Incidence, antibiotic resistance and clonal relations of MRSA strains isolated from a Romanian university hospital

Székely, Edit; Lörinczi, Lilla; Bilca, Doina; Fodor, Eleonóra; Sóki, Jozsef; Sabău, M

doi:10.1556/amicr.55.2008.1.1

Cited by 10 publications

(8 citation statements)

References 19 publications

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“…Even though the pre-surveillance department-distribution of MRSA in our study (50% ICU and 14% SD) is similar to the results reported in Romanian teaching hospital and Macedonian Clinical Centre [18,19], these rates almost equalized during the surveillance year (27.6% ICU and 24.1% SD) while the medical departments featured predominantly (37.9%). It is hard to find the solid grounds that underpin such a difference within a single center as well as to answer whether the surveillance play an important role.…”

Section: Discussionsupporting

confidence: 87%

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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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Section: Discussionsupporting

confidence: 87%

“…These rates are more than twice higher than reported to CAESAR for the entire country but similar to single clinical centers in neighboring countries, Romania and Macedonia [18,19]. Only rifampicin and erythromycin significantly changed in our study, first lowered and second increased during the AMR surveillance.…”

Section: Discussionsupporting

confidence: 67%

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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“…Unfortunately, this is also true for Eastern Europe including Romania. It is known that the MRSA rates are extremely high, ranging from approximately 30% up to 70% in recent Romanian studies [5], [6], [7], [8], [9], [10], [11], [12], thus reaching the highest prevalence levels reported anywhere in the world. According to the ECDC antimicrobial resistance surveillance (formerly EARSS), the MRSA rate among invasive infections was “equal to or above 25%” in 2008 and slightly above 50% in 2011/2012 [9]; [http://www.ecdc.europa.eu/en/publications/publications/antimicrobial-resistance-surveillance-europe-2011.pdf, http://www.ecdc.europa.eu/en/publications/publications/antimicrobial-resistance-surveillance-europe-2012.pdf].…”

Section: Introductionmentioning

confidence: 99%

Molecular Typing of MRSA and of Clinical Staphylococcus aureus Isolates from Iaşi, Romania

et al. 2014

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Romania is one of the countries with the highest prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the world. To obtain data on affiliation of MRSA to strains and clonal complexes and on the population of methicillin susceptible S. aureus (MSSA), clinical isolates from bloodstream infections, skin and soft tissue infections as well as from screening swabs were collected at hospitals in Ia?i, a city in the North-Eastern part of Romania. Isolates were characterised by microarray hybridisation. Nearly half of all isolates (47%), and about one third (34%) of bloodstream isolates were MRSA. The prevalence of the Panton-Valentine leukocidin (PVL) was also high (31% among MRSA, 14% among MSSA). The most common MRSA strain was a PVL-negative CC1-MRSA-IV that might have emerged locally, as a related MSSA was also common. PVL-positive CC8-MRSA-IV (“USA300”) and PVL-negative ST239-like MRSA-III were also frequently found while other MRSA strains were only sporadically detected. Among MSSA, PVL-positive CC121 as well as PVL-negative CC1, CC22 and CC45 predominated. Although this study provides only a snapshot of S. aureus/MRSA epidemiology in Romania, it confirms the high burden of MRSA and PVL on Romanian healthcare settings.

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“…8 Like other cephalosporins, ceftobiprole' s chemical structure consists of a ␤-lactam ring condensed with a sixmembered heterocycle and three variable side chain substituents (Figure 1). Planar geometry, unflexibility of the bicyclic system, and chemical functions in position C 3 (R 2 ), C 4 (R 3 ), and C 7 (R 1 ) are deemed largely involved in the overall biologic activity of cephalosporins. 9 Thus, for ceftobiprole, the large hydrophobic side chain in position R 1 was found more deeply enclosed into the binding pocket of PBP2a compared with nitrocefin, leading to a stronger interaction and the formation of a stable acyl-enzyme complex.…”

Section: Chemistry Structure and Functions Of Ceftobiprolementioning

confidence: 99%

“…1 A significant increase in MRSA infections has been reported worldwide, with a prevalence greater than 60% in the United States in 2003 (vs 2% in 1974 and 22% in 1995) and almost 50% in some European countries in 2008. [2][3][4] Methicillin resistance is due to the presence of the staphylococcal cassette chromosome mec (SCCmec) and the mecA gene, acquired by horizontal transfer from another species and integrated into the chromosome. 5 The mecA gene encodes a 78-kD penicillinbinding protein (PBP) called PBP2a, which has the faster rate of drug release compared with the unaltered PBP2 and the lowest binding affinity for methicillin and other ␤-lactams.…”

mentioning

confidence: 99%

Ceftobiprole: First Cephalosporin with Activity Against Methicillin‐Resistant Staphylococcus aureus

Vidaillac¹,

Rybak²

2009

Pharmacotherapy

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Ceftobiprole medocaril is the first member of a new series of advanced cephalosporins with activity against methicillin-resistant Staphylococcus aureus (MRSA). The drug received an approvable letter from the United States Food and Drug Administration (FDA) in March 2008 and from Health Canada in June 2008 for the treatment of complicated skin and skin structure infections including diabetic foot infections. Ceftobiprole exerts its antibacterial activity by inhibiting the penicillin-binding proteins (PBPs) involved in cell wall synthesis. It has an established stability against hydrolysis by many gram-positive beta-lactamases and a higher affinity for various PBPs (such as PBP2a of MRSA or PBP2x of Streptococcus pneumoniae), which leads to a wider spectrum of activity compared with older beta-lactams. Ceftobiprole activity does not cover extended-spectrum beta-lactamase-producing Enterobacteriaceae and some other pathogens, including Enterococcus faecium or Acinetobacter baumanii. Generally well tolerated, with nausea and taste disturbance being the most common adverse events, ceftobiprole appeared noninferior to empiric therapy in several clinical trials. Ceftobiprole is available only for intravenous administration; recommended dosage regimens have not been approved by the FDA as of this writing. However, based on the Canadian package insert, expected dosage recommendations are 500 mg as a 1-hour intravenous infusion every 12 hours for the treatment of complicated skin and skin structure infections caused by certain gram-positive pathogens, and 500 mg as a 2-hour infusion every 8 hours when susceptible gram-negative or both gram-positive and susceptible gram-negative pathogens are involved. Dosage adjustments are indicated for patients with moderate or severe renal impairment, and dosage recommendations are expected to be 500 or 250 mg, respectively, as a 2-hour infusion every 12 hours. Several precautions regarding hypersensitivity and drug incompatibility are reported. Ceftobiprole represents a promising option for the treatment of mono- and polymicrobial infections caused by multidrug-resistant gram-positive and susceptible gram-negative pathogens, but further toxicity and safety studies are warranted.

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Incidence, antibiotic resistance and clonal relations of MRSA strains isolated from a Romanian university hospital

Cited by 10 publications

References 19 publications

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

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

Molecular Typing of MRSA and of Clinical Staphylococcus aureus Isolates from Iaşi, Romania

Ceftobiprole: First Cephalosporin with Activity Against Methicillin‐Resistant Staphylococcus aureus

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