Methicillin-Resistant Staphylococcus Aureus Transmission and Hospital-Acquired Bacteremia in a Neonatal Intensive Care Unit in Greece
Autor: | Maria Tsolia, Anastassios Doudoulakakis, Nikolaos Giormezis, Evangelia Lebessi, Elisavet Bozavoutoglou, Iris Spiliopoulou, Angeliki Nika, Georgios Kalogeras, Maria Militsopoulou, Garyfallia Syridou |
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Rok vydání: | 2021 |
Předmět: |
Methicillin-Resistant Staphylococcus aureus
Microbiology (medical) medicine.medical_specialty Neonatal intensive care unit Exotoxins Bacteremia medicine.disease_cause Leukocidins Pregnancy Intensive Care Units Neonatal Internal medicine medicine Humans Infection control Pharmacology (medical) Retrospective Studies Cross Infection Greece Transmission (medicine) business.industry Infant Newborn Toxic shock syndrome toxin Staphylococcal Infections medicine.disease bacterial infections and mycoses Methicillin-resistant Staphylococcus aureus Hospitals Anti-Bacterial Agents Infectious Diseases Staphylococcus aureus Multilocus sequence typing Female business Multilocus Sequence Typing |
DOI: | 10.21203/rs.3.rs-231274/v1 |
Popis: | Background Staphylococcus aureus is a common pathogen causing hospital acquired infections (HAIs) in neonates. In this study, the epidemiology of methicillin-resistant S. aureus (MRSA) colonization and infections in a 30-bed, level III university-affiliated neonatal intensive care unit (NICU) located in a children's hospital was retrospectively investigated for the period 2014–2018. Methods Genes encoding Panton-Valentine Leukocidin (lukS/lukF-PV, PVL), toxic shock syndrome toxin (tst), exfoliative toxins (eta, etb), and the resistance genes mecA, mecC and fusB, were defined in 46 representative strains by PCRs. Relatedness of strains was assessed by MLST. Results Of 1538 neonates, 77 (5%) had a positive culture for MRSA (23/77 were NICU-acquired and 54/77 imported cases). Four MRSA bacteremias occurred. Most isolates were multi-resistant. One major clone was identified, ST225, among 40 tested neonatal strains (23/40, 58%). Of these, 14/23 were imported from the same maternity hospital (MH). Another clone, ST217, was predominant (4/6) among health care workers (HCWs), found colonized. Four isolates classified as ST80 were PVL-positive. Additional four strains carried tst (10%), belonging to ST30 and ST225 (two strains each), and two etb. The implicated MH was notified for the problem, decolonization treatment was successfully performed in HCWs and neonates. Strengthening of infection control measures with emphasis on hand hygiene was applied. Conclusions Uncovering reservoirs for on-going MRSA transmission in NICUs has proved challenging. Well known nosocomial MRSA clones are being constantly introduced and transmitted via MHs and HCWs. Effective infection prevention and control requires constant vigilance. |
Databáze: | OpenAIRE |
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