Molecular epidemiology of MRSA isolates in the intensive care unit during a 4-year-period

Molecular epidemiology of MRSA isolates in the intensive care unit during a 4-year-period

Objective: Methicillin resistant Staphylococcus aureus (MRSA) is a common cause of nosocomial infections in hospitalized patients , particularly in those who stay in intensive care unit(ICU). We aimed to compare MRSA strains isolated from ICU in order to detect relatedness between them since accurate epidemiological typing by reproducible and rapid methods is a major step in determining MRSA clones and sources of transmission for immediate infection control. Methods: From February 1998 to November 2001, 56 MRSA isolates from various clinical specimens from different patients who were hospitalized in ICL) of Marmara University Hospital were included in the study. These isolates were identified as MRSA by standard methods. Genotyping analysis was done by AP-PCR(arbitrarily primed polymerase chain reaction). Results and conclusion: The specimens which the MRSA strains isolated were as follows: 38(67.8%) from respiratory tract(deep trachéal aspirate and sputum), 10(17.8%) from blood, 4(7.1%) from wound infection and abscess, 2(3.6%)from catheters, 1(1.8%) from urine sample and 1 (1.8%) from joint fluid. By AP-PCR analysis 28/56 isolates exhibited 11 incidences of clusters throughout the study period. The longest time for a given incidence was 3 months and a given incidence affected 4 patients at most. We conclude that the AP-PCR method can easily be used in order to evaluate genotypic relatedness between MRSA isolates in our institution.

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  • 1. Thompson Rl, Cabezudo I, Wenzel RP. Epidemiology ofnosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982;97-.309-517. 2. Boyce JM. Methicillin-resistant Staphylococcus aureus: A continuing infection control challenge. Eur J Clin Microbiol Infect Dis 1994; 13:45-49. 5. Me Qowan JE Jr. Communication with hospital staff. In Balows A, Hausler WJ Jr, Hermann rL, Isenberg tlD, Shadomy HJ eds. Manual of Clinical Microbiology. 5th ed. Washington, DC: American Society for Microbiology, 1991:151-158. 4. Kloos WE, Bannerman TL. Staphylococcus and Micrococcus,. In: Murray PR, Baron EJ, PfallerMA, Tenover FC, Yolken RIi ed., Manual of Clinical Microbiology, 6th ed. Washington, DC:American society for Microbiology, 1995: 282-298. 5. van Belkum A, Bax R, Peerbooms P, Qoessens WflE, Leeuwen N, Quint Wgv. Comparison of phage typing and DMA fingerprinting by polymerase chain reaction for discrimination of methicillin-resistant Staphylococcus aureus strains.J Clin Microbiol 1993,-31:798-803. 6. Coello e t al. Risk factors for developing clinical infection with methicillin resistant Staphlococcus aureus . J tiosp Infect 1997,-37: 39-46,. 7. Richards MJ, Edwards JR, Culver Dfl, Qaynes RP. Nosocomial infections in combined medical-surgical inensive care units in the United States. Infect Control liosp Epidemiol 2000;21: 510-515,. 8. McQowan JE, Terry TM, Huang T, Hoi CL, Davies J. Nosocomial infeciions with gentamicin resistant Staphylococcus aureus: plasmid analysis as an epidemiological tool. J InfctDis 1979; 140: 864-872. 9. Olive M, Bean P. Principles and applications of methods for DNA based typing of microbial organisms. J Clin Microbiol 1999,37: 1661-1669.
  • 10. Grundmann H, Hahn A, Ehrenstein B, Qeiger K, Just H, Daschner F. Detection of cross- transmission of multiresistant Gram negative bacilli and Staphylococcus aureus in adult intentive care units by routine typing of clinical isolates. Clin Microbiol Infect 1999; 5: 355-363. 11. Tambic A, Power EGM, Talsania H, Anthony RM, French QL. Analyisis of an outbreak of non-phage typeable methicillin-resistant Staphylococcus aureus by using a randomly amplified polymorphic DNA assay. J Clin Microbiol. 199 7,35:3092-9 7. 12. Hsueh PR, Yang PC, Chen YC, Wang LH, Ho S W, Luh KT. Dissemination of two methicillin resistant Staphylococcus aureus clones exhibiting negative staphylase reactions in intentive care units. J Clin Microbiol 1999;37: 504-509.