Methicillin-resistant staphylococcus aureus (MRSA) carriage in a dermatology unit

Abstract

OBJECTIVE:The aim of this study was to characterize Staphylococcus aureus (MRSA) carriage in a dermatology unit.METHODS:This was a prospective and descriptive study. Over the course of 26 weeks, surveillance cultures were collected weekly from the anterior nares and skin of all patients hospitalized in a 20-bed dermatology unit of a tertiary-care hospital. Samples from healthcare workers (HCWS) were cultured at the beginning and end of the study. Colonized patients were put under contact precautions, and basic infection control measures were enforced. Staphylococcus aureus colonization pressure was determined monthly. Colonized and non-colonized patients were compared, and isolates were evaluated for antimicrobial susceptibility, SCCmec type, virulence factors, and type.RESULTS:Of the 142 patients evaluated, 64 (45%) were colonized by MRSA (39% hospital acquired; 25% community acquired; 36% indeterminate). Despite isolation precautions, hospital-acquired Staphylococcus aureus occurred in addition to the continuous entry of Staphylococcus aureus from the community. Colonization pressure increased from 13% to 59%, and pemphigus and other bullous diseases were associated with MRSA colonization. Eleven out of 71 HCWs (15%) were Staphylococcus aureus carriers, although only one worker carried a persistent clone. Of the hospital-acquired MRSA cases, 14/28 (50%) were SCCmec type IV (3 PFGE types), 13 were SCCmec type III (46%), and one had an indeterminate type. These types were also present among the community-acquired Staphylococcus aureus isolates. SSCmec type IV isolates were shown to be more susceptible than type III isolates. There were two cases of bloodstream infection, and the pvl and tst virulence genes were absent from all isolates.CONCLUSIONS:Dermatology patients were colonized by community- and hospital-acquired Staphylococcus aureus. Half of the nosocomial Staphylococcus aureus isolates were SCCmec type IV. Despite the identification of colonized patients and the subsequent contact precautions and room placement, Staphylococcus aureus colonization continued to occur, and colonization pressure increased. Pemphigus and other bullous diseases were associated with Staphylococcus aureus.

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

“…These SCCmec types were also detected in MRSA surveys conducted in different Brazilian hospitals. However, the prevalence of SCCmec types varied between different regions [3,[25][26][27][28][29][30][31]. The Brazilian epidemic clone (BEC) carrying the SCCmec type III has been the predominant clone in several hospitals in Brazil [28,29,32].…”

“…Staphylococcus aureus can be found as a harmless colonizer of skin and mucosa, mainly the anterior nares, in 20%-60% of the population [1][2][3]. Colonization by this bacterium is one important predisposing factor for staphylococcal infections [1].…”

Tendência de resistência entre isolados clínicos de Staphylococcus aureus em um hospital universitário do norte do Paraná de 2002 a 2011

“…Outro fato observado foi a redução da resistência a sulfametoxazol-trimetoprim, de 100%, em 1998100%, em , para 83,7%, em 2008100%, em (TEIXEIRA et al, 2012. Pacheco et al (2011) também encontraram índices elevados de resistência para isolados clínicos de MRSA em um hospital da cidade de São Paulo, 81% para eritromicina, 61% para gentamicina e 41% para clindamicina em isolados clínicos de MRSA. Os percentuais de resistência verificados por estes autores foram maiores do que os encontrados em nosso estudo, provavelmente pelo fato de terem sido incluídos apenas S. aureus resistentes a betalactâmicos, ao contrário do presente estudo, no qual avaliou a resistência de todos S. aureus isolados no período de estudo.…”

“…No entanto, apesar de alguns destes compostos antigos, como sulfametoxazol-trimetoprim, exibirem boa atividade contra MRSA, assim como verificado em nosso estudo, a falta de dados de eficácia clínica, assim como a preocupação com a toxicidade destes medicamentos, impedem que sejam usados no tratamento de infecções estafilocócicas invasivas graves (CHAUDHARI et al, 2014;POGUE et al, 2011).…”

Inhibition of staphyloxanthin biosynthesis in Staphylococcus aureus by rhodomyrtone, a novel antibiotic candidate

“…Staphylococcus aureus causes a wide spectrum of clinically significant hospital-and community-acquired infections in human, including skin and soft-tissue infections and lifethreatening systemic infection (Daum, 2008;Pacheco et al, 2011;Karamatsu et al, 2012). The frequency of meticillinresistant S. aureus (MRSA) infections has now been declared a public-health imperative (Okesola, 2011;Dhand & Sakoulas, 2012;Stefani et al, 2012).…”