We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections.
- Authors
Augusto, Mariana Fernandes; da Silva Fernandes, Débora Cristina; de Oliveira, Tamara Lopes Rocha; Cavalcante, Fernanda Sampaio; Chamon, Raiane Cardoso; Ferreira, Adriana Lúcia Pires; Nouér, Simone Aranha; Infection Control Group HUCFF/UFRJ; Rangel, Ana Pereira; Castiñeiras, Anna Carla; Gonçalez, Christiany Moçali; Freire, Joana; Guimarães, Luiz Felipe; Batista, Raquel; dos Santos, Kátia Regina Netto
- Abstract
Background: Staphylococcus aureus is one of the leading causes of bloodstream infections (BSI) worldwide. In Brazil, the hospital-acquired methicillin-resistant S. aureus USA100/SCCmecII lineage replaced the previously well-established clones. However, the emergence of community-associated (CA) MRSA lineages among hospitalized patients is an increasing issue. Methods: Consecutive S. aureus isolates recovered from BSI episodes of patients admitted between January 2016 and December 2018 in a Brazilian teaching hospital were tested for antimicrobial resistance, their genotypic features were characterized, and the clinical characteristics of the patients were evaluated. Results: A total of 123 S. aureus isolates were recovered from 113 patients. All isolates were susceptible to linezolid, teicoplanin and vancomycin and 13.8% were not susceptible to daptomycin. Vancomycin MIC50 and MIC90 of 2 mg/L were found for both MRSA and MSSA isolates. The MRSA isolation rate was 30.1% (37/123), and 51.4% of them carried the SCCmec type II, followed by SCCmecIV (40.5%). Among the 37 MRSA isolates, the main lineages found were USA100/SCCmecII/ST5 and ST105 (53.7%) and USA800/ST5/SCCmecIV (18.9%). Surprisingly, six (16%) CA-MRSA isolates, belonging to USA300/ST8/SCCmecIVa that carried PVL genes and the ACME cassette type I, were detected. These six patients with USA300 BSI had severe comorbidities, including cancer, and most had a Charlson score ≥ 5; furthermore, they were in wards attended by the same health professionals. MRSA isolates were associated with hospital acquired infections (p = 0.02) in more elderly patients (p = 0.03) and those diagnosed with hematologic cancer (p = 0.04). Among patients diagnosed with MRSA BSI, 19 (54.3%) died. Conclusions: The pandemic MRSA USA300 was detected for the first time in the Brazilian teaching hospital under study, and its cross-transmission most probably occurred between patients with BSI. This lineage may already be circulating among other Brazilian hospitals, which highlights the importance of carrying out surveillance programs to fight multidrug resistant and hypervirulent isolates.
- Subjects
METHICILLIN-resistant staphylococcus aureus; MEDICAL personnel; OLDER patients; STAPHYLOCOCCUS aureus; ENTEROCOCCAL infections; HEMATOLOGIC malignancies
- Publication
Antimicrobial Resistance & Infection Control, 2022, Vol 11, Issue 1, p1
- ISSN
2047-2994
- Publication type
Article
- DOI
10.1186/s13756-022-01154-3