RESUMEN
BACKGROUND: The epidemiology of Clostridium difficile infections (CDI) is changing rapidly worldwide; knowledge on the genotypes of C. difficile circulating in specialized geriatric hospitals and their resistance to antibiotics is scarce or non-existent. METHODS: Prospective study of the molecular epidemiology of CDI, conducted in a national geriatric hospital in Costa Rica for a period of 11 months. RESULTS: The study patients exhibited a diverse range of comorbidities, but none were associated with CDI. Polyclonality, including three new ribotypes, and a high level of resistance to antibiotics were determined by analysing the 32 isolates obtained in these cases. Despite the diversity in strains observed, the most frequent types were NAP6/RT002 and NAP2/RT001. NAP9/RT017 was associated with community acquisition. Nineteen types of antimicrobials were used before the onset of diarrhoea in the patients; no particular genotype was associated with the onset of infection or severity. CONCLUSION: Based on the abundance of strain types observed and their resistance to antibiotics in this geriatric hospital, these results contribute to a better overall understanding of the epidemiology of CDI worldwide, and to surveillance programmes targeting geriatric populations.
Asunto(s)
Clostridioides difficile/clasificación , Clostridioides difficile/genética , Infecciones por Clostridium/epidemiología , Infecciones por Clostridium/microbiología , Variación Genética , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Clostridioides difficile/aislamiento & purificación , Costa Rica/epidemiología , Diarrea/epidemiología , Diarrea/microbiología , Farmacorresistencia Bacteriana , Femenino , Hospitales , Humanos , Masculino , Epidemiología Molecular , Estudios Prospectivos , RibotipificaciónAsunto(s)
Proteínas Bacterianas/genética , Farmacorresistencia Bacteriana/genética , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/genética , Tigeciclina/farmacología , Antibacterianos/uso terapéutico , Niño , Fibrosis Quística/microbiología , Farmacorresistencia Bacteriana/efectos de los fármacos , Femenino , Humanos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Mutación , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/microbiologíaAsunto(s)
Alelos , Proteínas Bacterianas/genética , Enterococcus faecium/genética , Islas Genómicas , Péptido Sintasas/genética , Resistencia a la Vancomicina/genética , Anciano de 80 o más Años , Canadá/epidemiología , Enterococcus faecium/efectos de los fármacos , Enterococcus faecium/aislamiento & purificación , Femenino , Infecciones por Bacterias Grampositivas/epidemiología , Infecciones por Bacterias Grampositivas/microbiología , Humanos , Reacción en Cadena de la Polimerasa Multiplex , Recto/microbiología , Teicoplanina/farmacología , Vancomicina/farmacologíaRESUMEN
SUMMARYIncreasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has been reported in Canada. We report the results of a prospective surveillance of MRSA infections in Alberta over a consecutive 3-year period. A total of 8910 unique clinical MRSA isolates was analysed from July 2005 to June 2008. The incidence of MRSA infection increased over the study period and was highest in males, age group ⩾85 years, and the Calgary Area. CMRSA10 (USA300) and CMRSA2 (USA100/800) were the most common PFGE strain types, representing 53·0% and 27·9% of all isolates, respectively. Significant differences were noted between MRSA strains in the source of infection and antimicrobial susceptibility. The incidence of MRSA infection in Alberta has nearly doubled in the last 3 years; this is attributed to the emergence of CMRSA10 as the predominant strain.
Asunto(s)
Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Alberta/epidemiología , Técnicas de Tipificación Bacteriana , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Factores Sexuales , Adulto JovenAsunto(s)
Brotes de Enfermedades/veterinaria , Enfermedades de los Perros/epidemiología , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas/veterinaria , Animales , Reservorios de Enfermedades/veterinaria , Perros , Femenino , Masculino , Ontario/epidemiología , Infecciones Estafilocócicas/epidemiologíaRESUMEN
In this case-control study, cases [community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), n=79] and controls [community-associated methicillin-susceptible S. aureus (CA-MSSA), n=36] were defined as a laboratory-confirmed infection in a patient with no previous hospital-associated factors. Skin and soft tissue were the predominant sites of infection, both for cases (67.1%) and controls (55.6%). Most of the cases (79.7%) and controls (77.8%) were aged <30 years. Investigations did not reveal any significant statistical differences in acquiring a CA-MRSA or CA-MSSA infection. The most common shared risk factors included overcrowding, previous antibiotic usage, existing skin conditions, household exposure to someone with a skin condition, scratches/insect bites, and exposure to healthcare workers. Similar risk factors, identified for both CA-MRSA and CA-MSSA infections, suggest standard hygienic measures and proper treatment guidelines would be beneficial in controlling both CA-MRSA and CA-MSSA in remote communities.