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Molecular Surveillance of Clinical Methicillin-Resistant Staphylococcus aureus Isolates in Neonatal Intensive Care Units

  • Yhu-Chering Huang (a1) (a2), Lin-Hui Su (a1) (a3), Tsu-Lan Wu (a1) (a3) and Tzuo-Yien Lin (a1) (a2)

Abstract

Background and Objective:

Methicillin-resistant Staphylococcus aureus (MRSA) has become an important nosocomial pathogen in our neonatal intensive care units (NICUs) and accounts for almost all S. aureus clinical isolates. The objective of this study was to assess the relatedness of these MRSA strains.

Design:

MRSA clinical isolates were collected from infants hospitalized in our NICUs. Pulsed-field gel electrophoresis with SmaI digestion was used to fingerprint these isolates.

Setting:

Level-III NICUs in a university-affiliated children's hospital.

Results:

Between 1998 and 2000, a total of 122 MRSA clinical isolates were collected from 104 infants hospitalized in our NICUs. Fifteen infants had multiple isolates (range, 2 to 4 isolates). The sources of specimens included blood (72), pus (23), sputum (15), body fluids (3), and catheter tips (9). A total of 4 genotypes with 20 subtypes were identified. There were 2 genotypes in 1998, 2 genotypes in 1999, and 4 genotypes in 2000. All but 2 isolates belonged to either genotype A (63.1%; 7 subtypes) or genotype C (35.2%; 11 subtypes). Among the 15 infants with multiple isolates, the genotypes of the isolates from a single episode of MRSA infection were different in 2 of 12 cases, and reinfection with a new strain was noted in 3 of 5 cases with recurrent infections.

Conclusions:

Two predominant MRSA clones prevailed in our NICUs between 1998 and 2000. Polyclonal bacteremia and reinfection with a new strain were noted.

Copyright

Corresponding author

Division of Pediatric Infectious Diseases, Chang Gung Children's Hospital, 5, Fu-Shin Street, Kweishan, Taoyuan, Taiwan.ychuang@adm.cgmh.org.tw

References

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1.Jevons, MP. “Celbenin”-resistant staphylococci. BMJ 1961;1:124125.
2.Hryniewicz, W. Epidemiology of MRSA. Infection 1999;27(suppl 2):S13S16.
3.Chang, SC, Hsu, LY, Luh, KT, Hsieh, WC. Methicillin-resistant Staphylococcus aureus infection. J Formos Med Assoc 1988;87:157163.
4.Chang, SC, Sun, CC, Yang, LS, Luh, KT, Hsieh, WC. Increasing nosocomial infections of methicillin-resistant Staphylococcus aureus at a teaching hospital in Taiwan. Int J Antimicrob Agents 1997;8:109114.
5.Hsueh, PR, Liu, CY, Luh, KT. Current status of antimicrobial resistance in Taiwan. Emerg Infect Dis 2002;8:132137.
6.Chuang, YY, Huang, YC, Lee, CY, Lin, TY, Lien, RY, Chou, YH. Methicillin-resistant Staphylococcus aureus bacteremia in neonatal intensive care units: analysis of 90 episodes. Acta Paediatr 2004;93:786790.
7.Huskins, WC, Goldman, DA. Nosocomial infections. In: Feigin, RD, Cherry, JD, eds. Textbook of Pediatric Infectious Diseases, ed. 4, vol. 2. Philadelphia: W. B. Saunders; 1998:25452554.
8.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests, ed. 7. Wayne, PA: National Committee for Clinical Laboratory Standards; 2000.
9.Huang, YC, Su, LH, Wu, TL, et al.Molecular epidemiology of methicillin-resistant Staphylococcus aureus clinical isolates in Taiwan. J Clin Microbiol 2004;42:307310.
10.Tenover, FC, Arbeit, RD, Goering, RV, et al.Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:22332239.
11.Aires de Sousa, M, Santos Sanches, I, Ferro, ML, et al.Intercontinental spread of a multidrug-resistant clone. J Clin Microbiol 1998;36:25902596.
12.Aucken, HM, Ganner, M, Murchan, S, Cookson, BD, Johnson, AP. A new UK strain of epidemic methicillin-resistant Staphylococcus aureus (EMRSA-17) resistant to multiple antibiotics. J Antimicrob Chemother 2002;50:171175.
13.Ayliffe, GAJ. The progressive intercontinental spread of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 1997;24(suppl 1):S74S79.
14.de Lencastre, H, Severina, E, Milch, H, Konkoly, TM, Tomasz, A. Wide geographic distribution of a unique methicillin-resistant Staphylococcus aureus clone in Hungarian hospitals. Clin Microbiol Infect 1997;3:289296.
15.Pavillard, R, Harvey, K, Douglas, D, et al.Epidemic of hospital-acquired infections due to methicillin-resistant Staphylococcus aureus in major Victorian hospitals. Med J Aust 1982;69:451455.
16.Roberts, RB, de Lencastre, A, Eisner, W, et al.Molecular epidemiology of methicillin-resistant Staphylococcus aureus in 12 New York hospitals. J Infect Dis 1998;178:164171.
17.Salmenlinna, S, Lyytikainen, O, Kotilainen, R, Scotford, R, Siren, E, Vuopio-Varkila, J. Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Finland. Eur J Clin Microbiol Infect Dis 2000; 19:101107.
18.van Belkum, A, van Leeuwen, W, Verkooyen, R, Sacilik, SC, Cokmus, C, Verbrugh, H. Dissemination of a single methicillin-resistant Staphylococcus aureus clone among Turkish hospitals. J Clin Microbiol 1997;35:978981.
19.Haley, RW, Cushion, NB, Tenover, FC, et al.Eradication of endemic methicillin-resistant Staphylococcus aureus infections from a neonatal intensive care unit. J Infect Dis 1995;171:614624.
20.Chen, ML, Chang, SC, Pan, HJ, et al.Longitudinal analysis of methicillin-resistant Staphylococcus aureus isolates at a teaching hospital in Taiwan. J Formos Med Assoc 1999;98:426432.
21.Arbeit, RD, Slutsky, A, Barber, TW, et al.Genetic diversity among strains of Mycobacterium avium causing monoclonal and polyclonal bacteremia in patients with AIDS. J Infect Dis 1993;167:13841390.
22.Hakim, A, Deplano, A, Maes, N, Kentos, A, Rossi, C, Struelens, MJ. Polyclonal coagulase-negative staphylococcal catheter-related bacteremia documented by molecular identification and typing. Clin Microbiol Infect 1999;5:224227.
23.Van Eidre, J, Peetermans, WE, Struelens, MJ, Deplano, A, Bobbaers, H. Polyclonal staphylococcal endocarditis caused by genetic variability. Clin Infect Dis 2000;31:2430.
24.Van Wijngaerden, E, Peetermans, WE, Van Lierde, S, Van Eldere, J. Polyclonal staphylococcal endocarditis. Clin Infect Dis 1997;25:6971.
25.Wendt, C, Messar, SA, Hollis, RJ, Pfaller, MA, Herwaldt, LA. Epidemiology of polyclonal gram-negative bacteremia. Diagn Microbiol Infect Dis 1998;32:913.
26.Khatib, R, Sharma, M, Naqvi, SAH, Riederer, K, Almoujahed, MO, Fakih, MG. Molecular analysis of Staphylococcus aureus blood isolates shows lack of polyclonal bacteremia. J Clin Microbiol 2003;41:17171719.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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