Staphylococcus aureus carriage in older populations in community residential care homes: Prevalence and molecular characterization of MRSA isolates / Colonización por Staphylococcus aureus en pacientes institucionalizados en residencias geriátricas: prevalencia y caracterización molecular de los aislados resistentes a meticilina

Introduction: The epidemiology of S. aureus depends on conditions in specific populations. Few studies of S. aureus colonization in the older population have been performed in Spain. The aim of this study was to determine the prevalence of methicillin-resistant S. aureus (MRSA) colonization and its molecular epidemiological characteristics in an institutionalized population in community residential care homes in Cadiz, Spain. Methods: A cross-sectional epidemiological study was conducted in three residential care homes for older people. Axilla and nostril samples were tested. Identification of S. aureus and antimicrobial susceptibility testing were by MALDI-TOF and MicroScan panels. MRSA strains were subjected to SCCmec typing, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). The presence of Panton-Valentine leukocidin (PVL) genes was determined by PCR in all S. aureus strains. Results: A total of 293 residents were included. Fifty-one residents (17.4%) were colonized with methicillin-sensitive S. aureus (MSSA) and 11 (3.8%) with MRSA. Resistance to at least two aminoglycosides was observed in 25.4% of MSSA and 90.9% and of MRSA isolates, and resistance to levofloxacin in 80.3% of MSSA and 100% of MRSA isolates. SCCmecIV was detected in all isolates and all except one (ST-125) were ST-8. None of the S. aureus isolates were positive for PVL. Conclusions: A low rate of S. aureus carriage was detected and the prevalence of MRSA was very low. ST8-MRSA-IVc was the dominant clone, and only one strain belonged to ST125-MRSA-IVc. We found MRSA transmission within the residential care homes and a very high rate of quinolone resistance in MSSA and MRSA

Introducción: La epidemiología de S. aureus depende de las condiciones particulares de cada población. En España se han realizado pocos estudios sobre la colonización por S. aureus en la población geriátrica. El objetivo de este estudio es determinar la prevalencia de colonización por S. aureus resistente a meticilina (SARM) y sus características epidemiológicas moleculares en población institucionalizada en residencias de ancianos en Cádiz, España. Métodos: Se realizó un estudio epidemiológico transversal en 3 residencias de ancianos. Se estudiaron muestras de las fosas nasales y axilas. La identificación y las pruebas de sensibilidad se realizaron utilizando MALDI-TOF y paneles MicroScan(R). En los aislados de SARM se determinó el tipo de SCCmec y se tiparon mediante Multilocus Sequence Typing (MLST) y Pulsed-field Gel Electrophoresis (PFGE). La presencia de genes de la leucocidina de Panton-Valentine (LPV) se determinó mediante PCR en todas las cepas de S. aureus. Resultados: Se incluyeron un total de 293 residentes. Cincuenta y un residentes (17,4%) estaban colonizados por S. aureus sensible a la meticilina (SASM) y 11 (3,8%) por SARM. Se observó resistencia frente al menos 2 aminoglucósidos en el 25,4 y 90,9% y resistencia a levofloxacino en el 80,3 y 100% de los aislamientos de SASM y SARM, respectivamente. Se detectó SCCmecIV en todos los aislados, y todos, excepto uno (ST-125) correspondían al ST-8. Ninguno de los aislados de S. aureus fue positivo para LPV. Conclusiones: Se detectó una baja tasa de portadores de S. aureus, siendo el porcentaje de SARM muy bajo. ST8-MRSA-IVc fue el clon predominante, y solo una cepa pertenecía a ST125-MRSA-IVc. Se objetivó transmisión de SARM intracentro. Se observó una tasa muy alta de resistencia a quinolonas en SASM y SARM

Colonización por Staphylococcus aureus en población anciana institucionalizada en el área de la Bahía de Cádiz: prevalencia y factores de riesgo asociados / Staphylococcus aureus colonization in an institutionalized elderly population in the Bay of Cadiz area, Spain: prevalence and associated risk factors

Antecedentes y objetivo: Staphylococcus aureus es un problema para la salud causante de gran variedad de infecciones. El objetivo del estudio fue conocer la prevalencia y factores asociados a personas portadoras de S. aureus institucionalizadas en Cádiz. Pacientes y método: Estudio transversal entre septiembre de 2016 y mayo de 2017. Población: Residentes institucionalizados en los centros sociosanitarios con mayor número de plazas de Cádiz (N=359). La variable respuesta fue ser portador de S. aureus (sensible y resistente a meticilina, SASM y SARM respectivamente). Las variables independientes fueron: edad, sexo, comorbilidad, estado funcional, antibioterapia e ingreso hospitalario en los últimos tres meses. Se realizó análisis bivariado y con regresión logística. Resultados: Prevalencia de colonización: SASM 17,4% y SARM 3,8%. Haber recibido betalactámicos se relacionó significativamente con ser portador de SASM y SARM mediante regresión logística multivariante con una OR=3,3 y OR=3,8 respectivamente. Conclusiones: Existe baja prevalencia de portadores de S. aureus en la población estudiada. Recibir previamente betalactámicos se asoció significativamente con estar colonizado por SASM y SARM. Las prescripciones desde atención primaria son esenciales para el control de cepas patógenas multirresistentes

Background and objective: Staphylococcus aureus is a health problem behind a great variety of infections. The objective of the study was to establish the prevalence and risk factors of S. aureus carriers in community nursing homes in Cadiz. Patients and method: A cross study from September 2016 to May 2017. Population: All residents institutionalized in the largest long-term care facilities centers in Cadiz. The main variable was being a S. aureus carrier (sensitive and resistant to methicillin, MSSA and MRSA). The independent variables were age, sex, comorbidity, functional status, antibiotic therapy and hospitalization in the last three months. Bivariate analysis with logistic regression was conducted. Results: Prevalence of colonization: MSSA 17,4% and MRSA 3.8%. Use of beta-lactams was significantly related to a MSSA and MRSA carrier status using multivariate logistic regression OR = 3.3 and OR = 3.8. Conclusions: There is a low prevalence of S. aureus carriers in the study population. Use of beta-lactams before the study was significantly associated with being a carrier colonized by MSSA y MRSA. Primary care prescriptions are a key in controlling pathogenic multiresistant strains

Staphylococcus aureus colonization in an institutionalized elderly population in the Bay of Cadiz area, Spain: prevalence and associated risk factors. / Colonización por Staphylococcus aureus en población anciana institucionalizada en el área de la Bahía de Cádiz: prevalencia y factores de riesgo asociados.

BACKGROUND AND OBJECTIVE: Staphylococcus aureus is a health problem behind a great variety of infections. The objective of the study was to establish the prevalence and risk factors of S. aureus carriers in community nursing homes in Cadiz. PATIENTS AND METHOD: A cross study from September 2016 to May 2017. POPULATION: All residents institutionalized in the largest long-term care facilities centers in Cadiz. The main variable was being a S. aureus carrier (sensitive and resistant to methicillin, MSSA and MRSA). The independent variables were age, sex, comorbidity, functional status, antibiotic therapy and hospitalization in the last three months. Bivariate analysis with logistic regression was conducted. RESULTS: Prevalence of colonization: MSSA 17,4% and MRSA 3.8%. Use of beta-lactams was significantly related to a MSSA and MRSA carrier status using multivariate logistic regression OR = 3.3 and OR = 3.8. CONCLUSIONS: There is a low prevalence of S. aureus carriers in the study population. Use of beta-lactams before the study was significantly associated with being a carrier colonized by MSSA y MRSA. Primary care prescriptions are a key in controlling pathogenic multiresistant strains.

Staphylococcus aureus carriage in older populations in community residential care homes: Prevalence and molecular characterization of MRSA isolates.

INTRODUCTION: The epidemiology of S. aureus depends on conditions in specific populations. Few studies of S. aureus colonization in the older population have been performed in Spain. The aim of this study was to determine the prevalence of methicillin-resistant S. aureus (MRSA) colonization and its molecular epidemiological characteristics in an institutionalized population in community residential care homes in Cadiz, Spain. METHODS: A cross-sectional epidemiological study was conducted in three residential care homes for older people. Axilla and nostril samples were tested. Identification of S. aureus and antimicrobial susceptibility testing were by MALDI-TOF and MicroScan panels. MRSA strains were subjected to SCCmec typing, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). The presence of Panton-Valentine leukocidin (PVL) genes was determined by PCR in all S. aureus strains. RESULTS: A total of 293 residents were included. Fifty-one residents (17.4%) were colonized with methicillin-sensitive S. aureus (MSSA) and 11 (3.8%) with MRSA. Resistance to at least two aminoglycosides was observed in 25.4% of MSSA and 90.9% and of MRSA isolates, and resistance to levofloxacin in 80.3% of MSSA and 100% of MRSA isolates. SCCmecIV was detected in all isolates and all except one (ST-125) were ST-8. None of the S. aureus isolates were positive for PVL. CONCLUSIONS: A low rate of S. aureus carriage was detected and the prevalence of MRSA was very low. ST8-MRSA-IVc was the dominant clone, and only one strain belonged to ST125-MRSA-IVc. We found MRSA transmission within the residential care homes and a very high rate of quinolone resistance in MSSA and MRSA.