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Restriction Endonuclease Analysis of Plasmid DNA From Methicillin-Resistant Staphylococcus aureus: Clinical Application Over a Three-Year Period

  • Antoni Trilla (a1) (a2), Mary D. Nettleman (a2) (a3), Richard J. Hollis (a4), Mary Fredrickson (a3), Richard P. Wenzel (a2) and Michael A. Pfaller (a5)...

Abstract

Objective:

To investigate trends in plasmid types of methicillin-resistant Staphylococcus aureus over a 3-year period and determine the clinical impact of plasmid typing.

Design:

Restriction endonuclease analysis of plasmid DNA (REAP) was used to type 270 clinical isolates.

Setting:

A Veterans Affairs Medical Center.

Results:

Forty-four different REAP types were identified and, of these, 23 appeared only once. Types designed as V1 and V2 were more commonly found in nosocomial cases than in community-acquired cases (p<.05); whereas the K and D types were more common in isolates from community-acquired cases (<c.05). In 30 (11%) isolates, no plasmid was detected. When combined with epidemiological data, REAP typing revealed 4 small outbreaks that would have been missed using traditional epidemiological methods alone. In large outbreaks involving 10 or more cases, REAP typing data revealed unsuspected patterns of transmission.

Conclusions:

Multiple plasmid types were present in this endemic setting. Restriction endonuclease analysis of plasmid DNA was a practical and valuable adjunct to traditional epidemiological methods.

Copyright

Corresponding author

University of Iowa Hospitals , C41GH, Iowa City, Iowa 52242

References

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1.Preheim, LC, Rimland, D, Bittner, MJ. Methicillin-resistant Stufihylococcus aureus in Veterans Administration Medical Centers. Infect Control. 1987;8:191194.
2.Storch, GA, Radcliff, JL, Meyer, PL, Hinrichs, JH. Methicillin-resistant Staphylococcus aureas in a nursing home. Infect Control. 1987;8:2429.
3.Hsu, CC, Macaluso, CP, Special, L, Hubble, RH. High rate of Methicillin-resistance of Staphylococcus aureus isolated from hospitalized nursing home *patients. Arch Intern Med. 1988;148:569570.
4.Thomas, CJ, Bridge, J, Waterman, S, Vogt, J, Kilman, L, Hancock, G. Transmission and control of methicillin-resistant Staphylococcus uureus in a skilled nursing facility. Infect Control Hasp Epidemiol. 1989;10:106110.
5, Haley, RW, Hightower, AW, Khabbaz, RFet al. The emergence of methicillin-resistant Staphylococcus uureus infections in United States hospitals. Ann Intern Med. 1982;97:297308.
6.Standiiord, HC. Methicillin-resistant Staphylococcus uureus infections: it's time to get tough. Infect Control. 1987;5:187189.
7.Crossley, K, Loesch, D, Iandesman, B, Mead, K, Chern, M, Strate, RAn outbreak of infections caused by strains of Staphylococcus uureus resistant to methicillin and aminoglycosides. I. Clinical studies. J Infect Dis. 1979;139:273279.
8.Giamorellou, H, Papetropoulou, M, Daikos, GK. Methicillin-resistant Staphylococcus uureus infections during 19781979: Clinical and bacteriologic observations. J Antimicrob Chemother. 1981;7:649655.
9.Thompson, RL, Cabezudo, I, Wenzel, RF! Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus uureus. Ann Intern Med. 1982;97:309317.
10.Boyce, JM. Increasing prevalence of methicillin-resistant Stuphylococcus uureus in the United States. Infect Control Hosp Epidemiol. 1990;11:639642.
11.Jones, RN, Barry, AL, Gardiner, RV, Packer, RRThe prevalence of staphylococcal resistance penicillinase-resistant penicillins. A retrospective and prospective national surveillance trial of isolates from 40 medical centers. Diugn Microbial Infect Dis. 1989;12:385394.
12.Boyce, JM, White, RL, Spruill, EY. Impact of methicillin-resistant Staphylococcus aureus on the incidence of nosocomial staphylococcal infections.] Infect Dis. 1983;148:763.
13.Locksley, RM, Cohen, ML, Quinn, TC, et al. Multiply antibiotic-resistant Staphylococcus aureus: introduction, transmission and evolution of nosocomial infection. Ann Intern Med. 1982;97:317324.
14.Nettleman, MD, Trilla, A, Fredrickson, M, Pfaller, M. Assigning responsibility: using feedback to achieve sustained control of methicillin-resistant Staphylococcus uureus. Am J Med. 1991;91 (suppl 3B):228S232S.
15.Wenzel, RP, Nettleman, MD, Jones, RN, Pfaller, MA. Methicillin-resistant Staphylococcus uureus: implications for the 1990s and effective control measures. Am J Med. 1991;91 (suppl 3B):221S227S.
16.Peacock, JE, Marsik, FJ, Wenzel, RP. Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital. Ann Intern Med. 1980;93:526532
17.Schaefler, S, Jones, D, Perry, W, et al. Methicillin-resistant Staphylococcus aureus in New York City hospitals: inter-hospital spread of resistant strains of type 88. J Clin Microbial. 1984;20:536538.
18.Saravolatz, LD, Pohlod, DJ, Arking, LM. Community-acquired methicillin-resistant Staphylococcus aureus infections: a new source of nosocomial outbreaks. Ann Intern Med. 1982;97:325329.
19.Wakefield, DS, Pfaller, MA, Massanari, RM, Hammons, GT. Variation in methicillin-resistant Staphylococcus aureus occurrence by geographic location and hospital characteristics. Infect Control. 1987;8:151157.
20.Archer, GL, Mayhall, CG. Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections. J Clin Microbial. 1983;18:395399.
21.Licitra, CM, Brooks, RG, Terry, PM, Shaw, KJ, Hare, RS. Use of plasmid analysis and determination of aminoglycoside modify ing enzymes to characterize isolates from an outbreak of methicillin-resistant Staphylococcus aureus. J Clin Microbial. 1989;27:25352538.
22.Pfaller, MA, Wakefield, DS, Hollis, R, Fredrickson, M, Evans, E, Massanari, RM. The clinical microbiology laboratory as an aid in infection control: the application of molecular techniques in epidemiologic studies of methicillin-resistant Staphylococcus aureus. Diagn Microbial Infect Dis. 1991;14:209217.
23.Mayer, LW. Use of plasmid profiles in epidemiologic surveillance of disease outbreaks and in tracing the transmission of antibiotic resistance. Clin Microbial Rev. 1988;1:228243.
24.Nahaie, MR, Goodfellow, M, Harwood, CR. A rapid screening procedure for staphylococcal plasmids. J Microbial Method. 1984;2:7381.
25.Hartstein, AI, Morthland, VH, Eng, S, Archer, GL, Schoenknect, FD, Rashad, AL. Restriction enzyme analysis of plasmid DNA and bacteriophage typing of paired Staphylococcus aureus blood culture results. J Clin Microbiol. 1989;27:18741879.
26.Pfaller, MA. Hollis, RI. Use of nlasmid profiles and restriction endonuclease analysis of plasmid DNA as epidemiologic and diagnostic tools in the clinical microbiology laboratory. Clin Microbial Newslet. 1989;11:137141.
27.Zuccarelli, AJ, Roy, I, Harding, GP, Couperus, JJ. Diversity and stability of restriction enzyme profiles of plasmid DNA from methicillii-resistant Staphylococcus aureus. J Clin Microbial. 1990;28:97102.
28.Lyon, BR, May, JW, Skurray, RA. Analysis of plasmids in nosocomial strains of multiple antibiotic-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 1983;23:817826.
29.Rhinehart, E, Shlaes, DM, Keys, TF, et al. Nosocomial clonal dissemination of methicillin-resistant Staphylococcus aureus. Arch Intern Med. 1987;147:521524.
30.Mulligan, ME, Arbeit, RD. Epidemiologic and clinical utility of typing systems for differentiating among strains of methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol. 1991;12:2028.
31.Fournier, JM, Bouvet, A, Boutonnier, A, et al. Predominance of capsular polysaccharide type 5 among oxacillin-resistant Staphylococcus aureus. J Clin Microbial. 1987;25:19321933.
32.Mulligan, ME, Kwok, RY, Citron, DM, John, JF Jr, Smith, PB. Immunoblots, antimicrobial resistance, and bacteriophage typing of oxacillin-resistant Staphylococcus aureus. J Clin Microbial. 1988;26:23952401.
33.Jordens, JZ, Hall, LM. Characterisation of methicillin-resistant Staphylococcus aureus isolates by restriction endonuclease digestion of chromosomal DNA. J Med Microbial. 1988;27:117123.
34.Branger, C, Goullet, P, Boutonnier, A, Foumier, JM. Correlation between esterase electrophoretic types and capsular polysaccharide types 5 and 8 among methicillin-susceptible and methicillin-resistant strains of Staphylococcus aureus. J Clin Microbial. 1990;28:150151.
35.Bumie, JP, Matthews, RC, Lee, W, Murdoch, D. A comparison of immunoblot and DNA restriction patterns in characterising methicillin-resistant isolates of Staphylococcus aureus. J Med Microbial. 1989;29:255261.
36.Reboli, AC, John, JF Jr, Levkoff, AH. Epidemic methicillin-gentamicin-resistant Staphylococcus aureus in a neonatal intensive care unit. J Dis Child. 1989;143:3439.
37.Gamer, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control. 1988;16:128140.
38.Broderick, A, Mori, M, Nettleman, MD, Streed, SA, Wenzel, RP. Nosocomial infections: validation of surveillance and computer modeling to identify patients at risk. Am J Epidemiol. 1990;131:734742.
39.Thornsberry, C, McDougal, LK. Successful use of broth microdilution in susceptibility tests for methicillin-resistant (heteroresistam) staphylococci. J Clin Microbial. 1983;18:10841091.
40.National Committee for Clinical Laboratory Standards. Approved Standard M2-A3. Performance Standards for Antimicrobial Disk Susceptibility Tests. Villanova, Pa: National Committee for Clinical Laboratory Standards; 1984.
41.McDougal, LK, Thomsberry, C. New recommendations for disk diffusion antimicrobial susceptibility tests for methicillin-resistant (heteroresistant) staphylococci. J Clin Microbial. 1984;19:482488.
42.Opal, SM, Mayer, KH, Stenberg, MJ, et al. Frequent acquisition of multiple strains of methicillin-resistant Staphylococcus aureus by healthcare workers in an endemic hospital environment. Infect Control Hosp Epidemiol. 1990;11:479485.
43.Reboli, AC, John, JF, Platt, CG, Cantey, JR. Methicillin-resistant Staphylococcus aureus outbreak at a Veterans' Affairs Medical Center: importance of carriage of the organism by hospital nersonnel. Infect Control Hosp Epidemiol. 1990;11:291295.
44.Muder, RR, Brennen, C, Wagener, MM, et al. Methicillin-resistant staphylococcal colonization and infection in a long-term care facility. Ann Intern Med. 1991;114:107112.

Restriction Endonuclease Analysis of Plasmid DNA From Methicillin-Resistant Staphylococcus aureus: Clinical Application Over a Three-Year Period

  • Antoni Trilla (a1) (a2), Mary D. Nettleman (a2) (a3), Richard J. Hollis (a4), Mary Fredrickson (a3), Richard P. Wenzel (a2) and Michael A. Pfaller (a5)...

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