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Epidemiology and Clonality of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Causing Bacteremia in a Tertiary-Care Hospital in Spain

Published online by Cambridge University Press:  21 June 2016

Fernando Chaves ,
Jesus García-Martínez ,
Sonia de Miguel ,
Francisca Sanz  and
Joaquín R. Otero
Fernando Chaves*
Affiliation:
Servicio de Microbiología, Hospital Universitario Doce de Octubre, Madrid, Spain
Jesus García-Martínez
Affiliation:
Servicio de Microbiología, Hospital Universitario Doce de Octubre, Madrid, Spain
Sonia de Miguel
Affiliation:
Servicio de Microbiología, Hospital Universitario Doce de Octubre, Madrid, Spain
Francisca Sanz
Affiliation:
Servicio de Microbiología, Hospital Universitario Doce de Octubre, Madrid, Spain
Joaquín R. Otero
Affiliation:
Servicio de Microbiología, Hospital Universitario Doce de Octubre, Madrid, Spain
*
Servicio de Microbiología, Hospital Universitario Doce de Octubre, Avenida de Cordoba sn, Madrid 28041, Spain. fchaves.hdoc@salud.madrid.org
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Abstract

Objectives:

To describe the relative proportions of nosocomial and community-onset Staphylococcus aureus bacteremia at our institution and the epidemiologic characteristics and clonal diversity of S. aureus isolates, as determined by pulsed-field gel electrophoresis (PFGE) and antimicrobial resistance patterns.

Design:

Retrospective cohort study of all cases of S. aureus bacteremia between October 2001 and October 2002.

Setting:

A 1,300-bed, tertiary-care hospital.

Results:

One hundred sixty-two unique episodes of S. aureus bacteremia were identified. Forty-three cases (26.5%) were caused by methicillin-resistant S. aureus (MRSA). Most cases of S. aureus bacteremia, whether MRSA or methicillin susceptible (MSSA), were nosocomial in origin (77.2%) or were otherwise associated with the healthcare system (16%). Only 11 (6.8%) of the cases (all MSSA) were strictly community acquired. Thirty-five unique macrorestriction patterns were identified among the 154 isolates that were typed by PFGE. Four major genotypes were defined among the isolates of MRSA, with 36 (85.7%) represented by a single PFGE type. Of the isolates within this major clone, all (100%) were ciprofloxacin resistant and 77.8% were erythromycin resistant. In contrast, the 112 isolates of MSSA comprised 31 different PFGE types, 3 of which represented 42.9% of all MSSA isolates and were associated with both nosocomial and community-onset bacteremia.

Conclusions:

Most cases of S. aureus bacteremia in our healthcare region are nosocomial in origin or are acquired through contact with the healthcare system and are thus potentially preventable. To preclude dissemination of pathogenic clones, it is therefore necessary to redouble preventive measures in both the hospital and the community.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 2 , February 2005 , pp. 150 - 156
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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