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Current Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Elderly French People: Troublesome Clones on the Horizon

Rondeau, Claire ; Chevet, Guillaume ; Blanc, Dominique S ; Gbaguidi-Haore, Houssein ; Decalonne, Marie ; Dos Santos, Sandra ; Quentin, Roland ; van der Mee-Marquet, Nathalie

Frontiers in microbiology, 2016, Vol.7, p.31-31 [Periódico revisado por pares]

Switzerland: Frontiers Media

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  • Título:
    Current Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Elderly French People: Troublesome Clones on the Horizon
  • Autor: Rondeau, Claire ; Chevet, Guillaume ; Blanc, Dominique S ; Gbaguidi-Haore, Houssein ; Decalonne, Marie ; Dos Santos, Sandra ; Quentin, Roland ; van der Mee-Marquet, Nathalie
  • Assuntos: Bloodstream infection ; carriage ; elderly patients ; Life Sciences ; Microbiology ; Microbiology and Parasitology ; MRSA ; Residents ; Staphylococcus aureus
  • É parte de: Frontiers in microbiology, 2016, Vol.7, p.31-31
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
    Reviewed by: D. Scott Merrell, Uniformed Services University, USA; Yuji Morita, Aichi Gakuin University, Japan
    This article was submitted to Infectious Diseases, a section of the journal Frontiers in Microbiology
    Edited by: Rustam Aminov, Technical University of Denmark, Denmark
  • Descrição: In 2015, we conducted at 44 healthcare facilities (HCFs) and 21 nursing homes (NHs) a 3-month bloodstream infection (BSI) survey, and a 1-day prevalence study to determine the rate of carriage of methicillin-resistant Staphylococcus aureus (MRSA) in 891 patients and 470 residents. We investigated the molecular characteristics of the BSI-associated and colonizing MRSA isolates, and assessed cross-transmission using double-locus sequence typing and pulsed-field gel electrophoresis protocol. The incidence of MRSA-BSI was 0.040/1000 patient-days (19 cases). The prevalence of MRSA carriage was 4.2% in patients (n = 39) and 8.7% in residents (n = 41) (p < 0.001). BSI-associated and colonizing isolates were similar: none were PVL-positive; 86.9% belonged to clonal complexes 5 and 8; 93.9% were resistant to fluoroquinolones. The qacA/B gene was carried by 15.8% of the BSI-associated isolates [3/3 BSI cases in intensive care units (ICUs)], and 7.7% of the colonizing isolates in HCFs. Probable resident-to-resident transmission was identified in four NHs. Despite generally reassuring results, we identified two key concerns. First, a worryingly high prevalence of the qacA/B gene in MRSA isolates. Antisepsis measures being crucial to prevent healthcare-associated infections, our findings raise questions about the potential risk associated with chlorhexidine use in qacA/B(+) MRSA carriers, particularly in ICUs. Second, NHs are a weak link in MRSA control. MRSA spread was not controlled at several NHs; because of their frequent contact with the community, conditions are favorable for these NHs to serve as reservoirs of USA300 clone for local HCFs.
  • Editor: Switzerland: Frontiers Media
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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