1887

Abstract

A significant increase in the incidence of isolates of methicillin-resistant (MRSA), that were also resistant to lincosamides and streptogramin A (LS-MRSA), was observed in a French university hospital. Twenty-seven isolates from the outbreak were characterised, including 17 isolates from a plastic surgery ward and six control strains of MRSA. The strains were examined by antibiotyping and biotyping, and by three molecular methods: plasmid analysis, ribotyping and insertion sequence (IS) typing with IS256 sequence as a probe. Antibiotyping (five antibiotypes) was discriminatory because of the uncommon resistance phenotype of the epidemic strain. Biotyping (three biotypes), DNA plasmid analysis (four profiles) and ribotyping (two profiles) were poorly sensitive, in contrast to IS-typing (12 profiles). By the latter method, a coefficient of similarity (percentage similarity) compared to the predominant IS profile was calculated. Strains with a coefficient of similarity ⩾ 82% were considered as highly related to the epidemic strain, while those with a coefficient of similarity ⩽ 40% were regarded as distant. Results obtained with the five markers confirmed that an outbreak of hospital infection had occurred in the plastic surgery ward, with spread of the epidemic strain throughout the hospital.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/00222615-44-4-303
1996-04-01
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/jmm/44/4/medmicro-44-4-303.html?itemId=/content/journal/jmm/10.1099/00222615-44-4-303&mimeType=html&fmt=ahah

References

  1. Lacey R. W., Grinsted J. Genetic analysis of methicillin-resistant strains of Staphylococcus aureus: evidence for their evolution from a single clone. J Med Microbiol 1973; 6:511–526
    [Google Scholar]
  2. Acar J. F., Buu-Hoї A. Y. Resistance patterns of important Grampositive pathogens. J Antimicrob Chemother 1988; 21: Suppl C 41–47
    [Google Scholar]
  3. Maple P. A. C., Hamilton-Miller J. M. T., Brumfitt W. World-wide antibiotic resistance in methicillin-resistant Staphylococcus aureus. Lancet 1989; 1:537–540
    [Google Scholar]
  4. Leclercq R., Courvalin P. Intrinsic and unusual resistance to macrolide, lincosamide, and streptogramin antibiotics in bacteria. Antimicrob Agents Chemother 1991; 35:1273–1276
    [Google Scholar]
  5. Archer G. L., Mayhall C. G. Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections. J Clin Microbiol 1983; 18:395–399
    [Google Scholar]
  6. Blair J. E., Williams R. E. O. Phage typing of staphylococci. Bull WHO 1961; 24:771–784
    [Google Scholar]
  7. Chabbert Y. A., Pillet J. Correlation between ‘methicillin resistance’ and serotype in Staphylococcus. Nature 1967; 213:1137
    [Google Scholar]
  8. Goering R. V., Duensing T. D. Rapid field inversion gel electrophoresis in combination with an rRNA gene probe in the epidemiological evaluation of staphylococci. J Clin Microbiol 1990; 28:426–429
    [Google Scholar]
  9. Zuccarelli A. J., Roy I., Harding G. P., Couperus J. J. Diversity and stability of restriction enzyme profiles of plasmid DNA from methicillin-resistant Staphylococcus aureus. J Clin Microbiol 1990; 28:97–102
    [Google Scholar]
  10. Brosius J., Ullrich A., Raker M. A. Construction and fine mapping of recombinant plasmids containing the rrnB ribosomal RNA operon of E. coli. Plasmid 1981; 6:112–118
    [Google Scholar]
  11. Mahairas G. G., Minion F. C. Transformation of Mycoplasma pulmonis: demonstration of homologous recombination, introduction of cloned genes, and preliminary description of an integrating shuttle system. J Bacteriol 1989; 171:1775–1780
    [Google Scholar]
  12. Lyon B. R., May J. W., Skurray R. A. Tn4001: a gentamicin and kanamycin resistance transposon in Staphylococcus aureus. Mol Gen Genet 1984; 193:554–556
    [Google Scholar]
  13. Courvalin P., Goldstein F., Philippon A., Sirot J. (eds) L’antibiogramme. Paris: Vigot; 1985
    [Google Scholar]
  14. Sambrook J., Fritsch E. F., Maniatis T. (eds) Molecular cloning: a laboratory manual. 2nd edn Cold Spring Harbor Laboratory Press; Cold Spring Harbor, NY: 1989
    [Google Scholar]
  15. Bimboim H. C., Doly J. A rapid alkaline extraction procedure for screening recombinant plasmid DNA. Nucleic Acids Res 1979; 7:1513–1523
    [Google Scholar]
  16. De Buyser M. L., Morvan A., Grimont F., El Solh N. Characterization of Staphylococcus species by ribosomal RNA gene restriction patterns. J Gen Microbiol 1989; 135:989–999
    [Google Scholar]
  17. Grimont F., Grimont P. A. D. Ribosomal ribonucleic acid gene restriction patterns as potential taxonomic tools. Ann Inst Pasteur Microbiol 1986; 137B:165–175
    [Google Scholar]
  18. Dice L. R. Measures of the amount of ecologic association between species. Ecology 1945; 26:297–302
    [Google Scholar]
  19. Bismuth R. Cocci à Gram positif et aminosides. In Courvalin P. F., Goldstein A., Philippon Sirot J. (eds) L’Antibiogramme Paris: Vigot; 198529–39
    [Google Scholar]
  20. Leclercq R., Courvalin P. Bacterial resistance to macrolide, lincosamide, and streptogramin antibiotics by target modification. Antimicrob Agents Chemother 1991; 35:1267–1272
    [Google Scholar]
  21. Boyce J. M. Should we vigorously try to contain and control methicillin-resistant Staphylococcus aureus?. Infect Control Hosp Epidemiol 1991; 12:46–53
    [Google Scholar]
  22. Collins J. K., Smith J. S., Kelly M. T. Comparison of phage typing, plasmid mapping and antibiotic resistance patterns as epidemiologic markers in a nosocomial outbreak of methicillin-resistant Staphylococcus aureus infections. Diagn Microbiol Infect Dis 1984; 2:233–245
    [Google Scholar]
  23. Mulligan M. E., Arbeit R. D. Epidemiologic and clinical utility of typing systems for differentiating among strains of methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol 1991; 12:20–28
    [Google Scholar]
  24. Pfaller M. A. Typing methods for epidemiologic investigation. In Balows A., Hausler W. J., Herrmann K. L., Isenberg H. D., Shadomy H. J. (eds) Manual of clinical microbiology 5th edn Washington, DC: American Society for Microbiology; 1991171–182
    [Google Scholar]
  25. Cristino J. A., Pereira A. T. Plasmid analysis of 219 methicillin-resistant Staphylococcus aureus strains with uncommon profiles isolated in Lisbon. J Hosp Infect 1989; 13:133–141
    [Google Scholar]
  26. Kayser F. H., Berger-Bӓchi B., Beck W. D. Genetics of multiply-resistant Staphylococcus aureus. J Hosp Infect 1986; 7: Suppl A 19–27
    [Google Scholar]
  27. Blumberg H. M., Rimland D., Kiehlbauch J. A., Terry P. M., Wachsmuth I. K. Epidemiologic typing of Staphylococcus aureus by DNA restriction fragment length polymorphisms of rRNA genes: elucidation of the clonal nature of a group of bacteriophage-nontypeable, ciprofloxacinresistant, methicillin-susceptible S. aureus isolates. J Clin Microbiol 1992; 30:362–369
    [Google Scholar]
  28. Monzon-Moreno C., Aubert S., Morvan A., El Solh N. Usefulness of three probes in typing isolates of methicillin-resistant Staphylococcus aureus (MRSA). J Med Microbiol 1991; 35:80–88
    [Google Scholar]
  29. Walcher-Salesse S., Monzon-Moreno C., Aubert S., El Solh N. An epidemiological assessment of coagulase-negative staphylococci from an intensive care unit. J Med Microbiol 1992; 36:321–331
    [Google Scholar]
  30. Loncle V., Casetta A., Buu-Hoi A., El Solh N. Analysis of pristinamycin-resistant Staphylococcus epidermidis isolates responsible for an outbreak in a Parisian Hospital. Antimicrob Agents Chemother 1993; 37:2159–2165
    [Google Scholar]
  31. Galas D. J., Chandler M. Bacterial insertion elements. In Berg D. E., Howe M. M. (eds) Mobile DNA Washington, DC: American Society for Microbiology; 1989109–162
    [Google Scholar]
  32. Dyke K. G. H., Aubert S., El Solh N. Multiple copies of IS256 in staphylococci. Plasmid 1992; 28:235–246
    [Google Scholar]
  33. Tenover F. C., Arbeit R., Archer G. Comparison of traditional and molecular methods for typing isolates of Staphylococcus aureus. J Clin Microbiol 1994; 32:407–415
    [Google Scholar]
  34. Kreiswirth B., Komblum J., Arbeit R. D. Evidence for a clonal origin of methicillin resistance in Staphylococcus aureus. Science 1993; 259:227–230
    [Google Scholar]
  35. Struelens M. J., Deplano A., Godard C., Maes N., Serruys E. Epidemiologic typing and delineation of genetic relatedness of methicillin-resistant Staphylococcus aureus by macrorestriction analysis of genomic DNA by using pulsed-field gel electrophoresis. J Clin Microbiol 1992; 30:2599–2605
    [Google Scholar]
  36. Saulnier P., Boumeix C., Prévost G., Andremont A. Random amplified polymorphic DNA assay is less discriminant than pulsed-field gel electrophoresis for typing strains of methicillin-resistant Staphylococcus aureus. J Clin Microbiol 1993; 31:982–985
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/00222615-44-4-303
Loading
/content/journal/jmm/10.1099/00222615-44-4-303
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error