversity and epidemiological characteristics of Staphylococcus aureus: high prevalence of oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) associated with clinical isolates in Brazil

Andrade-Figueiredo

Leal-Balbino

2016

BMC Microbiol

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BackgroundStaphylococcus aureus is the major cause of global and nosocomial infections with a significant impact in hospitals worldwide. Our objective was to investigate clinical and molecular characteristics of S. aureus isolates causing infections in patients admitted to hospitals from Recife city, Brazil, and investigate the prevalence of oxacillin-susceptible mecA-positive S. aureus (OS-MRSA) in the region, as well as genetically characterize the isolates and compare with epidemic clones.ResultsWe characterized 89 isolates in total, 31 clinical methicillin-resistant S. aureus (MRSA) and 58 methicillin-sensitive (MSSA) isolates by PFGE, MLST, spa typing and SCCmec genotyping. Isolates belonging to international MRSA clones were present: Brazilian epidemic clone (BEC) (61 % of MRSA isolates), Paediatric (36 %), New York/Japan (3 %). Some MSSA isolates were related to MRSA clones: USA400-related (10 % of MSSA isolates), Berlin clone (2 %), Paediatric (14 %), New York/Japan (2 %) and Southwest Pacific clone (17 %). MLST revealed new sequence types (ST’s): ST2381, ST2382, and ST2383 and new spa types: 10548 and 10550. Among isolates phenotypically identified as MSSA by antimicrobial susceptibility assays, we verified 30 oxacillin-susceptible isolates, which exhibited the mecA gene, without mec complex amplification and were thus classified as OS-MRSA. We observed clonal spread of MRSA and MSSA, including OS-MRSA, within several areas of the main hospital investigated and closely related isolates between hospitals analyzed.ConclusionsThe results of this study suggest a possible spread of the strains in hospital environment that could be responsible for nosocomial infections. We documented the presence of several MRSA clones, as well as new MLST and spa types, that were responsible for severe infections in hospitalized patients. The finding of OS-MRSA isolates could have implications for therapy, because testing for mecA and PBP2a is not a routine procedure performed by clinical microbiology laboratories in Brazil and, as consequence, these isolates could be misclassified as MSSA. Our data alert to the necessity to develop more effective strategies for epidemiological control of S. aureus in order to avoid an increase of hospital infections provoked by this pathogen. We reinforce the use of genetic methods, in addition to phenotypic tests, for a precise identification of MRSA.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-016-0733-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Clonal diversity and epidemiological characteristics of Staphylococcus aureus: high prevalence of oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) associated with clinical isolates in Brazil

Andrade-Figueiredo

Leal-Balbino

2016

BMC Microbiol

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“…[ 1 ] Currently, the health problems associated with this microorganism have become more serious due to the increasing incidence of methicillin-resistant S. aureus (MRSA). [ 2 ] Several studies worldwide have reported the rate of nasal carriage of S. aureus strains, varying from 16.8% to 90%. [ 3 4 5 6 ] A causal relationship between S. aureus nasal carriage and infection is supported by the fact that the nasal strain and the infecting strain share the same genotype.…”

Section: Introductionmentioning

confidence: 99%

Mupirocin resistance in nasal carriage ofStaphylococcus aureusamong healthcare workers of a tertiary care rural hospital

Kaur¹,

Narayan²

2014

Indian Journal of Critical Care Medicine

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Introduction:Mupirocin (pseudomonic acid A) is a topical antimicrobial agent with excellent antistaphylococcal and antistreptococcal activity. A nasal formulation is approved by the United States Food and Drug Administration for eradicating nasal carriage in adult patients as well as in health care personnel. Resistance to mupirocin has already been reported worldwide. The increasing prevalence of mupirocin resistance among Staphylococcus aureus and coagulase-negative Staphylococcus (CoNS) species could be an important threat to the future use of mupirocin against methicillin-resistant S. aureus (MRSA). Thus, this study was carried out to find the prevalence of mupirocin resistance in S. aureus and CoNS by disc diffusion and to determine the rates of high-level and low-level mupirocin resistance in S. aureus and CoNS by disc diffusion.Materials and Methods:A total of 140 healthcare workers (HCWs) (doctor, nursing staff, housekeeping staff) were randomly selected. S. aureus and CoNS isolates were tested for mupirocin resistance by the disk diffusion method using 5 μg and 200 μg mupirocin discs. MRSA isolates were tested for antibiotics by Kirby-Bauer disc-diffusion method as per Clinical and Laboratory Standards Institute guidelines.Results:Out of 140 nasal swabs collected from HCWs, S. aureus was isolated in 38 (27.14%), and CoNS was isolated in 73 (52.14%). MRSA was isolated in 20 (14.28%) and methicillin-resistant coagulase-negative Staphylococci (MRCoNS) in 34 (24.29%. Methicillin-sensitive S. aureus (MSSA) and MSCoNS isolates were 100% sensitive to mupirocin, but two isolates from MRSA (1.43%) and five from MRCoNS (3.57%) were mupirocin resistant.Conclusion:The presence of mupirocin resistance in MRSA and MRCoNS is a cause for concern. It could be limited by regular surveillance and effective infection control initiatives so to inform health care facilities to guide therapeutic and prophylactic use of mupirocin.

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“…1). Of the 45 MRSA isolates, 73% (33/45) belonged to the Brazilian Epidemic Clone (ST239- SCC mec IIIA), 7% (3/45) to the pediatric clone (ST5- SCC mec IV), and 20% (9/45) to the sporadic clones (20). …”

Section: Resultsmentioning

confidence: 99%

Evaluation of different methods for detecting methicillin resistance in Staphylococcus aureus isolates in a university hospital located in the Northeast of Brazil

Júnior

Néri

Silva

et al. 2010

Braz. J. Microbiol.

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Many methods have been described for the detection of methicillin-resistant Staphylococcus aureus (MRSA), but the heterogeneous expression of methicillin resistance affects the reliability of these methods. The aim of the present study was to evaluate some methods for detecting methicillin resistance in Staphylococcus aureus isolates in a university hospital located in the Northeast of Brazil. Among the isolates, 15 were methicillin-susceptible and 45 were methicillin-resistant, including low-level heterogeneous resistance strains. Both the 30 ηg-cefoxitin disk and PBP2a test had 100% sensibility/specificity and appear to be good options for the detection of MRSA in the clinical laboratory.

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Genotyping of methicillin-resistant Staphylococcus aureus isolates obtained in the Northeast region of Brazil

Cited by 18 publications

References 18 publications

Clonal diversity and epidemiological characteristics of Staphylococcus aureus: high prevalence of oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) associated with clinical isolates in Brazil

Clonal diversity and epidemiological characteristics of Staphylococcus aureus: high prevalence of oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) associated with clinical isolates in Brazil

Mupirocin resistance in nasal carriage ofStaphylococcus aureusamong healthcare workers of a tertiary care rural hospital

Evaluation of different methods for detecting methicillin resistance in Staphylococcus aureus isolates in a university hospital located in the Northeast of Brazil

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