Characterization of MRSA in Canada from 2007 to 2016

2019 ◽  
Vol 74 (Supplement_4) ◽  
pp. iv55-iv63 ◽  
Author(s):  
Kimberly A Nichol ◽  
Heather J Adam ◽  
George R Golding ◽  
Philippe R S Lagacé-Wiens ◽  
James A Karlowsky ◽  
...  
Keyword(s):  
Susceptibility Testing ◽  
Tertiary Care ◽  
Molecular Characteristics ◽  
Broth Microdilution ◽  
Spa Typing ◽  
Common Cause ◽  
Healthcare Associated ◽  
Annual Proportion ◽  
Over Time

Abstract Objectives This study assessed the demographic and molecular characteristics of community-associated (CA) and healthcare-associated (HA) MRSA genotypes in Canadian hospitals between 2007 and 2016. Methods A total of 1963 MRSA were identified among 9103 Staphylococcus aureus isolates collected from inpatients and outpatients presenting to tertiary-care medical centres across Canada. Antimicrobial susceptibility testing was performed by broth microdilution in accordance with CLSI standards (M7 11th edition, 2018). PCR was performed to detect the Panton–Valentine leucocidin (PVL) genes and molecular analysis was performed by spa typing. Results Between 2007 and 2016, the annual proportion of S. aureus that were MRSA decreased from 26.1% to 16.9% (P < 0.0001). The proportion of CA-MRSA genotypes increased significantly from 20.8% in 2007 to 56.3% in 2016 (P < 0.0001) while HA-MRSA genotypes decreased from 79.2% to 43.8% throughout the study period (P < 0.0001). Predominant genotypes included HA genotype CMRSA2 (USA100/800) (53.6%) and CA genotype CMRSA10 (USA300) (24.9%). PVL was present in 30.1% of all MRSA isolates, including 78.4% of CA-MRSA and 1.7% of HA-MRSA genotypes. Resistance to clarithromycin, clindamycin, trimethoprim/sulfamethoxazole and fluoroquinolones decreased significantly over time (P < 0.0001). Conclusions The proportion of MRSA in Canada declined between 2007 and 2016. In contrast, the proportion of CA-MRSA strain types, particularly CMRSA10 (USA300), continues to increase. In 2016, CA-MRSA genotypes surpassed HA-MRSA as the most common cause of MRSA infections in Canadian hospitals.

Community-Associated Strains of Methicillin-ResistantStaphylococccus aureusas the Cause of Healthcare-Associated Infection

2006 ◽  
Vol 27 (10) ◽  
pp. 1051-1056 ◽  
Author(s):  
Blanca E. Gonzalez ◽  
Adriana M. Rueda ◽  
Samuel A. Shelburne ◽  
Daniel M. Musher ◽  
Richard J. Hamill ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Strain Analysis ◽  
Bloodstream Infections ◽  
Pfge Type ◽  
Molecular Characteristics ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Mrsa Strains ◽  
Healthcare Associated

Objective:Methicillin-resistantStaphylococcus aureus(MRSA) isolates from patients with community-associated infection have been described as strains genetically distinct from the strains isolated from patients with healthcare-associated infection. This study examines the hypothesis that community-associated MRSA (CA-MRSA) strains now cause serious infections in hospitalized patients.Methods.Thirty-seven clinical MRSA isolates were randomly selected from blood isolates obtained from July 2003 through June 2004. Strains were tested for staphylococcal chromosomal cassettemec(SCCmec) type, pulsed-field gel electrophoresis (PFGE) type, and presence of Panton-Valentine leukocidin (PVL) genes. Medical records review and epidemiologic classification was performed by an investigator blinded to the results of the bacterial strain analysis. Episodes of bloodstream infection were independently classified as either community-associated or healthcare-associated infections, and bacterial isolates were independently classified as either CA-MRSA strains or healthcare-associated MRSA (HA-MRSA) strains, according to established definitions.Setting.A tertiary care Veterans Affairs Medical Center.Results.Twenty-four (65%) of 37 MRSA isolates were SCCmectype IV, a genetic type characteristic of CA-MRSA strains; 22 of these 24 isolates belonged to the CA-MRSA clone USA300 and carried PVL genes. Thirteen (35%) of the 37 strains were SCCmectype II, of which 12 were USA100-ST5 and 12 lacked PVL genes. Thirty patients (81%) had healthcare-associated infections; 18 (60%) of these 30 were infected with isolates carrying markers of CA-MRSA strains. Of 7 patients with CA-MRSA infections, 6 were infected with isolates belonging to the USA300 clone. Patients with healthcare-associated bloodstream infections were as likely to be infected with a CA-MRSA strain as patients with a community-associated infection (P= .38).Conclusions.MRSA strains with molecular characteristics of CA-MRSA strains have emerged as an important cause of serious health-care-associated infection in our hospital.

Longitudinal analysis of ESBL and carbapenemase carriage among Enterobacterales and Pseudomonas aeruginosa isolates collected in Europe as part of the International Network for Optimal Resistance Monitoring (INFORM) global surveillance programme, 2013–17

2020 ◽  
Vol 75 (5) ◽  
pp. 1165-1173 ◽  
Author(s):  
Krystyna M Kazmierczak ◽  
Boudewijn L M de Jonge ◽  
Gregory G Stone ◽  
Daniel F Sahm
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Eastern Europe ◽  
Western Europe ◽  
Broth Microdilution ◽  
International Network ◽  
Surveillance Programme ◽  
Common Cause ◽  
Gram Negative ◽  
Resistance Monitoring ◽  
Over Time

Abstract Objectives To determine the spread of ESBLs and carbapenemases in Enterobacterales and Pseudomonas aeruginosa in Europe. Methods 45 335 Gram-negative bacilli were collected in 18 European countries as part of the International Network for Optimal Resistance Monitoring (INFORM) global surveillance programme from 2013 to 2017. Antimicrobial susceptibility was determined using broth microdilution, and 9546 isolates were screened for β-lactamase genes by PCR and sequencing. Results ESBLs were identified in 35.5% of Klebsiella pneumoniae and 18.5% of Escherichia coli. ESBL carriage was lowest among isolates in Northern/Western Europe and highest in Eastern Europe. CTX-M-15 was the dominant ESBL in all countries except Greece, where SHV-type ESBLs were more common. Carbapenemases (KPC, OXA-48-like, GES, NDM and VIM) were found in 3.4% of Enterobacterales and were most common among K. pneumoniae (10.5% of those collected). Carbapenemase carriage was lowest in Northern/Western and highest in Southern Europe. KPC-positive Enterobacterales were most abundant but the percentages of OXA-48-like-, NDM- and VIM-positive isolates increased over time and were correlated with an increase in meropenem non-susceptibility. Carbapenemases (VIM, IMP, NDM and GES) were also identified in 5.1% of P. aeruginosa and were commonly found in Eastern Europe. Carbapenemase carriage and meropenem non-susceptibility among P. aeruginosa fluctuated over the 5 years studied and were not well correlated. Conclusions ESBL and carbapenemase carriage varied by species and European subregion. Meropenem non-susceptibility in European isolates of Enterobacterales can be attributed to carbapenemase carriage and is increasingly caused by MBLs and OXA-48-like carbapenemases. Carbapenemases or other β-lactamases are not a common cause of meropenem non-susceptibility in P. aeruginosa in Europe.

The impact of vancomycin-resistant Enterococcus (VRE) screening policy change on the incidence of healthcare-associated VRE bacteremia

2021 ◽  
pp. 1-6
Author(s):  
Sun Young Cho ◽  
Hye Mee Kim ◽  
Doo Ryeon Chung ◽  
Jong Rim Choi ◽  
Myeong-A Lee ◽  
...  
Keyword(s):  
Policy Change ◽  
Tertiary Care ◽  
High Risk Patient ◽  
Hospital Setting ◽  
Molecular Characteristics ◽  
Screening Policy ◽  
Before And After ◽  
Vancomycin Resistant ◽  
Healthcare Associated ◽  
The Impact

Abstract Objective: To evaluate the impact of a vancomycin-resistant Enterococcus (VRE) screening policy change on the incidence of healthcare-associated (HA)-VRE bacteremia in an endemic hospital setting. Design: A quasi-experimental before-and-after study. Setting: A 1,989-bed tertiary-care referral center in Seoul, Republic of Korea. Methods: Since May 2010, our hospital has diminished VRE screening for admitted patients transferred from other healthcare facilities. We assessed the impact of this policy change on the incidence of HA-VRE bacteremia using segmented autoregression analysis of interrupted time series from January 2006 to December 2014 at the hospital and unit levels. In addition, we compared the molecular characteristics of VRE blood isolates collected before and after the screening policy change using multilocus sequence typing and pulsed-field gel electrophoresis. Results: After the VRE screening policy change, the incidence of hospital-wide HA-VRE bacteremia increased, although no significant changes of level or slope were observed. In addition, a significant slope change in the incidence of HA-VRE bacteremia (change in slope, 0.007; 95% CI, 0.001–0.013; P = .02) was observed in the hemato-oncology department. Molecular analysis revealed that various VRE sequence types appeared after the policy change and that clonally related strains became more predominant (increasing from 26.1% to 59.3%). Conclusions: The incidence of HA-VRE bacteremia increased significantly after VRE screening policy change, and this increase was mainly driven by high-risk patient populations. When planning VRE control programs in hospitals, different approaches that consider risk for severe VRE infection in patients may be required.

scholarly journals Characterization of Staphylococci with Reduced Susceptibilities to Vancomycin and Other Glycopeptides

1998 ◽  
Vol 36 (4) ◽  
pp. 1020-1027 ◽  
Author(s):  
Fred C. Tenover ◽  
Michael V. Lancaster ◽  
Bertha C. Hill ◽  
Christine D. Steward ◽  
Sheila A. Stocker ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Enterococcus Faecalis ◽  
Susceptibility Testing ◽  
Brain Heart Infusion ◽  
Pcr Analysis ◽  
Screening Methods ◽  
Broth Microdilution ◽  
Testing Procedures ◽  
Vancomycin Mics

During the last several years a series of staphylococcal isolates that demonstrated reduced susceptibility to vancomycin or other glycopeptides have been reported. We selected 12 isolates of staphylococci for which the vancomycin MICs were ≥4 μg/ml or for which the teicoplanin MICs were ≥8 μg/ml and 24 control strains for which the vancomycin MICs were ≤2 μg/ml or for which the teicoplanin MICs were ≤4 μg/ml to determine the ability of commercial susceptibility testing procedures and vancomycin agar screening methods to detect isolates with reduced glycopeptide susceptibility. By PCR analysis, none of the isolates with decreased glycopeptide susceptibility contained known vancomycin resistance genes. Broth microdilution tests held a full 24 h were best at detecting strains with reduced glycopeptide susceptibility. Disk diffusion did not differentiate the strains inhibited by 8 μg of vancomycin per ml from more susceptible isolates. Most of the isolates with reduced glycopeptide susceptibility were recognized by MicroScan conventional panels and Etest vancomycin strips. Sensititre panels read visually were more variable, although with some of the panels MICs of 8 μg/ml were noted for these isolates. Vitek results were 4 μg/ml for all strains for which the vancomycin MICs were ≥4 μg/ml. Vancomycin MICs on Rapid MicroScan panels were not predictive, giving MICs of either ≤2 or ≥16 μg/ml for these isolates. Commercial brain heart infusion vancomycin agar screening plates containing 6 μg of vancomycin per ml consistently differentiated those strains inhibited by 8 μg/ml from more susceptible strains. Vancomycin-containing media prepared in-house showed occasional growth of susceptible strains, Staphylococcus aureus ATCC 29213, and on occasion, Enterococcus faecalis ATCC 29212. Thus, strains of staphylococci with reduced susceptibility to glycopeptides, such as vancomycin, are best detected in the laboratory by nonautomated quantitative tests incubated for a full 24 h. Furthermore, it appears that commercial vancomycin agar screening plates can be used to detect these isolates.

scholarly journals Molecular characterization of methicillin-resistant Staphylococcus aureus isolated from the pig production chain in Northern Italy

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Ancuta Cezara Simon ◽  
Valentina Baldo ◽  
Nadia Losio ◽  
Virginia Filipello ◽  
Angelo Colagiorgi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Molecular Characterization ◽  
Northern Italy ◽  
Molecular Characteristics ◽  
Genetic Determinants ◽  
Spa Typing ◽  
Production Chain ◽  
Methicillin Resistant ◽  
Spa Type

This study aimed to evaluate the molecular characteristics of methicillin resistant Staphylococcus aureus (MRSA) isolated in the swine chain in Northern Italy. A sample of 50 fattening units located in Lombardy was selected. Five cutaneous samples at slaughtering and three environmental samples at farm were collected from each unit giving a total of 250 and 150 samples, respectively. A total of 25 MRSA isolates were isolated from 400 samples, in 17 different fattening units. At farm, 12 out of 250 samples were positive for MRSA (4,8 %), and 13 out of 150 samples at slaughter were identified as MRSA (8,7 %), giving an overall incidence among samples of 6,25 % (n = 25). Molecular characterization was carried out using multi-locus sequence typing (MLST) and spa-typing. Outcomes showed that most of the isolates belonged to ST398, carrying spa-types t899, t011, t18498, t1939, t1200, and t304. Nonetheless, three isolates were identified as ST97 (t1730 and t4795), and one as ST30, showing spa-type t318. Furthermore, a novel ST was identified, namely 5422, showing spa-type t1730. Heterogeneity in genotypes within the same farm was also found in different fattening units, with concern for the possibility of the exchange of genetic determinants among different lineages. Genetic diversity among MRSA isolates in pig fattening units has been observed, highlighting the possibility that some isolates could be able to infect different hosts, including human.

Detection of NDM-1 producing Klebsiella pneumoniae ST15 and ST147 in Iran during 2019–2020

2021 ◽  
Author(s):  
Zohreh Riahi Rad ◽  
Zahra Riahi Rad ◽  
Hossein Goudarzi ◽  
Mehdi Goudarzi ◽  
Hesam Alizade ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Molecular Typing ◽  
Susceptibility Testing ◽  
Carbapenem Resistance ◽  
Gram Negative Bacteria ◽  
Broth Microdilution ◽  
Gram Negative ◽  
Beta Lactamases

AbstractCarbapenems are employed to treat infections caused by Gram-negative bacteria including Klebsiella pneumoniae. This research is aimed to perform phenotypic detection of β-lactamases and molecular characterization of NDM-1 positive K. pneumoniae isolates. Another objective is to investigate NDM-1 producing K. pneumoniae among children in Iran. From 2019 to 2020, altogether 60 K. pneumoniae isolates were acquired from various patients in certain Iranian hospitals. Antimicrobial susceptibility testing was performed by disk diffusion and broth microdilution methods. In addition, mCIM and eCIM were used to confirm the production of carbapenemases and metallo-beta-lactamases (MBLs), respectively. Detection of resistance genes namely, blaNDM-1, blaIMP, blaVIM, blaKPC, blaOXA-48-like, blaCTX-M, blaSHV, blaTEM, and mcr-1 was performed by PCR and confirmed by DNA sequencing. Multilocus sequence typing (MLST) was employed to determine the molecular typing of the strains. According to the findings, the highest rate of carbapenem resistance was detected against doripenem 83.3% (50). Moreover, 31.7% (19) were resistant to colistin. Further to the above, altogether 80% (48) were carbapenemase-producing isolates and among them 46.7% (28) of the isolates were MBL and 33.3% (20) isolates were serine β-lactamase producer. According to the PCR results, 14 isolates produced blaNDM-1. Remarkably, four blaNDM-1 positive isolates were detected in children. In addition, these isolates were clonally related as determined by MLST (ST147, ST15). Altogether ten blaNDM-1 positive isolates were ST147 and four blaNDM-1 positive isolates were ST15. Based on the results, the emergence of NDM-producing K. pneumoniae among children is worrying and hence, it is necessary to develop a comprehensive program to control antibiotic resistance in the country.

PHENOTYPIC CHARACTERIZATION OF CLINICAL ISOLATES OF CANDIDA SPECIES AND ITS SUSCEPTIBILITY TO VARIOUS ANTIFUNGAL AGENTS: A STUDY FROM A TERTIARY CARE HOSPITAL IN WESTERN UTTAR PRADESH

2021 ◽  
pp. 57-59
Author(s):  
Navdeep Gambhir ◽  
Abhigyan Goel ◽  
Anita Pandey ◽  
Arjun Singh Bisht ◽  
Sadab Khan ◽  
...  
Keyword(s):  
Candida Species ◽  
Antifungal Agents ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Antifungal Susceptibility Testing ◽  
Phenotypic Characterization ◽  
Clinical Samples ◽  
Care Hospital

Background: Indiscriminate use of antifungal agents has led to rise in infections caused by Candida species in recent years. Studies on characterization of Candida species followed by antifungal susceptibility testing can be benecial in managing this problem. Objectives: To phenotypically characterize Candida species isolated from various clinical samples and to determine its susceptibility to various antifungal agents. Methods: A total of 119 Candida spp. isolated from various clinical samples were subjected for species identication and antifungal susceptibility testing using an automated Vitek-2 compact system. Results: There was predominance of Non albicans (NAC) species (82.35%) isolated from our Hospital. Candida species were isolated predominantly from blood (68.06%) sample followed by urine (26.05%). C. tropicalis was the predominant NAC species isolated (27.73%) followed by C.krusei, C.guilliermondii (12.61% each), C.parapsilosis (10.08%) and C. glabrata (7.56%). Overall the NAC isolates were resistant to uconazole, voriconazole, caspofungin, micafungin, amphotericin-B, and ucytosine as compared to C. albicans. Conclusion: Predominance of NAC species and emergence of antifungal drug resistance among NAC species is a matter of concern. Thus highlighting that susceptibility should be performed in all cases to achieve good therapeutic results. Strict infection control strategies and a restrictive antifungal policy should be implemented for better clinical outcome.

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

Characterization of particulate matter 2.5 in an urban tertiary care hospital in the Philippines

2015 ◽  
Vol 92 ◽  
pp. 432-439 ◽  
Author(s):  
Marian Fe Theresa C. Lomboy ◽  
Leni L. Quirit ◽  
Victorio B. Molina ◽  
Godofreda V. Dalmacion ◽  
Joel D. Schwartz ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
The Philippines ◽  
Care Hospital ◽  
Particulate Matter 2.5
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