Hospital-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) in Italy

Springer Science and Business Media LLC - Tập 8 Số 1 - 2009
Floriana Campanile1, Dafne Bongiorno1, Sonia Borbone1, Stefania Stefani1
1Department of Microbiology, University of Catania, Italy

Tóm tắt

Abstract The aim of our study was to trace the dynamic changes of hospital-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) lineages in Italy, comparing the genotypic backgrounds of contemporary isolates over a period of 17 years, with those of a sample of early MRSA strains from 1980. In total, 301 non-repetitive MRSA clinical isolates, recovered from 19 Italian hospitals between 1990 and 2007 were selected and analyzed for their antibiotic resistance, typed by PFGE and SCCmec, grouped into clonal-types and further characterized using Multi Locus Sequence Typing (MLST). A sample of fifteen early MRSA strains from 1980 was also used for comparison. The most interesting feature was the recent increase of ST228-MRSA-I (formerly the Italian clone; PFGE E) over the period 2000–2007 (57%), when compared to the period 1990–1999 (29%), and its stability to date, associated with a decrease of the highly epidemic ST247-MRSA-IA (formerly the Iberian clone; PFGE A), (23% from 1990 to 1999, 6% from 2000 to 2007). ST1-MRSA-I (1 out of 2 strains carrying ccr A2B2), ST8-MRSA-I (4 strains), ST15-MRSA-I (1 out of 4 carrying ccr A2B2) and ST30-MRSA-I (2 out of 5 carrying no ccr AB-types and ccr C) were the predominant earliest STs among the MRSA strains in 1980. A temporal shift in the susceptibility levels to glycopeptides was observed: strains with vancomycin MIC of ≥ 2 mg/L increased from 19.4% to 35.5%. In conclusion, we describe the alternation of MRSA clones that occurred in hospitals from 1990 to 2007 and the increase of the glycopeptide MIC levels, reflecting a worldwide trend. We document the detection of ST1, ST8, ST15 and ST30 in the 1980 isolates; we hypothesize their possible latency and their appearance as the current CA-MRSA clones.

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Tài liệu tham khảo

Stefani S, Varaldo PE: Epidemiology of methicillin-resistant staphylococci in Europe. Clin Microbiol Infect. 2003, 9 (12): 1179-86. 10.1111/j.1469-0691.2003.00698.x

Luzzaro F, Viganò EF, Fossati D, Grossi A, Sala A, Sturla C, Saudelli M, Toniolo A, AMCLI Lombardia Hospital Infectious Study Group : Prevalence and drug susceptibility of pathogens causing bloodstream infections in northern Italy: a two-year study in 16 hospitals. Eur J Clin Microbiol Infect Dis. 2002, 21 (12): 849-55.

Pan A, Carnevale G, Catenazzi P, Colombini P, Crema L, Dolcetti L, Ferrari L, Mondello P, Signorini L, Tinelli C, Roldan EQ, Carosi G: Trends in methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections: effect of the MRSA "search and isolate" strategy in a hospital in Italy with hyperendemic MRSA. Infect Control Hosp Epidemiol. 2005, 26 (2): 127-33. 10.1086/502515

Raineri E, Crema L, De Silvestri A, Acquarolo A, Albertario F, Carnevale G, Latronico N, Petrosillo N, Tinelli C, Zoncada A, Pan A: Methicillin-resistant Staphylococcus aureus control in an intensive care unit: a 10 year analysis. J Hosp Infect. 2007, 67 (4): 308-15. 10.1016/j.jhin.2007.08.013

Rodloff AC, Leclercq R, Debbia EA, Cantón R, Oppenheim BA, Dowzicky MJ: Comparative analysis of antimicrobial susceptibility among organisms from France, Germany, Italy, Spain and the UK as part of the tigecycline evaluation and surveillance trial. Clin Microbiol Infect. 2008, 14 (4): 307-14. 10.1111/j.1469-0691.2007.01943.x

Robinson DA, Enright MC: Multilocus sequence typing and the evolution of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect. 2004, 10 (2): 92-7. 10.1111/j.1469-0691.2004.00768.x

Mato R, Campanile F, Stefani S, Crisóstomo MI, Santagati M, Sanches SI, de Lencastre H: Clonal types and multidrug resistance patterns of methicillin-resistant Staphylococcus aureus (MRSA) recovered in Italy during the 1990s. Microb Drug Resist. 2004, 10 (2): 106-13. 10.1089/1076629041310109

Enright MC, Robinson DA, Randle G, Feil EJ, Grundmann H, Spratt BG: The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA). Proc Natl Acad Sci USA. 2002, 99 (11): 7687-92. 10.1073/pnas.122108599

Feil EJ, Li BC, Aanensen DM, Hanage WP, Spratt BG: eBURST: inferring patterns of evolutionary descent among clusters of related bacterial genotypes from multilocus sequence typing data. J Bacteriol. 2004, 186 (5): 1518-30. 10.1128/JB.186.5.1518-1530.2004

Holden MT, Feil EJ, Lindsay JA, Peacock SJ, Day NP, Enright MC, Foster TJ, Moore CE, Hurst L, Atkin R, Barron A, Bason N, Bentley SD, Chillingworth C, Chillingworth T, Churcher C, Clark L, Corton C, Cronin A, Doggett J, Dowd L, Feltwell T, Hance Z, Harris B, Hauser H, Holroyd S, Jagels K, James KD, Lennard N, Line A, Mayes R, Moule S, Mungall K, Ormond D, Quail MA, Rabbinowitsch E, Rutherford K, Sanders M, Sharp S, Simmonds M, Stevens K, Whitehead S, Barrell BG, Spratt BG, Parkhill J: Complete genomes of two clinical Staphylococcus aureus strains: evidence for the rapid evolution of virulence and drug resistance. Proc Natl Acad Sci USA. 2004, 101 (26): 9786-91. 10.1073/pnas.0402521101

Diep BA, Gill SR, Chang RF, Phan TH, Chen JH, Davidson MG, Lin F, Lin J, Carleton HA, Mongodin EF, Sensabaugh GF, Perdreau-Remington F: Complete genome sequence of USA300, an epidemic clone of community-acquired meticillin-resistant Staphylococcus aureus. Lancet. 2006, 367 (9512): 731-9. 10.1016/S0140-6736(06)68231-7

Lindsay JA, Moore CE, Day NP, Peacock SJ, Witney AA, Stabler RA, Husain SE, Butcher PD, Hinds J: Microarrays reveal that each of the ten dominant lineages of Staphylococcus aureus has a unique combination of surface-associated and regulatory genes. J Bacteriol. 2006, 188 (2): 669-76. 10.1128/JB.188.2.669-676.2006

Hope R, Livermore DM, Brick G, Lillie M, Reynolds R, BSAC Working Parties on Resistance Surveillance : Non-susceptibility trends among staphylococci from bacteraemias in the UK and Ireland, 2001–06. J Antimicrob Chemother. 2008, 62 (Suppl 2): ii65-74. 10.1093/jac/dkn353

Sakoulas G, Moellering RC: Increasing antibiotic resistance among methicillin-resistant Staphylococcus aureus strains. Clin Infect Dis. 2008, 46 (Suppl 5): S360-7. 10.1086/533592

Valentini P, Parisi G, Monaco M, Crea F, Spanu T, Ranno O, Tronci M, Pantosti A: An uncommon presentation for a severe invasive infection due to methicillin-resistant Staphylococcus aureus clone USA300 in Italy: a case report. Ann Clin Microbiol Antimicrob. 2008, 7: 11- 10.1186/1476-0711-7-11

Stefani S, Bongiorno D, Cafiso V, Campanile F, Crapis M, Cristini F, Sartor A, Scarparo C, Spina D, Viale P: Pathotype and susceptibility profile of a community-acquired methicillin-resistant Staphylococcus aureus strain responsible for a case of severe pneumonia. Diagn Microbiol Infect Dis. 2009, 63 (1): 100-4. 10.1016/j.diagmicrobio.2008.09.012

Enright MC: The evolution of a resistant pathogen–the case of MRSA. Current opinion in pharmacology. 2003, 3 (5): 474-479. 10.1016/S1471-4892(03)00109-7

Rossney AS, Lawrence MJ, Morgan PM, Fitzgibbon MM, Shore A, Coleman DC, Keane CT, O'Connell B: Epidemiological typing of MRSA isolates from blood cultures taken in Irish hospitals participating in the European Antimicrobial Resistance Surveillance System (1999–2003). Eur J Clin Microbiol Infect Dis. 2006, 25 (2): 79-89. 10.1007/s10096-006-0091-5

Conceição T, Aires-de-Sousa M, Füzi M, Tóth A, Pászti J, Ungvári E, van Leeuwen WB, van Belkum A, Grundmann H, de Lencastre H: Replacement of methicillin-resistant Staphylococcus aureus clones in Hungary over time: a 10-year surveillance study. Clin Microbiol Infect. 2007, 13 (10): 971-9. 10.1111/j.1469-0691.2007.01794.x

Francois P, Harbarth S, Huyghe A, Renzi G, Bento M, Gervaix A, Pittet D, Schrenzel J: Methicillin-resistant Staphylococcus aureus, Geneva, Switzerland, 1993–2005. Emerg Infect Dis. 2008, 14 (2): 304-7. 10.3201/eid1402.070229

Kerttula AM, Lyytikäinen O, Kardén-Lilja M, Ibrahem S, Salmenlinna S, Virolainen A, Vuopio-Varkila J: Nationwide trends in molecular epidemiology of methicillin-resistant Staphylococcus aureus, Finland, 1997–2004. BMC Infect Dis. 2007, 7: 94- 10.1186/1471-2334-7-94

Vindel A, Trincado P, Gómez E, Cabrera R, Boquete T, Solá C, Valdezate S, Saez-Nieto JA: Prevalence and evolution of methicillin-resistant Staphylococcus aureus in Spanish hospitals between 1996 and 2002. J Clin Microbiol. 2006, 44 (1): 266-70. 10.1128/JCM.44.1.266-270.2006

Blanc DS, Petignat C, Wenger A, Kuhn G, Vallet Y, Fracheboud D, Trachsel S, Reymond M, Troillet N, Siegrist HH, Oeuvray S, Bes M, Etienne J, Bille J, Francioli P, Zanetti G: Changing molecular epidemiology of methicillin-resistant Staphylococcus aureus in a small geographic area over an eight-year period. J Clin Microbiol. 2007, 45 (11): 3729-36. 10.1128/JCM.00511-07

Stefani S, Mezzatesta ML, Tempera G, Debbra E, Schito AM, Nicoletti G, Marchére A: Comparative activity of linezolid against staphylococci and enterococci isolated in Italy. Clin Microbiol Infect. 2002, 8 (6): 368-72. 10.1046/j.1469-0691.2002.00429.x

Nicoletti G, Schito G, Fadda G, Boros S, Nicolosi D, Marchese A, Spanu T, Pantosti A, Monaco M, Rezza G, Cassone A, Garaci E, : Bacterial isolates from severe infections and their antibiotic susceptibility patterns in Italy: a nationwide study in the hospital setting. J Chemother. 2006, 18 (6): 589-602.

Varaldo PE, Cipriani P, Focá A, Geraci C, Giordano A, Madeddu MA, Orsi A, Pompei R, Prenna M, Repetto A: Identification, clinical distribution, and susceptibility to methicillin and 18 additional antibiotics of clinical Staphylococcus isolates: nationwide investigation in Italy. J Clin Microbiol. 1984, 19 (6): 838-43.

Clinical Laboratory Standards, C.L.S.I: Performance Standards for Antimicrobial Susceptibility Testing – Approved Standard. 2008, Clinical and Laboratory Standard Institute: Wayne PA – USA.

Campanile F, Bongiorno D, Borbone S, Venditti M, Giannella M, Franchi C, Stefani S: Characterization of a variant of the SCCmec element in a bloodstream isolate of Staphylococcus intermedius. Microb Drug Resist. 2007, 13 (1): 7-10. 10.1089/mdr.2006.9991

Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, Swaminathan B: Interpreting chromosomal DNA restriction patterns produced by pulsed- field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol. 1995, 33 (9): 2233-2239.

Oliveira DC, de Lencastre H: Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2002, 46 (7): 2155-61. 10.1128/AAC.46.7.2155-2161.2002

Kondo Y, Ito T, Ma XX, Watanabe S, Kreiswirth BN, Etienne J, Hiramatsu K: Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. Antimicrob Agents Chemother. 2007, 51 (1): 264-74. 10.1128/AAC.00165-06

Cassone M, Campanile F, Pantosti A, Venditti M, Stefani S: Identification of a variant "Rome clone" of methicillin-resistant Staphylococcus aureus with decreased susceptibility to vancomycin, responsible for an outbreak in an intensive care unit. Microb Drug Resist. 2004, 10 (1): 43-9. 10.1089/107662904323047790

Krziwanek K, Luger C, Sammer B, Stumvoll S, Stammler M, Sagel U, Witte W, Mittermayer H: MRSA in Austria–an overview. Clin Microbiol Infect. 2008, 14 (3): 250-9. 10.1111/j.1469-0691.2007.01896.x

Deurenberg RH, Vink C, Kalenic S, Friedrich AW, Bruggeman CA, Stobberingh EE: The molecular evolution of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect. 2007, 13 (3): 222-35. 10.1111/j.1469-0691.2006.01573.x

Amorim ML, Aires de Sousa M, Sanches IS, Sá-Leão R, Cabeda JM, Amorim JM, de Lencastre H: Clonal and antibiotic resistance profiles of methicillin-resistant Staphylococcus aureus (MRSA) from a Portuguese hospital over time. Microb Drug Resist. 2002, 8 (4): 301-9. 10.1089/10766290260469561

Teixeira LA, Resende CA, Ormonde LR, Rosenbaum R, Figueiredo AM, de Lencastre H, Tomasz A: Geographic spread of epidemic multiresistant Staphylococcus aureus clone in Brazil. J Clin Microbiol. 1995, 33 (9): 2400-4.

Cookson BD, Phillips I: Epidemic methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother. 1988, 21 (Suppl C): 57-65.

Pérez-Roth E, Lorenzo-Díaz F, Batista N, Moreno A, Méndez-Alvarez S: Tracking methicillin-resistant Staphylococcus aureus clones during a 5-year period (1998 to 2002) in a Spanish hospital. J Clin Microbiol. 2004, 42 (10): 4649-56. 10.1128/JCM.42.10.4649-4656.2004

Monaco M, Antonucci R, Palange P, Venditti M, Pantosti A: Methicillin-resistant Staphylococcus aureus necrotizing pneumonia. Emerg Infect Dis. 2005, 11 (10): 1647-8.

Deurenberg RH, Stobberingh EE: The evolution of Staphylococcus aureus. Infect Genet Evol. 2008, 8 (6): 747-63. 10.1016/j.meegid.2008.07.007

Gales AC, Sader HS, Andrade SS, Lutz L, Machado A, Barth AL: Emergence of linezolid-resistant Staphylococcus aureus during treatment of pulmonary infection in a patient with cystic fibrosis. Int J Antimicrob Agents. 2006, 27 (4): 300-2. 10.1016/j.ijantimicag.2005.11.008

Tsiodras S, Gold HS, Sakoulas G, Eliopoulos GM, Wennersten C, Venkataraman L, Moellering RC, Ferraro MJ: Linezolid resistance in a clinical isolate of Staphylococcus aureus. Lancet. 2001, 358 (9277): 207-8. 10.1016/S0140-6736(01)05410-1

Soriano A, Marco F, Martínez JA, Pisos E, Almela M, Dimova VP, Alamo D, Ortega M, Lopez J, Mensa J: Influence of vancomycin minimum inhibitory concentration on the treatment of methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis. 2008, 46 (2): 193-200. 10.1086/524667

Steinkraus G, White R, Friedrich L: Vancomycin MIC creep in non-vancomycin-intermediate Staphylococcus aureus (VISA), vancomycin-susceptible clinical methicillin-resistant S. aureus (MRSA) blood isolates from 2001–05. J Antimicrob Chemother. 2007, 60 (4): 788-94. 10.1093/jac/dkm258

Sakoulas G, Gold HS, Cohen RA, Venkataraman L, Moellering RC, Eliopoulos GM: Effects of prolonged vancomycin administration on methicillin-resistant Staphylococcus aureus (MRSA) in a patient with recurrent bacteraemia. J Antimicrob Chemother. 2006, 57 (4): 699-704. 10.1093/jac/dkl030

Sakoulas G, Moise-Broder PA, Schentag J, Forrest A, Moellering RC, Eliopoulos GM: Relationship of MIC and bactericidal activity to efficacy of vancomycin for treatment of methicillin-resistant Staphylococcus aureus bacteremia. J Clin Microbiol. 2004, 42 (6): 2398-402. 10.1128/JCM.42.6.2398-2402.2004

Castanheira M, Jones R, DSader H: Update of the in vitro activity of daptomycin tested against 6710 Gram-positive cocci isolated in North America (2006). Diagn Microbiol Infect Dis. 2008, 61 (2): 235-239. 10.1016/j.diagmicrobio.2008.01.016

Alós JI, García-Cañas A, García-Hierro P, Rodríguez-Salvanés F: Vancomycin MICs did not creep in Staphylococcus aureus isolates from 2002 to 2006 in a setting with low vancomycin usage. J Antimicrob Chemother. 2008, 62 (4): 773-5. 10.1093/jac/dkn246

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