USA300, A strain of community-associated methicillin-resistant Staphylococcus aureus, crossing Belgium’s borders: outbreak of skin and soft tissue infections in a hospital in Belgium

Kaïret, K.; Ho, Eugenia; Kerkhoven, D. Van; Boes, Juul; Calenbergh, S. Van; Pattyn, Luc; Lemay, Pierre

doi:10.1007/s10096-016-2883-6

Cited by 15 publications

(9 citation statements)

References 10 publications

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“…PVL is regarded as one of the main features of CA-MRSA and a clinically relevant virulence marker for S. aureus 3 . In recent years, cases of nosocomial PVL-positive MRSA transmissions and outbreaks in Europe have been accumulating 5 , 12 , 13 thus suggesting that the barrier between community- and hospital-associated MRSA has already been penetrated. Although PVL is associated with the severity of infection 3 , the characterization of MRSA isolates in hospitalized patients in Germany in terms of PVL is not consequently pursued.…”

Section: Discussionmentioning

confidence: 99%

“…Although the prevalence of this MRSA clone in Europe is generally considered to be low 8 , 10 , we found a remarkably high proportion of USA300 MRSA clones circulating in the community 2 and USA300 is indeed the most commonly imported MRSA into the European continent through intercontinental travel 19 . Moreover, USA300 MRSA clones can be classified as epidemic, as demonstrated by their expansive properties and dominance on the American continents 20 and further highlighted by accumulating reports on nosocomial transmission events and outbreaks in Europe 5 , 12 , 13 .…”

Section: Discussionmentioning

confidence: 99%

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Entry of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus into the hospital: prevalence and population structure in Heidelberg, Germany 2015–2018

Klein

Hannesen

Zanger

et al. 2020

Sci Rep

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Staphylococcus aureus is one of the major pathogens causing community-and healthcare-acquired infections. the presence of the virulence factor panton-Valentine leukocidin (pVL) is associated with recurrent infection and clinical severity and generally regarded as a feature of community associatedmethicillin-resistant Staphylococcus aureus (MRSA). to date, the focus of pVL-positive MRSA in hospitalized patients has been on outbreaks. We aimed to investigate whether pVL-positive MRSA has penetrated the community-hospital barrier by determining the prevalence of pVL in MRSA of hospitalized patients. MRSA strains isolated from patients hospitalized > 48 h in Heidelberg University Hospital between 2015 and 2018 Isolates were analysed for the presence of PVL and subjected to spatyping. PVL-positive MRSA were then characterized by whole genome sequencing. We analysed 740 MRSA isolates in the study period and identified 6.2% (n = 46) PVL-positivity. 32.6% of PVL-positive MRSA met the criteria for nosocomial acquisition. the most frequent clones among the pVL-positive strains were ST80-t044 (21.7%, n = 10/46) and ST8-t008 (19.5%, n = 9/46). WGS identified three possible transmission clusters involving seven patients. in conclusion, we found successful epidemic pVL-positive MRSA clones entering the hospital and causing nosocomial infections. preventive measures and constant surveillance should be maintained to prevent transmissions and clonal outbreaks. Staphylococcus aureus is one of the major causes of community and hospital acquired infections. Methicillinresistance is an ongoing problem locally and globally. Although the overall prevalence of methicillin-resistant S. aureus (MRSA) in Germany is declining 1, MRSA strains harboring the pathogenic marker Panton-Valentine leukocidin (PVL) are isolated more frequently 2. The presence of PVL is relevant, as it is associated with a more severe clinical presentation, often with recurrences, deep and multiple lesions and frequent transmission to contact persons, irrespective of methicillin resistance 3-6. In addition, PVL-positive S. aureus often displays multiple resistances to commonly used antibiotics to treat S. aureus infections 3,7. PVL has been linked to community-associated (CA-) MRSA 6. Although the overall prevalence of PVL in Germany is considered low according to data acquired by Schaumburg et al. 8 , a study by Jappe et al. 9 revealed

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Entry of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus into the hospital: prevalence and population structure in Heidelberg, Germany 2015–2018

Klein

Hannesen

Zanger

et al. 2020

Sci Rep

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“…Although the impact of the proposed approach has not been systematically evaluated, these observations in conjunction with our report suggests that a history of recurrent SSTI is a potent marker for colonization with epidemic CA-MRSA and could thus prove useful for its early detection and timely eradication in newly admitted patients before invasion of epidemic CA-MRSA into European hospitals becomes an unchangeable fact. A recent report of a USA300 outbreak in a Belgium hospital demonstrates the urgency of this issue 10 and justifies taking measures before direct evidence is available. Finally, European surveillance activities must address the silent invasion by USA300-LV and must monitor the import and spread of ACME-neg, MLST 8, SCCmec IVc MRSA.…”

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confidence: 99%

Transmission of ST8-USA300 Latin American Variant Methicillin-Resistant Staphylococcus aureus on a Neonatal Intensive Care Unit: Recurrent Skin and Soft- Tissue Infections as a Marker for Epidemic Community-Associated-MRSA Colonization

Nurjadi

Klein

Zimmermann

et al. 2017

Infect. Control Hosp. Epidemiol.

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“…CA-MRSA bacteria are much less prevalent in Europe, where the European ST80-IV CA-MRSA clone, USA300 CA-MRSA strains, and other lineages, such as ST22-IV, coexist. Infections with PVL-positive MRSA have been described in most European countries as Austria (34), Germany (35), Bulgaria (36), Spain (37), UK (38), Italy/ NICU (39), Belgium (40), France (41).…”

Section: Discussionmentioning

confidence: 99%

Expanding PVL positive MRSA healthcare-associated infections outbreak in a newborns unit, caused by hospital hygiene shortcomings

Drăgulescu¹,

Oprea²,

Zorescu

et al. 2018

Revista Romana De Medicina De Laborator

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A prolonged outbreak of Healthcare-Associated Infections (HCAIs) evolved since December 2013, in a Newborns Unit from Hospital A, sited in the North-Eastern development region, Romania. A first cluster consisted of 19 cases, of which 18 infections in newborns and 1 labour infectious complication in a mother. Except for five cases declared and treated in the Neonatology Unit as hospital-acquired infections, the other cases were discharged and further required rehospitalisation and treatment. Eight of these innitialy discharged cases were readmitted to the Pediatric Surgery Unit and two others to the Pediatrics Unit of Hospital B, while three others were readmitted to three hospitals: one to the Pediatrics Unit of Hospital C, and other two to Hospital A and Hospital D, respectively. The mother with the labour infectious complication was readmitted to the Gynecology Unit of the Hospital A. A number of fifteen Staphylococcus aureus (S. aureus) strains isolated from the HCAI first episode and 8 strains from 7 HCWs were received by „Cantacuzino” Institute, Nosocomial Infections and Antibiotic Resistance Laboratory from the County Public Health Directorate, for confirmation and molecular typing. After a first round of interventions for infection control, a second episode bursted in Hospital A and our laboratory received six other S. aureus isolates from newborns, hospital environment, and HCWs. Public Health interventions based on epidemiologic data and molecular microbiology results were finally successful. The evolution of all cases was favorable. An important factor favoring the outbreak was the moving of the Birth Unit of Hospital A to an innapropriate location for an 18-month interval, more than innitially estimated, in relation to rehabilitation of the ward. We considered to report this episode taking into account the unusual evolution, the risk of multiresistant bacterial strains spreading, and multiple unwanted consequences caused by shortcomings in providing appropriate hygiene conditions.

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USA300, A strain of community-associated methicillin-resistant Staphylococcus aureus, crossing Belgium’s borders: outbreak of skin and soft tissue infections in a hospital in Belgium

Abstract: we report the first Belgian outbreak of CA-MRSA USA300 in this article. A strict search and destroy strategy and continued surveillance are required in the management of CA-MRSA USA300.

Cited by 15 publications

References 10 publications

Entry of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus into the hospital: prevalence and population structure in Heidelberg, Germany 2015–2018

Entry of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus into the hospital: prevalence and population structure in Heidelberg, Germany 2015–2018

Transmission of ST8-USA300 Latin American Variant Methicillin-Resistant Staphylococcus aureus on a Neonatal Intensive Care Unit: Recurrent Skin and Soft- Tissue Infections as a Marker for Epidemic Community-Associated-MRSA Colonization

Expanding PVL positive MRSA healthcare-associated infections outbreak in a newborns unit, caused by hospital hygiene shortcomings

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