Mupirocin for Controlling Methicillin-ResistantStaphylococcus Aureus: Lessons From a Decade of Use at a University Hospital

2005 ◽  
Vol 26 (7) ◽  
pp. 662-667 ◽  
Author(s):  
Adriana M. Vivoni ◽  
Kátia R. N. Santos ◽  
Márcia P. de-Oliveira ◽  
Marcia Giambiagi-deMarval ◽  
Adriana L. P. Ferreira ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Molecular Epidemiology ◽  
Gel Electrophoresis ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
University Hospital ◽  
Incidence Density ◽  
Mupirocin Resistance ◽  
Restricted Use ◽  
Over Time

AbstractBackground:From 1990 to 1995 at Hospital Universitario dementino Fraga Filho, patients colonized or infected with methicillin-resistantStaphylococcus aureus(MRSA) were treated with mupirocin to eliminate MRSA carriage. In 1995, 65% of MRSA patients at this hospital had mupirocin-resistant isolates. Starting in 1996, mupirocin use was restricted to patients colonized, but not infected, with MRSA.Objectives:To describe the use of mupirocin for controlling MRSA over a decade and to analyze the molecular epidemiology of mupirocin-resistant MRSA infections at this hospital.Setting:A 490-bed, tertiary-care university hospital.Methods:The incidence densities of patients with MRSA and acquisition of mupirocin by the hospital were calculated for the period 1992–2001.S. aureusisolates from 1999–2000 were analyzed by pulsed-field gel electrophoresis. Mupirocin-resistant MRSA isolates from 1994–1995 and 1999–2000 were analyzed forileS-2gene background polymorphisms.Results:The incidence density of MRSA patients increased slightly over time, whereas the purchase of mupirocin decreased dramatically. Mupirocin-resistant MRSA infections decreased from 65% in 1994–1995 to 15% in 1999–2000. The MRSA Brazilian clone, detected in 1992, was still highly prevalent. The sameileS-2 encoding plasmid found in 1994–1995 persisted in three identical MRSA isolates from 1999–2000 belonging to the Brazilian clone.Conclusions:After mupirocin use decreased, theileS-2 encoding plasmid persisted in only a few Brazilian clone isolates. Our data on mupirocin-resistant MRSA incidence and mupirocin use strongly suggested that restricted use was related to decreased rates of mupirocin resistance at our hospital. (Infect Control Hosp Epidemiol 2005;26:662-667)

Methicillin-Resistant Staphylococcus aureus in Tertiary Care Institutions of the Canadian Prairies 1990-1992

1994 ◽  
Vol 15 (10) ◽  
pp. 646-651 ◽  
Author(s):  
J. Embil ◽  
K. Ramotar ◽  
L. Romance ◽  
M. Alfa ◽  
J. Conly ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Acute Care ◽  
Gel Electrophoresis ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Teaching Hospitals ◽  
Polymorphism Analysis ◽  
Canadian Prairies ◽  
Pulsed Field ◽  
Care Teaching

AbstractObjective:To review experience with methicillin-resistant Staphylococcus aureus (MRSA) in tertiary acute-care teaching hospitals on the Canadian prairies.Design:Retrospective review for a 36-month period, 1990 through 1992.Setting:Five tertiary acute-care teaching hospitals in three Canadian prairie provinces.Methods:MRSA isolates and susceptibility were identified through the clinical microbiology laboratory at each institution. For each patient, data collected included duration of institutional residence prior to isolation, patient ethnic background, age, sex, and antimicrobial susceptibility. Epidemiologic typing of strains used restriction fragment length polymorphism analysis by pulsed-field gel electrophoresis.Results:Two hundred fifty-nine MRSA isolates were identified in 135 patients during the 36 months, with substantial institutional variation in number of isolates. No consistent increase in yearly numbers of isolates was apparent. Patients usually had MRSA identified at admission (62%); only one of five centers had the majority of isolates acquired nosocomially. Patients with MRSA present at admission were more frequently of aboriginal (First Nations) ethnicity (62% compared with 14% of nosocomial; P<0.001). Pulsed-field gel electrophoresis of 167 isolates from 135 patients revealed 46 different strains with little interprovincial or inter-institutional identity of strains.Conclusions:MRSA isolated in patients in tertiary care institutions in these three Canadian provinces usually is acquired prior to admission. A disproportionate number of isolates are identified in aboriginal Canadians. Epidemiologic typing was consistent with a polyclonal origin of MRSA in this geographic area.

Carriage of Multiple Subtypes of Methicillin-ResistantStaphylococcus aureusby Intensive Care Unit Patients

2006 ◽  
Vol 27 (10) ◽  
pp. 1063-1067 ◽  
Author(s):  
Megan S. C. Lim ◽  
Caroline L. Marshall ◽  
Denis Spelman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gel Electrophoresis ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Control Procedure ◽  
Anatomical Site ◽  
Single Patient ◽  
Infection Control Procedure ◽  
Over Time

Objective:To determine how consistently patients are colonized with methicillin-resistantStaphylococcus aureus(MRSA) at various sites and how many subtypes can be carried simultaneously by a single patient.Setting.A 28-bed Intensive care unit in a tertiary-care referral hospital.Methods.A total of 1,181 patients were screened by culture of swab specimens obtained from the nose, throat, groin, and axilla on admission to the intensive care unit (ICU), twice weekly during their ICU stay, and at discharge.Results.MRSA was isolated at least once from 224 patients. Of these isolates, 359 were selected from 32 patients to be subtyped using pulsed-field gel electrophoresis. The rate of compliance with collection of swab specimens was 79.9%. The combination of sites colonized varied frequently over time for many patients. Of patients who had swab specimens obtained twice in 1 day, 8.7% had discordant results from the 2 swab sets. No patient had a clinical isolate that was not of an identical subtype to an isolate from an anatomical site that was sampled for screening. Half the patients carried multiple subtypes during their stay, with up to 4 subtypes per patient.Conclusions.The findings of this study may indicate that these patients have been colonized with MRSA on more than one occasion, possibly because of multiple breaches in infection control procedure. In MRSA-colonized patients, anatomical sites were intermittently colonized and carriage of multiple subtypes was common. These findings indicate that MRSA carriage is not a fixed state but may vary over time.

scholarly journals Detection of the novel IMP-38 among carbapenemase-producing Enterobacteriaceae in a university hospital, China

2014 ◽  
Vol 8 (08) ◽  
pp. 1044-1048 ◽  
Author(s):  
Zijuan Jian ◽  
Yanming Li ◽  
Wenen Liu ◽  
Hongling Li ◽  
Yunli Zhang ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
University Hospital ◽  
The Novel ◽  
Pulsed Field ◽  
Carbapenem Resistant ◽  
Neonatal Ward ◽  
Carbapenem Resistant Enterobacteriaceae

Introduction: This study set out to investigate the molecular epidemiology of carbapenemase-producing Enterobacteriaceae isolates collected from Xiang Ya Hospital, Hunan, China. Methodology: The carbapenemase genes from Enterobacteriaceae isolates were determined by PCR and sequencing. Relatedness of Klebsiella pneumoniae isolates was evaluated by pulsed-field gel electrophoresis. Results: Twenty-four out of 738 non-repetitive Enterobacteriaceae isolates harbored carbapenemase genes including IMP-38, a novel IMP-type metallo-enzyme. Nine IMP-38-producing isolates were shown to originate from the same clone and caused a small outbreak in the neonatal ward. Conclusions: IMP-38, a novel IMP-type metallo-enzyme, was one of the predominant types of carbapenemase in the clinical carbapenem-resistant Enterobacteriaceae isolates in our hospital.

scholarly journals Molecular Epidemiology of Staphylococcus aureus Isolates from Horses by Pulsed-Field Gel Electrophoresis.

1999 ◽  
Vol 10 (3/4) ◽  
pp. 73-77
Author(s):  
Akira SHIMIZU ◽  
Toru ANZAI ◽  
Manabu FUJITA ◽  
Osamu KAKUTANI ◽  
Michihiro TAKAGI ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Molecular Epidemiology ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field

scholarly journals Molecular epidemiology of Mycobacterium avium complex isolated from patients with and without AIDS in Brazil and England

1999 ◽  
Vol 122 (3) ◽  
pp. 435-440 ◽  
Author(s):  
M. A. S. TELLES ◽  
M. D. YATES ◽  
M. CURCIO ◽  
S. Y. M. UEKI ◽  
M. PALACI ◽  
...  
Keyword(s):  
Molecular Epidemiology ◽  
Mycobacterium Avium ◽  
Gel Electrophoresis ◽  
Mycobacterium Avium Complex ◽  
Opportunistic Pathogen ◽  
Pulsed Field Gel Electrophoresis ◽  
The World ◽  
Unique Strain ◽  
Over Time ◽  
Hiv Negative

Mycobacterium avium complex (MAC) is ubiquitous throughout the world. It is an opportunistic pathogen in AIDS patients but the number of cases in HIV negative patients is also increasing. The aim of this study was to determine whether patients were being infected with different MAC strains or whether one strain was dominant. DNA obtained from isolates in Brazil and England were compared using pulsed field gel electrophoresis (PFGE). Strains from 22 Brazilian patients clustered into 7 groups but 68/90 patients had a unique strain. In all patients, Brazilian and English, the same strain was isolated repeatedly over time, some over several years. This study shows that it is most likely that Man is infected from the environment and that one strain can survive without change for many years both in the environment and in Man.

scholarly journals Clonal Dissemination and mupA Gene Polymorphism of Mupirocin-Resistant Staphylococcus aureus Isolates from Long-Term-Care Facilities in South Korea

2006 ◽  
Vol 50 (1) ◽  
pp. 365-367 ◽  
Author(s):  
Jae Il Yoo ◽  
Eun Shim Shin ◽  
Jeong Ok Cha ◽  
Jeom Kyu Lee ◽  
Young Hee Jung ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Gel Electrophoresis ◽  
Long Term Care ◽  
Fragment Length Polymorphism ◽  
Pulsed Field Gel Electrophoresis ◽  
Term Care ◽  
Care Facilities ◽  
Mupirocin Resistance ◽  
High Level

ABSTRACT We identified 25 high-level mupirocin-resistant (MuH) and 21 low-level mupirocin-resistant (MuL) Staphylococcus aureus isolates from eight long-term-care facilities (LTCFs). The pulsed-field gel electrophoresis patterns of 19 MuH and 19 MuL isolates from two facilities were identical for 18 and 15 isolates, respectively. The most predominant mupA restriction fragment length polymorphism type was found in 21 MuH isolates. We conclude that clonal transmission of MuH and MuL S. aureus strains occurred in these LTCFs. This is the first report of clonal transfer of mupirocin resistance in LTCFs.

scholarly journals Understanding the Local Epidemiology of Methicillin-Resistant Staphylococcus aureus by Pulsed-Field Gel Electrophoresis in an Indian Tertiary Care Centre

2021 ◽  
Author(s):  
Avinandan Saha ◽  
Priyanka Prasad ◽  
Gita Nataraj
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Gel Electrophoresis ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Methicillin Resistant ◽  
Pulsed Field ◽  
Hospital Infection Control ◽  
Prospective Longitudinal

Abstract Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of community and hospital-acquired infections (HAIs). In the year preceding this study, our laboratory reported an MRSA isolation rate of 2% from 50,549 specimens. Molecular typing of MRSA identifies sources of infection, transmission chains and informs infection control practices, and pulsed-field gel electrophoresis (PFGE) is the gold standard. This study was conducted to gain an understanding of the local molecular epidemiology of MRSA in our hospital using PFGE, to inform hospital infection control practices.Methods: This prospective longitudinal study was conducted in the microbiology laboratory of our 2,200-bed tertiary care teaching hospital in Mumbai, India.The antibiotic susceptibility profiles and pulsed-field profiles (PFPs) of 100 consecutive non-duplicate clinical isolates of MRSA were obtained. The PFPs were compared to check for relatedness of isolates. The distribution of various pulsotypes across disciplines and hospital locations was examined.Results: Clinical specimens accounted for 86 (86%) of the MRSA isolates, whilst 14 (14%) were from screening of healthcare workers. Maximum isolates, 68 (68%), were from surgical disciplines. Confirmed HAIs accounted for 25 (25%) MRSA isolates. Seventeen antibiotypes were obtained and there was no correlation between antibiotype and pulsotype. Totally 43 pulsotypes were identified, with most isolates, 40 (40%), belonging to pulsotype 1. Seven clusters were identified. Cluster I had maximum pulsotypes, 14, and 58 (58%) isolates. Isolates belonging to clusters I and II were found in all hospital locations. Relatedness was observed between isolates from HAIs and screening specimens, and between community and HAI isolates.Conclusions: PFGE typing revealed the disciplines at greatest risk from MRSA in our hospital. The commonality between MRSA isolated from HAIs and screening of healthcare workers, and between MRSA isolated from HAIs and from community-acquired infections highlighted the horizontal transmission of MRSA and the need to reinforce infection control measures to limit this.

Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 48-49
Author(s):  
Javaid Ahmad Bhat ◽  
Shariq Rashid Masoodi
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
Resistance Mechanisms ◽  
North India ◽  
Global Public Health ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Effective Prevention ◽  
Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

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