Molecular analysis of methicillin-resistant Staphylococcus aureus dissemination among healthcare professionals and/or HIV patients from a tertiary hospital

• Published in: Revista da Sociedade Brasileira de Medicina Tropical 2016-02, Vol.49 (1), p.51-56
• Main Authors: Okado, Jessica Baleiro, Bogni, Simoni Camila, Reinato, Lílian Andreia Fleck, Martinez, Roberto, Gir, Elucir, Camargo, Ilana Lopes Baratella da Cunha
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Anti-Bacterial Agents - pharmacology; Antimicrobial agents; Bacterial Typing Techniques; Cross Infection - microbiology; Cross Infection - transmission; Daptomycin; Electrophoresis, Gel, Pulsed-Field; Epidemiology; h-VISA; Health care; HIV; HIV Infections - microbiology; HIV patients; Hospitals; Human immunodeficiency virus; Humans; Infectious Disease Transmission, Professional-to-Patient - statistics & numerical data; Lentivirus; Medical personnel; Methicilin-resistant Staphylococcus aureus; Methicillin-Resistant Staphylococcus aureus - genetics; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Microbial Sensitivity Tests; Molecular Epidemiology; Multilocus Sequence Typing; Nosocomial infection; Patients; Public health; Retroviridae; Staphylococcal Infections - microbiology; Staphylococcal Infections - transmission; Staphylococcus aureus; Staphylococcus infections; Teicoplanin resistance; Tertiary Care Centers; TROPICAL MEDICINE
• ISSN: 0037-8682; 1678-9849; 1678-9849; 0037-8682
• DOI: 10.1590/0037-8682-0284-2015

Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen in community settings. MRSA colonized individuals may contribute to its dissemination; the risk of MRSA infection is increased in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients, although the prevalence of colonization in this group is not well established. The present study addressed this issue by characterizing MRSA isolates from HIV/AIDS patients and their healthcare providers (HCPs) to determine whether transmission occurred between these two populations. A total of 24 MRSA isolates from HIV-infected patients and five from HCPs were collected between August 2011 and May 2013. Susceptibility to currently available antimicrobials was determined. Epidemiological typing was carried out by pulsed-field gel electrophoresis, multilocus sequence typing, and Staphylococcus cassette chromosome (SCCmec) typing. The presence of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) and heterogeneous daptomycin-resistant Staphylococcus aureus (hDRSA) was confirmed by population analysis profile. Isolates characterized in this study were also compared to isolates from 2009 obtained from patients at the same hospital. A variety of lineages were found among patients, including ST5-SCCmecII and ST30-SCCmecIV. Two isolates were Panton-Valentine leukocidin-positive, and hVISA and hDRSA were detected. MRSA isolates from two HCPs were not related to those from HIV/AIDS patients, but clustered with archived MRSA from 2009 with no known relationship to the current study population. ST105-SCCmecII clones that colonized professionals in 2011 and 2012 were already circulating among patients in 2009, but there is no evidence that these clones spread to or between HIV/AIDS patients up to the 7th day of their hospitalization.