Hostname: page-component-848d4c4894-8kt4b Total loading time: 0 Render date: 2024-06-19T05:03:02.081Z Has data issue: false hasContentIssue false
  • English
  • Français

Outbreak Among HIV-Infected Patients of Staphylococcus aureus Resistant to Cotrimoxazole and Methicillin

Published online by Cambridge University Press:  02 January 2015

Roberto Alonso ,
Belen Padilla ,
Carlos Sánchez-Carrillo ,
Patricia Muñoz ,
Marta Rodríguez-Creixems  and
Emilio Bouza
Roberto Alonso*
Affiliation:
Servicio de Microbiología Clinica y Enfermedades Infecciosas., Hospital General Universitario, “Gregorio Marañón, ” Madrid, Spain
Belen Padilla
Affiliation:
Servicio de Microbiología Clinica y Enfermedades Infecciosas., Hospital General Universitario, “Gregorio Marañón, ” Madrid, Spain
Carlos Sánchez-Carrillo
Affiliation:
Servicio de Microbiología Clinica y Enfermedades Infecciosas., Hospital General Universitario, “Gregorio Marañón, ” Madrid, Spain
Patricia Muñoz
Affiliation:
Servicio de Microbiología Clinica y Enfermedades Infecciosas., Hospital General Universitario, “Gregorio Marañón, ” Madrid, Spain
Marta Rodríguez-Creixems
Affiliation:
Servicio de Microbiología Clinica y Enfermedades Infecciosas., Hospital General Universitario, “Gregorio Marañón, ” Madrid, Spain
Emilio Bouza
Affiliation:
Servicio de Microbiología Clinica y Enfermedades Infecciosas., Hospital General Universitario, “Gregorio Marañón, ” Madrid, Spain
*
Servicio de Microbiología, Hospital General Universitario, “Gregorio Marañón, ” C/Doctor Esquerdo, 46. 28007 Madrid, Spain
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To describe an outbreak of trimethoprim-sulfamethoxazole (cotrimoxazole)–resistant and methicillin-resistant Staphylococcus aureus (CMRSA) in a unit housing patients infected with the human immunodeficiency virus (HIV).

Design:

Prospective study involving patients colonized or infected with CMRSA.

Patients:

15 hospitalized patients with cultures positive for CMRSA.

Methods:

Isolates of CMRSA were collected and characterized. Molecular typing of the epidemic strains was carried out after total DNA extraction by restriction endonuclease analysis and random amplification of polymorphic DNA.

Results:

The epidemic was brought under control with the reinforcement of nosocomial transmission measures and with systematic nasal decontamination with mupirocin of all patients admitted to the HIV unit. Molecular typing techniques showed the existence of two epidemic strains: strain A was present in the 12 patients admitted to the HIV unit and strain B in the remaining 3 patients hospitalized elsewhere.

Conclusions:

Cotrimoxazole may no longer be a reliable and effective alternative for glycopeptides in patients with infection caused by MRSA strains, and HIV units should be particularly alert for CMRSA strains.

Type
Originals Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 9 , September 1997 , pp. 617 - 621
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Boyce, JM. Nosocomial staphylococcal infections. Ann Intern Med 1981;95:241–242.CrossRefGoogle ScholarPubMed
2. Parras, F, Rodríguez, M, Bouza, E, et al. Brote epidémico de Staphylococcus aureus resistente a meticilina (SARM) en un hospital general: informe preliminar. Enferm Infecc Microbiol Clin 1991;4:200–207.Google Scholar
3. Bouza, E, Martínez-Beltrán, J, the Spanish Group for the Study of Staphylococci. Staphylococci in Spain. J Chemother 1988;(suppl 4):15–17.Google Scholar
4. Bouza, E, Martínez-Beltrán, J, Grupo de Trabajo para el estudio de Estafilococos. Estudio multicéntrico sobre la prevalencia de estafilococos en España. Enferm Infecc Microbiol Clin 1988;3:68–79.Google Scholar
5. Diaz, MD, Sánchez-Carrillo, C, Bouza, E, et al. Evolución de la resistencia de Staphylococcus species aislados en hospitales Españoles. Tercer estudio. Rev Clin Esp 1994;194:814–820.Google Scholar
6. Bouza, E, Parras, F. Aproximación actual al tratamiento y prevención de la infección por estafilococos resistentes a la meticilina. In: Bouza, E, Rodríguez-Creixems, M, eds. Staphylococcus aureus Resistente a la Meticilina: Situación Actual. Madrid, Spain: 1992:189–223.Google Scholar
7. Markowitz, N, Quinn, EL, Saravolatz, LD. Trimethoprim-sulfamethoxazole compared with vancomycin for the treatment of Staphylococcus aureus infection. Ann Intern Med 1992;117:390–398.CrossRefGoogle ScholarPubMed
8. Centers for Disease Control. 1993 revised CDC HIV classification system and expanded AIDS surveillance definition for adolescents and adults. MMWR 1992;41(RR-17).Google Scholar
9. Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
10. Ballows, A, Hausler, WJ Jr, Herrmann, KL, Isenberg, HD, Shadomy, HJ. In: Manual of Clinical Microbiology. 5th ed. Washington, DC: American Society of Microbiology; 1991:222–237.Google Scholar
11. National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved standard. M7-A2. Villanova, PA: NCCLS; 1990.Google Scholar
12. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility tests. Approved standard. Document M2-A4. Villanova, PA: NCCLS; 1993.Google Scholar
13. Pitcher, DJ, Saunders, NA, Owen, RJ. Rapid extraction of bacterial DNA with guanidinium thiocyanate. Letters in Applied Microbiology 1989;8:151–154. Letter.CrossRefGoogle Scholar
14. Alonso, R, Nicholson, PS, Pitt, TL. Rapid extraction of high purity chromosomal DNA from Serratia marcescens . Letters in Applied Microbiology 1993;16:77–79. Letter.CrossRefGoogle ScholarPubMed
15. Sambrook, J, Fritsch, EF, Maniatis, T. In: Molecular Cloning: A Laboratory Manual. 2nd ed. Plainview, NY: Cold Spring Harbor Laboratory Press; 1989. Appendices E5-E7.Google Scholar
16. Alonso, R, Auken, H, Pitt, TL, Pérez-Díaz, JC, Baquero, F. Ribotyping on Serratia . Epidemiol Infect 1993;111:99–107.CrossRefGoogle ScholarPubMed
17. Welsh, J, McClelland, M. Fingerprinting genomes using PCR with arbitrary primers. Nucleic Acids Res 1990;18:7213–7218.CrossRefGoogle ScholarPubMed
18. Williams, JGK, Kubelik, AR, Livak, KJ, Rafalski, JA, Tingey, SV. DNA polymorphisms amplified by arbitrary primers are useful as genetic markers. Nucleic Acids Res 1990;18:6531–6535.CrossRefGoogle ScholarPubMed
19. Jevons, MP. ‘Celbenin’-resistant staphylococci. BMJ 1961;1:124–125.CrossRefGoogle Scholar
20. Wenzel, RP. The emergence of methicillin-resistant Staphylococcus aureus . Ann Intern Med 1982;97:440–442.CrossRefGoogle ScholarPubMed
21. Pérez Trallero, E, Garcia Arenzana, J, Ansa Castañeda, A, Paisán Grisolia, L. Unusual multiresistant Staphylococcus aureus in a newborn nursery. Am J Dis Child 1981;135:689–692.Google Scholar
22. Voss, A, Milatovic, D, Wallrauch-Schwarz, C, Rosdahl, VT, Braveny, I. Methicillin-resistant Staphylococcus aureus in Europe. Eur J Clin Microbiol Infect Dis 1994;13:50–55.CrossRefGoogle ScholarPubMed
23. Markowitz, N, Pohlod, DJ, Saravolatz, LD, Quin, EI. In vitro susceptibility patterns of methicillin-resistant and susceptible Staphylococcus aureus strains in a population of parenteral drug abusers from 1972 to 1981. Antimicrob Agents Chemother 1983;23:450–457.CrossRefGoogle Scholar
24. Parras, F, Guerrero, C, Bouza, E, et al. Comparative study of mupirocin and oral cotrimoxazole plus topical fusidic acid in eradication of nasal carriage of methicillin-resistant Staphylococcus aureus . Antimicrob Agents Chemother 1995;39:175–179.CrossRefGoogle ScholarPubMed
25. Hill, RL, Duckworth, GH, Casewell, MW. Elimination of nasal carriage of methicillin-resistant Staphylococcus aureus with mupirocin during a hospital outbreak. J Antimicrob Agents Chemother 1988;22:377–384.CrossRefGoogle ScholarPubMed
26. Samra, Z, Gadba, R. Antibiotic susceptibility and phage typing of methicillin-resistant Staphylococcus aureus clinical isolates from blood cultures of 692 patients in 15 Israeli hospitals. Eur J Epidemiol 1993;9:559–562.Google ScholarPubMed
27. Qadri, SM, Halim, M, Ueno, Y, Saldin, H. Susceptibility of methicillin-resistant Staphylococcus aureus to minocycline and other antimicrobials. Chemotherapy 1994;40:26–29.CrossRefGoogle ScholarPubMed
28. Goetz, MB, Mulligan, ME, Kwork, R, O'Brien, H, Caballes, C, García, JP. Management and epidemiologic analysis of an outbreak due to methicillin-resistant Staphylococcus aureus . Am J Med 1992;6:607–614.CrossRefGoogle Scholar