Changing Italian nosocomial-community trends and heteroresistance in Staphylococcus aureus from bacteremia and endocarditis
Open Access
- 7 August 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Microbiology & Infectious Diseases
- Vol. 31 (5), 739-745
- https://doi.org/10.1007/s10096-011-1367-y
Abstract
Bloodstream infections due to Staphylococcus aureus (BSI) are serious infections both in hospitals and in the community, possibly leading to infective endocarditis (IE). The use of glycopeptides has been recently challenged by various forms of low-level resistance. This study evaluated the distribution of MSSA and MRSA isolates from BSI and IE in 4 Italian hospitals, their antibiotic susceptibility—focusing on the emergence of hVISA—and genotypic relationships. Our results demonstrate that the epidemiology of MRSA is changing versus different STs possessing features between community-acquired (CA)- and hospital-acquired (HA)-MRSA groups; furthermore, different MSSA isolated from BSI and IE were found, with the same backgrounds of the Italian CA-MRSA. The hVISA phenotype was very frequent (19.5%) and occurred more frequently in isolates from IE and in both the MSSA and MRSA strains. As expected, hVISA were detected in MRSA with vancomycin minimum inhibitory concentrations (MICs) of 1–2 mg/l, frequently associated with the major SCCmec I and II nosocomial clones; this phenotype was also detected in some MSSA strains. The few cases of MR-hVISA infections evaluated in our study demonstrated that 5 out of 9 patients (55%) receiving a glycopeptide, died. Future studies are required to validate these findings in terms of clinical impact.Keywords
This publication has 32 references indexed in Scilit:
- Failure of Vancomycin Continuous Infusion against Experimental Endocarditis Due to Vancomycin-Intermediate Staphylococcus aureusAntimicrobial Agents and Chemotherapy, 2011
- Global Distribution and Evolution of Panton‐Valentine Leukocidin–Positive Methicillin‐SusceptibleStaphylococcus aureus,1981–2007The Journal of Infectious Diseases, 2010
- Emergence of SCC mec Type IV and SCC mec Type V Methicillin-Resistant Staphylococcus aureus Containing the Panton-Valentine Leukocidin Genes in a Large Academic Teaching Hospital in Central Switzerland: External Invaders or Persisting Circulators?Journal of Clinical Microbiology, 2010
- Familial Furunculosis Associated with Community-Acquired Leukocidin-Positive Methicillin-Susceptible Staphylococcus aureus ST152Journal of Clinical Microbiology, 2010
- Microbiological Characteristics of Community-Associated Staphylococcus aureus Causing Uncomplicated Bacteremia and Infective EndocarditisJournal of Clinical Microbiology, 2010
- Heterogeneous Vancomycin‐Intermediate Susceptibility Phenotype in Bloodstream Methicillin‐ResistantStaphylococcus aureusIsolates from an International Cohort of Patients with Infective Endocarditis: Prevalence, Genotype, and Clinical SignificanceThe Journal of Infectious Diseases, 2009
- Cooccurrence of Predominant Panton-Valentine Leukocidin-Positive Sequence Type (ST) 152 and Multidrug-Resistant ST 241 Staphylococcus aureus Clones in Nigerian HospitalsJournal of Clinical Microbiology, 2009
- Genotypic and phenotypic relationships among methicillin-resistant Staphylococcus aureus from three multicentre bacteraemia studiesJournal of Antimicrobial Chemotherapy, 2009
- CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care settingAmerican Journal of Infection Control, 2008
- Staphylococcus aureus EndocarditisJAMA, 2005