1887

Abstract

The objective of this study was to investigate the relationship between molecular epidemiology and antibiotic susceptibility of methicillin-resistant (MRSA) over a period of 4 years. The antibiotype of all MRSA isolates that were identified during a yearly period of 3 months was determined; 50 consecutive non-replicate MRSA isolates were typed each year. Susceptibility rates to gentamicin, tobramycin and ofloxacin remained stable (95, 16 and 4 %, respectively). In contrast, the proportion of MRSA isolates susceptible to erythromycin increased progressively from 10.5 to 32.5 % ( < 0.001). PFGE analysis of genomic DNA from 200 isolates revealed the presence of 15 different clones. Two epidemic clones were identified, which contained 150 (clone A) and 28 (clone C) isolates. Non-epidemic strains were more frequently susceptible to ofloxacin (31.8 versus 1.1 %) and tobramycin (45.4 versus 16.8 %) than epidemic strains; those isolates that were susceptible to all antibiotics tested belonged to sporadic clones. The increase of erythromycin susceptibility within MRSA isolates was caused by the emergence of clone C. This study suggests that when selection pressure exerted by an antibiotic is insufficient (i.e. below a threshold level), fitness advantages play a predominant role in the dissemination of MRSA clones. The balance between the selection pressure exerted by antibiotics and the disadvantage of lower replication rates of resistant strains in the absence of antibiotics complicates the biological model of clonal dissemination of epidemic MRSA strains.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.05252-0
2003-09-01
2019-11-13
Loading full text...

Full text loading...

/deliver/fulltext/jmm/52/9/JM520912.html?itemId=/content/journal/jmm/10.1099/jmm.0.05252-0&mimeType=html&fmt=ahah

References

  1. Albertini, M. T., Benoit, C., Berardi, L. & 25 other authors ( 2002;). Surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBLE) in Northern France: a five-year multicentre incidence study.The Microbiology Surveillance Network of Northern France. J Hosp Infect 52, 107–113.[CrossRef]
    [Google Scholar]
  2. Aubry-Damon, H., Legrand, P., Brun-Buisson, C., Astier, A., Soussy, C. J. & Leclercq, R. ( 1997;). Reemergence of gentamicin-susceptible strains of methicillin-resistant Staphylococcus aureus: roles of an infection control program and changes in aminoglycoside use. Clin Infect Dis 25, 647–653.[CrossRef]
    [Google Scholar]
  3. Bailly, P., Mulin, B., Minary, P. & Talon, D. ( 1999;). Contrôle des infections à Staphylococcus aureus méticillino-résistant dans un CHU: analyse critique des résultats obtenus.Le Réseau Franc-Comtois de Lutte contre les Infections Nosocomiales. Med Mal Infect 29, 178–183 (in French).[CrossRef]
    [Google Scholar]
  4. Bertrand, X., Thouverez, M. & Talon, D. ( 2000;). Antibiotic susceptibility and genotypic characterization of methicillin-resistant Staphylococcus aureus strains in eastern France. J Hosp Infect 46, 280–287.[CrossRef]
    [Google Scholar]
  5. Blanc, D. S., Francioli, P., Le Coustumier, A., Gazagne, L., Lecaillon, E., Gueudet, P., Vandenesch, F. & Etienne, J. ( 2001;). Reemergence of gentamicin-susceptible strains of methicillin-resistant Staphylococcus aureus in France: a phylogenetic approach. J Clin Microbiol 39, 2287–2290.[CrossRef]
    [Google Scholar]
  6. Boyce, J. M. ( 1990;). Increasing prevalence of methicillin-resistant Staphylococcus aureus in the United States. Infect Control Hosp Epidemiol 11, 639–642.[CrossRef]
    [Google Scholar]
  7. Galdbart, J.-O., Morvan, A. & El Solh, N. ( 2000;). Phenotypic and molecular typing of nosocomial methicillin-resistant Staphylococcus aureus strains susceptible to gentamicin isolated in France from 1995 to 1997. J Clin Microbiol 38, 185–190.
    [Google Scholar]
  8. Laurent, F., Lelièvre, H., Cornu, M., Vandenesch, F., Carret, G., Etienne, J. & Flandrois, J. P. ( 2001;). Fitness and competitive growth advantage of new gentamicin-susceptible MRSA clones spreading in French hospitals. J Antimicrob Chemother 47, 277–283.[CrossRef]
    [Google Scholar]
  9. Lelièvre, H., Lina, G., Jones, M. E. & 9 other authors ( 1999;). Emergence and spread in French hospitals of methicillin-resistant Staphylococcus aureus with increasing susceptibility to gentamicin and other antibiotics. J Clin Microbiol 37, 3452–3457.
    [Google Scholar]
  10. Lemaître, N., Sougakoff, W., Masmoudi, A., Fievet, M.-H., Bismuth, R. & Jarlier, V. ( 1998;). Characterization of gentamicin-susceptible strains of methicillin-resistant Staphylococcus aureus involved in nosocomial spread. J Clin Microbiol 36, 81–85.
    [Google Scholar]
  11. Levy, S. B. ( 1994;). Balancing the drug-resistance equation. Trends Microbiol 2, 341–342.[CrossRef]
    [Google Scholar]
  12. Natsch, S., Hekster, Y. A., de Jong, R., Heerdink, E. R., Herings, R. M. & van der Meer, J. W. ( 1998;). Application of the ATC/DDD methodology to monitor antibiotic drug use. Eur J Clin Microbiol Infect Dis 17, 20–24.[CrossRef]
    [Google Scholar]
  13. Polyzou, A., Slavakis, A., Pournaras, S., Maniatis, A. N., Sofianou, D. & Tsakris, A. ( 2001;). Predominance of a methicillin-resistant Staphylococcus aureus clone susceptible to erythromycin and several other non-β-lactam antibiotics in a Greek hospital. J Antimicrob Chemother 48, 231–234.[CrossRef]
    [Google Scholar]
  14. Pournaras, S., Slavakis, A., Polyzou, A., Sofianou, D., Maniatis, A. N. & Tsakris, A. ( 2001;). Nosocomial spread of an unusual methicillin-resistant Staphylococcus aureus clone that is sensitive to all non-β-lactam antibiotics, including tobramycin. J Clin Microbiol 39, 779–781.[CrossRef]
    [Google Scholar]
  15. Prevost, G., Jaulhac, B. & Piemont, Y. ( 1992;). DNA fingerprinting by pulsed-field gel electrophoresis is more effective than ribotyping in distinguishing among methicillin-resistant Staphylococcus aureus isolates. J Clin Microbiol 30, 967–973.
    [Google Scholar]
  16. Salmenlinna, S. & Vuopio-Varkila, J. ( 2001;). Recognition of two groups of methicillin-resistant Staphylococcus aureus strains based on epidemiology, antimicrobial susceptibility, hypervariable-region type, and ribotype in Finland. J Clin Microbiol 39, 2243–2247.[CrossRef]
    [Google Scholar]
  17. Soussy, C. J., Carret, G., Cavallo, J. D. & 15 other authors ( 2000;). Antibiogram Committee of the French Microbiology Society.Report 2000-2001. Pathol Biol 48, 832–871 (in French).
    [Google Scholar]
  18. Talon, D., Delière, E. & Bertrand, X. ( 2002;). Characterization of methicillin-resistant Staphylococcus aureus strains susceptible to tobramycin. Int J Antimicrob Agents 20, 174–179.[CrossRef]
    [Google Scholar]
  19. Tenover, F. C., Arbeit, R. D., Goering, R. V., Mickelsen, P. A., Murray, B. E., Persing, D. H. & Swaminathan, B. ( 1995;). Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33, 2233–2239.
    [Google Scholar]
  20. Torvaldsen, S., Roberts, C. & Riley, T. V. ( 1999;). The continuing evolution of methicillin-resistant Staphylococcus aureus in Western Australia. Infect Control Hosp Epidemiol 20, 133–135.[CrossRef]
    [Google Scholar]
  21. Voss, A., Milatovic, D., Wallrauch-Schwarz, C., Rosdahl, V. T. & Braveny, I. ( 1994;). Methicillin-resistant Staphylococcus aureus in Europe. Eur J Clin Microbiol Infect Dis 13, 50–55.[CrossRef]
    [Google Scholar]
  22. Witte, W., Braulke, C., Cuny, C., Heuck, D. & Kresken, M. ( 2001;). Changing pattern of antibiotic resistance in methicillin-resistant Staphylococcus aureus from German hospitals. Infect Control Hosp Epidemiol 22, 683–686.[CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.05252-0
Loading
/content/journal/jmm/10.1099/jmm.0.05252-0
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