Molecular analysis of methicillin-resistant Staphylococcus aureus dissemination among healthcare professionals and/or HIV patients from a tertiary hospital
Rev. Soc. Bras. Med. Trop; 49 (1), 2016
Publication year: 2016
Abstract INTRODUCTION:
Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen in community settings. MRSA colonized individuals may contribute to its dissemination; the risk of MRSA infection is increased in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients, although the prevalence of colonization in this group is not well established. The present study addressed this issue by characterizing MRSA isolates from HIV/AIDS patients and their healthcare providers (HCPs) to determine whether transmission occurred between these two populations.METHODS:
A total of 24 MRSA isolates from HIV-infected patients and five from HCPs were collected between August 2011 and May 2013. Susceptibility to currently available antimicrobials was determined. Epidemiological typing was carried out by pulsed-field gel electrophoresis, multilocus sequence typing, and Staphylococcus cassette chromosome (SCCmec) typing. The presence of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) and heterogeneous daptomycin-resistant Staphylococcus aureus (hDRSA) was confirmed by population analysis profile. Isolates characterized in this study were also compared to isolates from 2009 obtained from patients at the same hospital.RESULTS:
A variety of lineages were found among patients, including ST5-SCCmecII and ST30-SCCmecIV. Two isolates were Panton-Valentine leukocidin-positive, and hVISA and hDRSA were detected. MRSA isolates from two HCPs were not related to those from HIV/AIDS patients, but clustered with archived MRSA from 2009 with no known relationship to the current study population.CONCLUSIONS:
ST105-SCCmecII clones that colonized professionals in 2011 and 2012 were already circulating among patients in 2009, but there is no evidence that these clones spread to or between HIV/AIDS patients up to the 7th day of their hospitalization.
Antibacterianos/farmacología, Técnicas de Tipificación Bacteriana, Infección Hospitalaria/microbiología, Infección Hospitalaria/transmisión, Electroforesis en Gel de Campo Pulsado, Infecciones por VIH/microbiología, Transmisión de Enfermedad Infecciosa de Profesional a Paciente/estadística & datos numéricos, Staphylococcus aureus Resistente a Meticilina/genética, Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación, Pruebas de Sensibilidad Microbiana, Epidemiología Molecular, Tipificación de Secuencias Multilocus, Infecciones Estafilocócicas/microbiología, Infecciones Estafilocócicas, Centros de Atención Terciaria