Healthcare-AssociatedStaphylococcus aureusBacteremia and the Risk for Methicillin Resistance: Is the Centers for Disease Control and Prevention Definition for Community-Acquired Bacteremia Still Appropriate?

2005 ◽  
Vol 26 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Olivier Lesens ◽  
Yves Hansmann ◽  
Eimar Brannigan ◽  
Susan Hopkins ◽  
Pierre Meyer ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Disease Control ◽  
Methicillin Resistance ◽  
Blood Cultures ◽  
New Classification ◽  
Control And Prevention ◽  
Centers For Disease Control ◽  
Mrsa Strains ◽  
Healthcare Associated ◽  
Hospital Acquired

AbstractObjective:To evaluate a new classification for bloodstream infections that differentiates hospital acquired, healthcare associated, and community acquired in patients with blood cultures positive forStaphylococcus aureus.Design:Prospective, observational study.Setting:Three tertiary-care, university-affiliated hospitals in Dublin, Ireland, and Strasbourg, France.Patients:Two hundred thirty consecutive patients older than 18 years with blood cultures positive forS. aureus.Methods:S. aureusbacteremia (SAB) was defined as hospital acquired if the first positive blood culture was performed more than 48 hours after admission. Other SABs were classified as healthcare associated or community acquired according to the definition proposed by Friedman et al. When available, strains of methicillin-resistantStaphylococcus aureus(MRSA) were analyzed by pulsed-field gel electrophoresis (PFGE).Results:Eighty-two patients were considered as having community-acquired bacteremia according to the Centers for Disease Control and Prevention (CDC) classification. Of these 82 patients, 56% (46) had healthcare-associated SAB. MRSA prevalence was similar in patients with hospital-acquired and healthcare-associated SAB (41% vs 33%;P> .05), but significantly lower in the group with community-acquired SAB (11%;P< .03). PFGE of MRSA strains showed that most community-acquired and healthcare-associated MRSA strains were similar to hospital-acquired MRSA strains. On multivariate analysis, Friedman's classification was more effective than the CDC classification for predicting MRSA.Conclusion:These results support the call for a new classification for community-acquired bacteremia that would account for healthcare received outside the hospital by patients with SAB.

Accuracy and reliability of electronic versus CDC surveillance criteria for non-ventilator hospital-acquired pneumonia

2019 ◽  
pp. 1-3
Author(s):  
Haiyan Ramirez Batlle ◽  
Michael Klompas ◽  
Keyword(s):  
Disease Control ◽  
Healthcare Associated Infections ◽  
Control And Prevention ◽  
Hospital Acquired Pneumonia ◽  
Centers For Disease Control ◽  
Healthcare Associated ◽  
Hospital Acquired

Abstract Nonventilator hospital-acquired pneumonia (NV-HAP) is one of the most common healthcare-associated infections, but most hospitals do not track it. We created a pilot electronic definition for NV-HAP and compared its accuracy to Centers for Disease Control and Prevention (CDC) criteria. Kappa values for the electronic definition and CDC criteria versus “true” pneumonia were similar: 0.40 and 0.47, respectively.

scholarly journals Staphylococcus aureus PBP4 Is Essential for β-Lactam Resistance in Community-Acquired Methicillin-Resistant Strains

2008 ◽  
Vol 52 (11) ◽  
pp. 3955-3966 ◽  
Author(s):  
Guido Memmi ◽  
Sergio R. Filipe ◽  
Mariana G. Pinho ◽  
Zhibiao Fu ◽  
Ambrose Cheung
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Healthy Individuals ◽  
Penicillin Binding Protein ◽  
Methicillin Resistant ◽  
Fold Reduction ◽  
Resistant Strains ◽  
Mrsa Strains ◽  
Hospital Acquired ◽  
Major Target

ABSTRACT Recent cases of infections caused by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) (CA-MRSA) strains in healthy individuals have raised concerns worldwide. CA-MRSA strains differ from hospital-acquired MRSAs by virtue of their genomic background and increased virulence in animal models. Here, we show that in two common CA-MRSA isolates, USA300 and MW2 (USA400), a loss of penicillin binding protein 4 (PBP4) is sufficient to cause a 16-fold reduction in oxacillin and nafcillin resistance, thus demonstrating that mecA, encoding PBP2A, is not the sole determinant of methicillin resistance in CA-MRSA. The loss of PBP4 was also found to severely affect the transcription of PBP2 in cells after challenge with oxacillin, thus leading to a significant decrease in peptidoglycan cross-linking. Autolysis, which is commonly associated with the killing mechanism of penicillin and β-lactams, does not play a role in the reduced resistance phenotype associated with the loss of PBP4. We also showed that cefoxitin, a semisynthetic β-lactam that binds irreversibly to PBP4, is synergistic with oxacillin in killing CA-MRSA strains, including clinical CA-MRSA isolates. Thus, PBP4 represents a major target for drug rediscovery against CA-MRSA, and a combination of cefoxitin and synthetic penicillins may be an effective therapy for CA-MRSA infections.

scholarly journals Change of the Frequency of Methicillin Resistance and Antibiogram Resistance Profile of Staphylococcus aureus within a Period of 15 Years

2021 ◽  
Author(s):  
Kamuran Şanlı ◽  
Selen Zeliha Mart Kömürcü ◽  
Nilgün Kansak ◽  
Rıza Adaleti
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Methicillin Resistance ◽  
Erythromycin Resistance ◽  
Resistance Profile ◽  
Antimicrobial Resistance Profile ◽  
Gentamicin Resistance ◽  
Successful Control ◽  
Mrsa Strains ◽  
Hospital Acquired

Objective: The aim of this retrospective study was to evaluate the rate and antimicrobial resistance profile of community-acquired (CA) and hospital-acquired (HA) methicillin-resistant and sensitive Staphylococcus aureus (MRSA, MSSA) strains between 2004 and 2019. Method: Within the scope of the research, the rate of MRSA and MSSA and the change in antimicrobial resistance profile over time were investigated using two research data of 210 Staphylococcus aureus strains isolated in 2004, and 401 in 2019. Results: While any significant change was not seen in the rates of CA-MRSA (32.4%) and CA-MSSA (67.6%) in 2004, and of CA-MRSA (31.6%) and CA-MSSA (68.4%) in 2019, the prevalence of HA-MRSA decreased by 56.1% in 2004 and 30.7% in 2019 and of HA-MSSA increased by 43.9% in 2004 and 69.3% in 2019. No resistance to vancomycin and teikoplanin was observed in MRSA strains. Resistance of CA-MRSA against ciprofloxacin, levofloxacin, clindamycin and gentamicin decreased. In CA-MSSA an increase of penicillin resistance as well as a decrease in gentamicin resistance was observed. In resistance of HA-MRSA against ciprofloxacin, levofloxacin, erythromycin, clindamycin, gentamicin decreased. HA-Resistance of MSSA against fusidic acid increased and against ciprofloxacin and trimethoprim/sulfamethoxazole and erythromycin resistance decreased. Conclusion: It was found that the rate of HA-MRSA decreased during the given period of 15 years. Vancomycin or teicoplanin resistance was not observed in MRSA and MSSA. While against ciprofloxacin, levofloxacin, clindamycin, gentamicin decreased in both CA-MRSA and HA-MRSA. A closer follow-up of the prevalence and antimicrobial resistance profiles of these strains is of utmost importance for the successful control of the infections caused by MRSA and MSSA.

scholarly journals Isolation, Detection and Molecular Characterization of Staphylococcus aureus from Postoperative Infections

2020 ◽  
pp. 63-67
Author(s):  
Ritya Mary Jibu ◽  
R. V. Geetha ◽  
T. Lakshmi
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Infection ◽  
Molecular Characterization ◽  
Methicillin Resistance ◽  
Healthcare Associated Infection ◽  
Postoperative Infections ◽  
Coagulase Negative Staphylococci ◽  
Mrsa Strains ◽  
Healthcare Associated

Post operative infections that occur after surgical procedures can cause a lot of complications like sepsis, organ failure or even death. These are the third most commonly reported healthcare associated infection. The most common cause of wound infection regardless of procedure performed remains gram-positive cocci which comprise more than 50% of all infections. Specifically, Staphylococcus aureus and coagulase-negative staphylococci are the most frequent organisms isolated from a wound infection. There has been an increasing incidence of MRSA strains reported in hospitals across the globe. The main aim of our study is isolation, detection and molecular characterization of Staphylococcus aureus from postoperative infections.  Samples were collected from post operative patients with infected wounds. The area around the wound was cleaned. Exudates were collected from the wound with a sterile swab stick. The samples were inoculated on different solid culture mediums and the plates were incubated in the presence of oxygen at 37°C overnight. There were many standard procedures done in which tube coagulase was taken as the main criteria. Antibiotic susceptibility testing was done by Kirby Bauer method following Clinical and Laboratory Standards Institute (CLSI) guidelines using commercially available cefoxitin (30 μg) disc (HiMedia) and the results were compared with Staphylococcus aureus ATCC 25923 and MRSA ATCC 43300 control strains. The MRSA strains were identified and detection of Mec A gene that codes for methicillin resistance is done using PCR technique.

scholarly journals Genetic Diversity of Methicillin-Resistant Staphylococcus Aureus Among Japanese Inpatients in the Early 1980s

2020 ◽  
Author(s):  
Hui Zuo ◽  
Yuki Uehara ◽  
Yujie Lu ◽  
Takashi Sasaki ◽  
Keiichi Hiramatsu
Keyword(s):  
Staphylococcus Aureus ◽  
Population Structure ◽  
Methicillin Resistance ◽  
The United States ◽  
Type I ◽  
Methicillin Resistant ◽  
Global Pandemic ◽  
Mrsa Strains ◽  
Healthcare Associated ◽  
Genotypic Characteristics

Abstract Background: Methicillin-resistant Staphylococcus aureus (MRSA) was recognized as a serious nosocomial pathogen in Japan starting in the early 1980s. Limited genotypic characteristics on healthcare-associated MRSA (HA-MRSA) associated with “hospital MRSA panics” in Japan in this era. Therefore, this study aimed to determine the characteristics of Japanese HA-MRSA strains in the early 1980s and their linkage with current MRSA strains.Methods: For 194 S. aureus strains isolated in the early 1980s, we determined methicillin resistance phenotypically and genotypically and performed multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec) typing, and whole-genome sequencing. Results: Twenty mecA-positive MRSA (10.3%), 8 mecA-negative MRSA (4.1%) and 3 mecA-positive methicillin-susceptible S. aureus (MSSA) (1.5%) strains were identified. The frequent sequence type (ST) was ST30 (n=11), followed by ST5 (n=8), ST81 (n=4), and ST247 (n=3). Rates of SCCmec types I, II, and IV were 65.2%, 13.0%, and 17.4%, respectively. ST30-SCCmec I (n=7) and ST5-SCCmec I (n=5) were predominant genotypes. Only two strains exhibited tst-positive ST5-SCCmec II, which is the current Japanese HA-MRSA genotype. Moreover, 73.3% of SCCmec type I strains were susceptible to imipenem compared with SCCmec type II strains (0%). All ST30 strains shared a common ancestor with strain 55/2053, which resulted in a global pandemic of Panto-Valentine leukocidin (PVL)-positive and penicillin-resistant MSSA spread in Europe and the United States in the 1950s. Conclusions: Our results demonstrated the heterogeneous population structure of Japanese HA-MRSA during the early 1980s, which comprised diverse clones that are mostly rare in recent years. The shift to the current homogenous population structure of HA-MRSA strains consisting of tst-positive ST5-SCCmec II might result from the clinical introduction of new antimicrobials including imipenem.

scholarly journals How to prevent transmission of MRSA in the open community?

2004 ◽  
Vol 9 (11) ◽  
pp. 1-2 ◽  
Author(s):  
F Vandenesch ◽  
J Etienne
Keyword(s):  
Methicillin Resistance ◽  
Past History ◽  
The United States ◽  
Hospital Acquired Infection ◽  
History Of ◽  
Mrsa Strains ◽  
Healthcare Associated ◽  
Resistance Rates ◽  
Low Prevalence ◽  
Hospital Acquired

In the past 20 to 30 years, methicillin-resistant Staphylococcus aureus (MRSA) strains have been present in hospitals and have become a major cause of hospital-acquired infection. Methicillin resistance rates of S. aureus vary considerably between countries, with a high prevalence in the United States, and southern Europe (&gt;20%) and a low prevalence in northern Europe (&lt; or =5%). Community-acquired MRSA emerged worldwide in the late 1990s. There has been great confusion in the literature between healthcare-associated MRSA infections occurring in the community in patients who are at risk of acquiring hospital MRSA (such as those with past history of hospital admission, immunocompromised status, etc.), and true CA-MRSA infections due to strains that are present in the community only.

scholarly journals Prevalencia de infecciones hospitalarias en un hospital peruano de nivel IV, en el año 2008.

2011 ◽  
Vol 22 (2) ◽  
Author(s):  
Luis Francisco Hidalgo ◽  
Jorge Enrique Marroquín ◽  
Juana Antigoni ◽  
Frine Samalvides
Keyword(s):  
Staphylococcus Aureus ◽  
Disease Control ◽  
Control And Prevention ◽  
Centers For Disease Control ◽  
De Medicina

  Objetivo:Determinar la prevalencia puntual de infecciones hospitalarias (IH) en un hospital peruano de Nivel IV, en el año 2008. Material y métodos: Estudio descriptivo de corte transversal. Infecciones hospitalarias fueron identificadas empleando los criterios del Centers for Disease Control and Prevention (CDC) de 1999. Resultados: En total se evaluaron 1578 pacientes: 685 varones y 893 mujeres. La prevalencia de infecciones hospitalarias por 100 pacientes hospitalizados fue de 7,54 (7,05, 6,77, 7,31, 4,55, 0,75 y 26,85, en los servicios de Medicina, Cirugía, Pediatría, Ginecología–Obstetricia, Emergencia y Unidad de Cuidados Intensivos respectivamente). El número de pacientes con infecciones hospitalarias fue 119, 62 varones y 57 mujeres. La mediana de hospitalización en los pacientes con infecciones hospitalarias fue de 22 días y 6 días en los pacientes que no presentaron IH. 127 infecciones hospitalarias diagnosticadas en los 119 pacientes: 113 con una infección hospitalaria, cuatro pacientes con dos y dos pacientes con tres. La IH más común fue neumonía (25,2%), seguida por infecciones de tracto urinario (24,4%), infección de herida quirúrgica profunda (11%) y bacteriemia (6,3%). De 32 pacientes con neumonía nosocomial, 10 tenían ventilación mecánica. 61,3% de los pacientes con infección de tracto urinario hospitalario contaba con catéter urinario. Los agentes infecciosos más comunes fueron Pseudomona aeruginosa 16,1% y Staphylococcus aureus 9,7%. Conclusiones: La prevalencia de infecciones intrahospitalarias hallada se encuentra en el rango esperado para hospitales de similar complejidad. (Rev Med Hered 2011;22:76-81).

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