Methicillin/Oxacillin-resistant Staphylococcus aureus as a hospital and public health threat in Brazil

Carvalho, Karinne Spirandelli; Mamizuka, Elsa Masae; Filho, Paulo Pinto Gontijo

doi:10.1590/s1413-86702010000100014

Cited by 27 publications

(29 citation statements)

References 60 publications

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“…Currently, S. aureus is one of the leading causes of healthcare-associated infection worldwide. Most importantly, a substantial proportion of staphylococcal infections are caused by methicillinresistant S. aureus (MRSA), which also exhibits resistance to several other antimicrobials [5,6], contributing to its persistence as a human pathogen for decades.…”

Section: Introductionmentioning

confidence: 99%

Molecular and phenotypic characteristics of methicillin-resistant Staphylococcus aureus isolated from hospitalized patients

Oliveira

Morey

Santos

et al. 2015

J Infect Dev Ctries

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Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of infections acquired in both community and hospital settings. In this study, MRSA isolated from different sources of hospitalized patients was characterized by molecular and phenotypic methods. Methodology: A total of 123 S. aureus isolates were characterized according to their genetic relatedness by repetitive element sequence based-PCR (REP-PCR), in vitro antimicrobial susceptibility profile, SCCmec typing and presence of seven virulence factor-encoding genes. Results: REP-PCR fingerprinting showed low relatedness between the isolates, and the predominance of one specific lineage or clonal group was not observed. All isolates were susceptible to teicoplanin and linezolide. All isolates were resistant to cefoxitin and penicillin, and the majority were also resistant to one or more other antimicrobials. Fifty isolates (41.7%) were intermediately resistant to vancomycin. Most isolates harbored SCCmec type II (53.7%), followed by type I (22.8%), type IV (8.1%) and type III (1.6%). All isolates harbored at least two virulence factor-encoding genes, and the prevalence was as follows: coa, 100%; icaA, 100%; hla, 13.0%; hlb, 91.1%, hld, 91.1%; lukS-PV and lukF-PV, 2.4%; and tst, 34.1%. A positive association with the presence of hla and SCCmec type II, and tst and SCCmec type I was observed. Conclusion: This study showed the high virulence potential of multidrug-resistant MRSA circulating in a teaching hospital. A high prevalence of MRSA showing intermediate vancomycin resistance was also observed, indicating the urgent need to improve strategies for controlling the use of antimicrobials for appropriate management of S. aureus infections.

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Section: Introductionmentioning

confidence: 99%

Molecular and phenotypic characteristics of methicillin-resistant Staphylococcus aureus isolated from hospitalized patients

Oliveira

Morey

Santos

et al. 2015

J Infect Dev Ctries

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“…Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen throughout the world but in Brazil it accounts for more than half of all S. aureus isolates in most hospitals [1].…”

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confidence: 99%

Molecular characterization of methicillin-resistantStaphylococcus aureusresistant to tigecycline and daptomycin isolated in a hospital in Brazil

Dabul

Camargo

2013

Epidemiol. Infect.

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SUMMARYWe report the molecular characterization of methicillin-resistant Staphylococcus aureus (MRSA) with resistance to tigecycline and to daptomycin isolated from intensive-care-unit patients in Brazil over a 6-month period. Thirty-six isolates (25 from infection sites, 11 from nasal sites) recovered from 23 patients who presented with MRSA infection during this period were characterized by pulsed-field gel electrophoresis, multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec) typing, and antimicrobial susceptibility profiling. Ten isolates from six patients and two isolates from different patients were resistant to tigecycline and daptomycin, respectively. Eight pulsotypes were identified and one, type A, accounted for 21 isolates from 12 patients; type A isolates were SCCmecII as were a further nine isolates of other pulsotypes. All but four of the total isolates were sequence type (ST) 5 or ST105 and classified as clonal complex (CC) 5; the historically prevalent lineage in Brazil, ST239-SCCmecIII, was identified in only three patients. Tigecycline-resistant strains were all ST105-SCCmecII and two patients were nasally colonized by strains of the same pulsotype found in infection sites. Two ST5-SCCmecII were daptomycin resistant after 48 h incubation. The origin and mechanism of these resistant strains remains unknown and further studies are warranted to determine whether such clones are becoming endemic in Brazilian hospitals and to assess their impact on infection control practice.

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“…Although moderate declining of hospital-acquired MRSA (HA-MRSA) bacteremia was recently observed in a few European countries, the United States and Australia [3][4][5], this pathogen is the most common single multidrug resistant (MDR) cause of HAIs in Europe, the United States, Asia, and Brazil [6][7][8][9]. The European/EEA population-mean of invasive HA-MRSA infections in 2013 was 18.0% [10]; however, these percentages vary greatly within a continent, from 0 in Iceland up to 64.5% in Romania, indicating major differences in epidemiology of MRSA bacteremia, while data from the non-EU states of the Balkan region remain underrepresented.…”

Section: Introductionmentioning

confidence: 99%

Differences in MRSA prevalence and resistance patterns in a tertiary center before and after joining an international program for surveillance of antimicrobial resistance

Djurić

Jovanović²,

Branka³

et al. 2017

Acta Microbiologica et Immunologica Hungarica

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Methicillin-resistant Staphylococcus aureus (MRSA) emerged as one of the most important causes of hospital-acquired bloodstream infections (BSIs), especially the multidrug resistant clones. The aim of the present study was to compare prevalence and resistance patterns of MRSA bacteremia in the major tertiary-care academic and referral center in Serbia before and after implementing an active antimicrobial resistance (AMR) surveillance. Laboratory-based before-after study was conducted during a two-year period (January 2012 to December 2013) in Clinical Centre of Serbia. Isolation and identification of bacterial strains were done following standard microbiological procedures. During the AMR surveillance, nearly twice more bloodstream samples were collected compared to the year without surveillance (1,528 vs. 855). In total, 43 isolates of MRSA were identified. MRSA was significantly more prevalent during the AMR surveillance compared to the previous year [14 (66.7%) to 29 (76.3%); P = 0.046]. During the AMR surveillance, MRSA more frequently originated from medical departments compared to intensive care unit, surgical department, and internal medicine (P = 0.027) indicating increasing MRSA infections in patients with less severe clinical condition and no apparent risk factors. Higher prevalence of MRSA and its lower susceptibility to erythromycin were revealed by implementation of active AMR surveillance, which may reflect more thoughtful collection of bloodstream samples from patients with suspected BSI.

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Methicillin/Oxacillin-resistant Staphylococcus aureus as a hospital and public health threat in Brazil

Cited by 27 publications

References 60 publications

Molecular and phenotypic characteristics of methicillin-resistant Staphylococcus aureus isolated from hospitalized patients

Molecular and phenotypic characteristics of methicillin-resistant Staphylococcus aureus isolated from hospitalized patients

Molecular characterization of methicillin-resistantStaphylococcus aureusresistant to tigecycline and daptomycin isolated in a hospital in Brazil

Differences in MRSA prevalence and resistance patterns in a tertiary center before and after joining an international program for surveillance of antimicrobial resistance

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