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Community-associated methicillin-resistant Staphylococcus aureus in hospital nursery and maternity units.

Bratu S, Eramo A, Kopec R, Coughlin E, Ghitan M, Yost R, Chapnick EK, Landman D, Quale J - Emerging Infect. Dis. (2005)

Bottom Line: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has rarely been reported in the hospital setting.Genes for Panton-Valentine leukocidin and staphylococcal enterotoxin K were detected in all isolates, and most contained other enterotoxin genes.Testing of nearly 2,000 MRSA isolates collected during citywide surveillance studies from 1999 to 2003 showed that approximate, equals 1% were genetically related to MW2.

View Article: PubMed Central - PubMed

Affiliation: State University of New York-Downstate, Brooklyn, New York 11203, USA.

ABSTRACT
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has rarely been reported in the hospital setting. We report an outbreak of 7 cases of skin and soft tissue infections due to a strain of CA-MRSA. All patients were admitted to the labor and delivery, nursery, or maternity units during a 3-week period. Genetic fingerprinting showed that the outbreak strain was closely related to the USA 400 strain that includes the midwestern strain MW2. All isolates contained the staphylococcal chromosome cassette mec type IV. Genes for Panton-Valentine leukocidin and staphylococcal enterotoxin K were detected in all isolates, and most contained other enterotoxin genes. Testing of nearly 2,000 MRSA isolates collected during citywide surveillance studies from 1999 to 2003 showed that approximate, equals 1% were genetically related to MW2. CA-MRSA strain MW2 has been present in this region at least since 1999. This study documents the spread of this strain among healthy newborns at 1 hospital.

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A) Ribotype and B) pulsed-field gel electrophoresis patterns of 8 clinical isolates of methicillin-resistant Staphylococcus aureus. Outbreak-related isolates P1–P7 are closely related to MW2. Clinical isolate P8 and the 3 isolates from healthcare workers (S1–S3) are unrelated to the outbreak strain.
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Figure 2: A) Ribotype and B) pulsed-field gel electrophoresis patterns of 8 clinical isolates of methicillin-resistant Staphylococcus aureus. Outbreak-related isolates P1–P7 are closely related to MW2. Clinical isolate P8 and the 3 isolates from healthcare workers (S1–S3) are unrelated to the outbreak strain.

Mentions: Susceptibility testing showed that all 8 isolates were susceptible to clindamycin, ciprofloxacin, trimethoprim-sulfamethoxazole, rifampin, doxycycline, linezolid, and vancomycin. Of the 8 clinical isolates, 7 (isolates P1-P7) belonged to 1 ribotype that was identical to the prototypical MW2 strain (Figure 2). PFGE confirmed that the 7 isolates were identical and closely related to MW2 (Figure 2). All 7 contained SCCmec type IV. Since the 7 isolates appeared identical, MLST was performed on one of the isolates and showed sequence type 1. The PFGE and MLST pattern are the same as CA-MRSA clone USA 400, which also includes MW2 (21). Among these 7 isolates, all contained SEK and PVL, 6 contained SEC and SEH, and 5 contained SEA. None was found to have genes encoding SEB or TSST-1. The eighth clinical isolate, from a catheter-site infection, was distinct from the outbreak strain by ribotyping and PFGE (Figure 2). For this isolate, SCCmec was nontypable, and MLST typing confirmed a distinct allelic profile. None of the genes encoding toxins was detected.


Community-associated methicillin-resistant Staphylococcus aureus in hospital nursery and maternity units.

Bratu S, Eramo A, Kopec R, Coughlin E, Ghitan M, Yost R, Chapnick EK, Landman D, Quale J - Emerging Infect. Dis. (2005)

A) Ribotype and B) pulsed-field gel electrophoresis patterns of 8 clinical isolates of methicillin-resistant Staphylococcus aureus. Outbreak-related isolates P1–P7 are closely related to MW2. Clinical isolate P8 and the 3 isolates from healthcare workers (S1–S3) are unrelated to the outbreak strain.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3367583&req=5

Figure 2: A) Ribotype and B) pulsed-field gel electrophoresis patterns of 8 clinical isolates of methicillin-resistant Staphylococcus aureus. Outbreak-related isolates P1–P7 are closely related to MW2. Clinical isolate P8 and the 3 isolates from healthcare workers (S1–S3) are unrelated to the outbreak strain.
Mentions: Susceptibility testing showed that all 8 isolates were susceptible to clindamycin, ciprofloxacin, trimethoprim-sulfamethoxazole, rifampin, doxycycline, linezolid, and vancomycin. Of the 8 clinical isolates, 7 (isolates P1-P7) belonged to 1 ribotype that was identical to the prototypical MW2 strain (Figure 2). PFGE confirmed that the 7 isolates were identical and closely related to MW2 (Figure 2). All 7 contained SCCmec type IV. Since the 7 isolates appeared identical, MLST was performed on one of the isolates and showed sequence type 1. The PFGE and MLST pattern are the same as CA-MRSA clone USA 400, which also includes MW2 (21). Among these 7 isolates, all contained SEK and PVL, 6 contained SEC and SEH, and 5 contained SEA. None was found to have genes encoding SEB or TSST-1. The eighth clinical isolate, from a catheter-site infection, was distinct from the outbreak strain by ribotyping and PFGE (Figure 2). For this isolate, SCCmec was nontypable, and MLST typing confirmed a distinct allelic profile. None of the genes encoding toxins was detected.

Bottom Line: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has rarely been reported in the hospital setting.Genes for Panton-Valentine leukocidin and staphylococcal enterotoxin K were detected in all isolates, and most contained other enterotoxin genes.Testing of nearly 2,000 MRSA isolates collected during citywide surveillance studies from 1999 to 2003 showed that approximate, equals 1% were genetically related to MW2.

View Article: PubMed Central - PubMed

Affiliation: State University of New York-Downstate, Brooklyn, New York 11203, USA.

ABSTRACT
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has rarely been reported in the hospital setting. We report an outbreak of 7 cases of skin and soft tissue infections due to a strain of CA-MRSA. All patients were admitted to the labor and delivery, nursery, or maternity units during a 3-week period. Genetic fingerprinting showed that the outbreak strain was closely related to the USA 400 strain that includes the midwestern strain MW2. All isolates contained the staphylococcal chromosome cassette mec type IV. Genes for Panton-Valentine leukocidin and staphylococcal enterotoxin K were detected in all isolates, and most contained other enterotoxin genes. Testing of nearly 2,000 MRSA isolates collected during citywide surveillance studies from 1999 to 2003 showed that approximate, equals 1% were genetically related to MW2. CA-MRSA strain MW2 has been present in this region at least since 1999. This study documents the spread of this strain among healthy newborns at 1 hospital.

Show MeSH
Related in: MedlinePlus