Clonality among multidrug-resistant hospital-associated Staphylococcus epidermidis in northern Europe

Abstract

Using pulsed-field gel electrophoresis (PFGE) we have previously described the occurrence and possible dissemination of a clone of multidrug-resistant Staphylococcus epidermidis (MDRSE) in 2 hospitals in northern Sweden during 2001-2003. The aims of the present study were to investigate if this clone still persisted, 7 y later, in these 2 hospitals and whether this specific clone was detectable among clinical isolates from 9 other hospitals, 6 Swedish as well as a Norwegian, Danish and a German hospital. In total, 173 clinical isolates of MDRSE isolated during 2003 to 2008 were analysed using PFGE, of which 22 isolates were also characterized by multilocus sequence typing (MLST). Two dominating PFGE types (types A and B) were identified, consisting of 56 (32%) and 38 (22%) isolates, respectively. Type A, which was detected in the Norwegian and all Swedish hospitals, proved indistinguishable to the clone previously identified in 2001-2003 and corresponded with a novel sequence type (ST215). Type B was discovered in the German, Danish and in 7 Swedish hospitals and corresponded with ST2. In conclusion, we have demonstrated the occurrence, persistence and potential dissemination of 2 MDRSE genotypes, including a novel sequence type (ST215), within hospitals in northern Europe.

Comparative Epidemiology of Staphylococcus epidermidis Isolates from Patients with Catheter-Related Bacteremia and from Healthy Volunteers

“…The patients' clinical histories were also different in the two groups, as patients from the CRBSI-specific PFGE group were more often exposed to antibiotics within the month preceding the CRBSI episode, more often had a severe clinical presentation, and developed their CRBSI episode on a catheter 3 days "older" on average. ST2 isolates accounted for nearly 20% of all CRBSIs isolates and were thus not as frequently recovered as in other studies conducted in the United States, Australia, or Germany, where the majority of S. epidermidis isolates responsible for nosocomial infections belonged to ST2 (9,10,33). However, all of the ST2 isolates belonged to the CRBSIspecific PFGE group.…”

Genetic Analysis of Glycopeptide-Resistant Staphylococcus epidermidis Strains from Bone and Joint Infections

“…4). These findings show that the GRSE strains isolated from BJIs in the Paris area are representative of the populations of multidrugresistant strains circulating in hospitals worldwide (10,11,(29)(30)(31)(32)(33). Almost 95% of these strains belong to the STs of the main clonal complex, principally ST2, ST5, and ST23, and most of these strains are resistant to numerous antibiotics, such as oxacillin, macro- lides, quinolones, and fucidic acid.…”

“…Resistance to fluoroquinolones, erythromycin, clindamycin, gentamicin, rifampin, tetracycline, and chloramphenicol is also frequent (1,(6)(7)(8). Multilocus sequence typing (MLST) analysis suggests that multidrug resistance in S. epidermidis is associated with a small number of related clones, mostly belonging to ST2 and related sequence types (STs) (9)(10)(11).…”

Teicoplanin non-susceptible coagulase-negative staphylococci in a large Australian healthcare network: Implications for treatment with vancomycin

“…2 Some CoNS are able to colonise polymer surfaces by the formation of a thick, adherent, multilayered biofilm which can interfere with host defense mechanisms such as opsonophagocytosis. 3 Over the past few decades, the significance of CoNS has increased due to the growing number of device implantations and immunocompromised patients. CoNS are now the second most common cause of prosthetic valve endocarditis after S. aureus and one of the most frequent pathogens isolated from deep-seated prosthetic implant infections.…”