Mupirocin and Chlorhexidine Genotypic Resistance Found in Staphylococcus aureus Isolated From Young Infants Below 90 Days Old: A Genetic Basis for Eradication Failure
| Autor: | Jong Hyun Kim, Sun Hee Park, Joonhong Park, Ki Cheol Park, Dong-Gun Lee, Hyun Mi Kang |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Methicillin-Resistant Staphylococcus aureus Microbiology (medical) Staphylococcus aureus Neonatal intensive care unit Disinfectant Leukocidin Mupirocin medicine.disease_cause Microbiology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine 030225 pediatrics Drug Resistance Bacterial medicine Humans Prospective Studies 030212 general & internal medicine Typing business.industry Chlorhexidine Infant Newborn Infant Staphylococcal Infections Anti-Bacterial Agents Infectious Diseases Carriage chemistry Carrier State Pediatrics Perinatology and Child Health Anti-Infective Agents Local Female business medicine.drug |
| Zdroj: | Pediatric Infectious Disease Journal. 40:49-54 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/inf.0000000000002882 |
| Popis: | Objectives To investigate the genetic characteristics associated with eradication failure of Staphylococcus aureus in infants below 90 days old. Methods S. aureus isolated from clinical specimen cultures (blood, surgical tissue, or drainage, pus, etc.) and routine screening cultures in the neonatal intensive care unit (nasal and axillary skin swab) from patients below 90 days old were collected prospectively for 1 year, from August 2017 to July 2018. The isolates underwent typing and screening for genes associated with chlorhexidine (qacA/B), quaternary ammonium (smr), and mupirocin resistance (iles mutation, mupA, mupB), as well as Panton-Valentine leukocidin (PVL) toxin. Results During the study period, 40 nonduplicate isolates were included for analyses, of which 70.0% were methicillin-resistant S. aureus (MRSA). Mupirocin resistance was found in 25% of the total isolates; 17.4% of the colonizers; and 35.3% of the pathogens (P = 0.196). Chlorhexidine resistance gene was found in 3 MRSA isolates colonized in the nares of preterm infants. All isolates harbored the disinfectant quaternary ammonium compound (QAC) resistance gene. PVL toxin gene was found in 57.5%, and the presence of PVL gene among colonizers and pathogens was similar (69.6% vs. 41.2%, P = 0.072). Conclusions Mupirocin, chlorhexidine, and QAC-resistant MRSAs harboring the PVL toxin gene were found in the nasal carriages of preterm infants. In this highly vulnerable patient population, one-fourth of the isolates harbored mupirocin-resistant genes, and all were resistant to QAC disinfectants. These strains are associated with persistence in both carriage and environmental reservoirs within the hospitals. |
| Databáze: | OpenAIRE |
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