RESUMO
Typing of meticillin resistant Staphylococcus aureus (MRSA) by whole genome sequencing (WGS) is performed routinely in Copenhagen since January 2013. We describe the relatedness, based on WGS data and epidemiological data, of 341 MRSA isolates. These comprised all MRSA (n = 300) identified in Copenhagen in the first five months of 2013. Moreover, because MRSA of staphylococcal protein A (spa)-type 304 (t304), sequence type (ST) 6 had been associated with a continuous neonatal ward outbreak in Copenhagen starting in 2011, 41 t304 isolates collected in the city between 2010 and 2012 were also included. Isolates from 2013 found to be of t304, ST6 (n=14) were compared to the 41 earlier isolates. In the study, isolates of clonal complex (CC) 22 were examined in detail, as this CC has been shown to include the hospital-acquired epidemic MRSA (EMRSA-15) clone. Finally, all MRSA ST80 were also further analysed, as representatives of an important community-acquired MRSA in Europe. Overall the analysis identified 85 spa-types and 35 STs from 17 CCs. WGS confirmed the relatedness of epidemiologically linked t304 neonatal outbreak isolates. Several non-outbreak related patients had isolates closely related to the neonatal isolates suggesting unrecognised community chains of transmission and insufficient epidemiological data. Only four CC22 isolates were related to EMRSA-15. No community spread was observed among the 13 ST80 isolates. WGS successfully replaced conventional typing and added information to epidemiological surveillance. Creation of a MRSA database allows clustering of isolates based on single nucleotide polymorphism (SNP) calling and has improved our understanding of MRSA transmission.
Assuntos
Genoma Bacteriano/genética , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Tipagem Molecular/métodos , Análise de Sequência de DNA/métodos , Proteína Estafilocócica A/genética , Toxinas Bacterianas , Dinamarca/epidemiologia , Exotoxinas , Humanos , Leucocidinas/genética , Epidemiologia Molecular , Polimorfismo de Nucleotídeo Único , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologiaRESUMO
Meticillin-resistant Staphylococcus aureus (MRSA) is a major problem in hospitals worldwide. Hand hygiene is recognised as crucial in limiting the spread of MRSA but less is known about the role of MRSA reservoirs in the inanimate hospital environment. We evaluated the effect of hydrogen peroxide vapour diffused by Sterinis((R)) against MRSA in two experimental hospital settings and in two field trials. Dipslides were used for MRSA detection and quantification before and after using the Sterinis disinfection process. In the first experimental hospital setting, four epidemic MRSA strains were placed at five locations and left for one week. All strains survived the week but not the disinfection process. In field trial one 14 upholstered chairs from a department with many MRSA positive patients were left for one month in a closed room prior to disinfection. MRSA was found on the upholstery of four of the 14 chairs. Three chairs became MRSA negative immediately after the disinfection, the fourth 24h later. The second field trial was in the private home of a MRSA positive family of four individuals. One location was found MRSA positive, remaining so after the Sterinis cycles. We found Sterinis to be effective against MRSA in the experimental hospital setting and upholstered chairs, but not in the private home of heavily colonised MRSA patients.
Assuntos
Desinfetantes/farmacologia , Desinfecção/métodos , Microbiologia Ambiental , Peróxido de Hidrogênio/farmacologia , Resistência a Meticilina , Staphylococcus aureus/efeitos dos fármacos , Contagem de Colônia Microbiana , Hospitais , Humanos , Staphylococcus aureus/isolamento & purificação , VolatilizaçãoRESUMO
The purpose of this study was to characterise methicillin-resistant Staphylococcus aureus (MRSA) isolates from the Republic of Georgia, part of the former Soviet Union. Thirty-two non-duplicate MRSA isolates were collected in the period from May 2006 to February 2007. The patient data were analysed and the isolates were characterised by staphylococcal protein A (spa) typing, staphylococcal chromosome cassette mec (SCCmec) typing, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE) and the detection of Panton-Valentine leukocidin (PVL) genes. Only two closely related spa types were found; 29 isolates were of spa type 459 and three were t030. The spa types belonged to sequence type (ST) 239, clonal complex (CC) 8. All isolates were multiresistant, PVL-negative and harboured SCCmec type IIIA. Based on the molecular findings and PFGE, the isolates most closely resembled the pandemic Brazilian clone (ST239-IIIA).