umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Molecular epidemiology of meticillin-resistant coagulase-negative staphylococci in a Swedish county hospital: evidence of intra- and interhospital clonal spread
Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Clinical Bacteriology. Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Clinical Bacteriology.
Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Clinical Bacteriology.
Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
2006 (English)In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 64, no 2, 177-183 p.Article in journal (Refereed) Published
Abstract [en]

During a 10-month period in 2003, consecutive routine clinical cultures from patients treated in 15 different ward units in a Swedish county hospital were screened for the presence of meticillin-resistant coagulase-negative staphylococci (CNS). Genetic similarity between isolates was analysed using pulsed-field gel electrophoresis (PFGE). The results were compared with multi-drug-resistant Staphylococcus epidermidis isolated previously at the tertiary referral hospital. In total, 428 isolates of CNS were identified, of which 188 (44%) were meticillin resistant. Three clusters (Groups A, B and C) of S. epidermidis, each consisting of more than 10 isolates, with a PFGE-DNA similarity of >90% were identified. The strains in Groups A and B (N=15 and N=13, respectively), which were generally resistant to gentamicin, co-trimoxazole and clindamycin, originated from 24 patients, of whom 21 had been treated in the intensive care unit (ICU) before sampling. The third cluster, Group C, involved 14 isolates from 14 patients. Only two of these patients had stayed at the ICU, and all for less than one day. Isolates in Group C were less resistant than those in Groups A and B. Isolates belonging to Group A showed an identical PFGE profile compared with multi-drug-resistant S. epidermidis isolated from patients at the referral hospital. This study demonstrated the persistence and spread of meticillin-resistant clones of CNS within the county hospital, especially in the ICU, and possible interhospital spread of a multi-drug-resistant clone between the county and referral hospitals.

Place, publisher, year, edition, pages
2006. Vol. 64, no 2, 177-183 p.
Keyword [en]
Coagulase-negative staphylococci; Meticillin resistant; PFGE; Clonal spread; Epidemiology; Intrahospital; Interhospital
National Category
Microbiology in the medical area
Research subject
Clinical Bacteriology
Identifiers
URN: urn:nbn:se:umu:diva-22742DOI: 10.1016/j.jhin.2006.06.013PubMedID: 16911846OAI: oai:DiVA.org:umu-22742DiVA: diva2:217931
Available from: 2009-05-18 Created: 2009-05-18 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Molecular epidemiology of coagulase-negative staphylococci in hospitals and in the community
Open this publication in new window or tab >>Molecular epidemiology of coagulase-negative staphylococci in hospitals and in the community
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Coagulase-negative staphylococci (CoNS) and in particular Staphylococcus epidermidis have emerged as major pathogens primarily causing nosocomial infections in patients with indwelling medical devices. These infections are often caused by multidrug-resistant strains of S. epidermidis (MDRSE). Other clinical entities due to CoNS are lower urinary tract infections (UTI) in women and native valve endocarditis. The purpose of this work was to investigate the frequency of antibiotic resistance and the molecular epidemiology of both hospital and community-associated isolates of S. epidermidis in order to examine if certain clones are related to MDRSE infections. Furthermore, we aimed to explore if specific clones of S. saprophyticus are associated with UTI in women.

Methods

A total of 359 hospital-associated methicillin-resistant isolates of CoNS obtained from 11 hospitals in northern Europe and 223 community-associated staphylococcal isolates were examined. Furthermore, 126 isolates of S. saprophyticus isolated from women with uncomplicated UTI from five different locations in northern Europe were analyzed. Pulsed-field gel electrophoresis (PFGE) was used for genotyping. Additionally, some of the S. epidermidis isolates were analyzed with multilocus sequence typing (MLST). Antibiotic susceptibility was determined for all isolates by the disc diffusion test.

Results

293 of the 359 (82%) hospital-associated and 124 of the 223 (56%) community-associated isolates belonged to the species S. epidermidis. Among the hospital-associated S. epidermidis isolates, two dominating PFGE types (type A and B) were distinguished, comprising 78 (27%) and 51 (17%) isolates, respectively. Type A, which was detected in a Norwegian and eight Swedish hospitals, corresponded with a novel sequence type (ST215). Type B was discovered in a German, a Danish and seven Swedish hospitals and corresponded with ST2. In contrast, community-associated isolates of S. epidermidis were genetically extremely diverse with no predominating genotype, and showed a low rate of antibiotic resistance; only two (1.6%) methicillin-resistant strains were detected.

Among 126 analyzed isolates of S. saprophyticus, 47 different PFGE profiles were identified. Several clusters of genetically highly related isolates were detected among isolates obtained from different locations and periods of time.

Conclusion

We have demonstrated the occurrence, persistence and potential dissemination of two multidrug-resistant S. epidermidis (MDRSE) genotypes, including a novel sequence type (ST215), within hospitals in northern Europe. Community-associated isolates of S. epidermidis showed a low rate of methicillin-resistance and were genetically heterogeneous. These results indicate that MDRSE by large are confined to the hospital setting in our region. Moreover, although the S. saprophyticus population was quite heterogeneous, indistinguishable isolates of S. saprophyticus causing lower UTI in women were identified in different countries 11 years apart, indicating the persistence and geographical spread of some clones of S. saprophyticus.

Place, publisher, year, edition, pages
Umeå: Umeå university, 2010. 74 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1354
Keyword
staphylococcus epidermidis, staphylococcus saprophyticus, electrophoresis, gel, pulsed-field, genetic diversity, methicillin-resistance, UTI, drug resistance, multiple, bacterial, epidemiology, molecular, cross infection, molecular sequence data
National Category
Microbiology in the medical area Microbiology in the medical area Infectious Medicine
Research subject
Clinical Bacteriology; Microbiology; Infectious Diseases
Identifiers
urn:nbn:se:umu:diva-34289 (URN)978-91-7459-020-3 (ISBN)
Public defence
2010-09-03, Byggnad 6L, Major Groove,, Mikrobiologi, Norrlands Universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2010-05-28 Created: 2010-05-25 Last updated: 2012-07-09Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Widerström, MicaelMonsen, TorWiström, Johan
By organisation
Clinical BacteriologyInfectious Diseases
In the same journal
Journal of Hospital Infection
Microbiology in the medical area

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 132 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf