CIBICI   14215
CENTRO DE INVESTIGACION EN BIOQUIMICA CLINICA E INMUNOLOGIA
Unidad Ejecutora - UE
artículos
Título:
NEW PATTERNS OF METHICILLIN-RESISTANT Staphylococcus aureus (MRSA) CLONES, COMMUNITY-ASSOCIATED MRSA GENOTYPES BEHAVE LIKE HEALTHCARE-ASSOCIATED MRSA GENOTYPES WITHIN HOSPITALS, ARGENTINA
Autor/es:
ANA L. EGEA; PAULA GAGETTI; RICARDO LAMBERGHINI; DIEGO FACCONE; CELESTE LUCERO; ANA VINDEL; DARIO TOSORONIE; ANALÍA GARNERO; HECTOR A. SAKA; MARCELO GALAS; JOSÉ L. BOCCO; ALEJANDRA CORSO; CLAUDIA SOLA
Revista:
INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY (PRINT)
Editorial:
ELSEVIER GMBH
Referencias:
Año: 2014
ISSN:
1438-4221
Resumen:
Methicillin-resistant Staphylococcus aureus (MRSA) burden is increasing worldwide in hospitals[healthcare-associated (HA)-MRSA] and in communities [community-associated (CA)-MRSA]. However,the impact of CA-MRSA within hospitals remains limited, particularly in Latin America. A countrywiderepresentative survey of S. aureus infections was performed in Argentina by analyzing 591 clinical isolatesfrom 66 hospitals in a prospective cross-sectional, multicenter study (Nov-2009). This work involvedhealthcare-onset infections-(HAHO, >48 hospitalization hours) and community-onset (CO) infections[including both, infections (HACO) in patients with healthcare-associated risk-factors (HRFs) and infec-tions (CACO) in those without HRFs]. MRSA strains were genetically typed as CA-MRSA and HA-MRSAgenotypes (CA-MRSAGand HA-MRSAG) by SCCmec- and spa-typing, PFGE, MLST and virulence genesprofile by PCR. Considering all isolates, 63% were from CO-infections and 55% were MRSA [39% CA-MRSAGand 16% HA-MRSAG]. A significantly higher MRSA proportion among CO- than HAHO-S. aureusinfections was detected (58% vs 49%); mainly in children (62% vs 43%). The CA-MRSAG/HA-MRSAGhaveaccounted for 16%/33% of HAHO-, 39%/13% of HACO- and 60.5%/0% of CACO-infections. Regarding theepidemiological associations identified in multivariate models for patients with healthcare-onset CA-MRSAGinfections, CA-MRSAGbehave like HA-MRSAGwithin hospitals but children were the highestrisk group for healthcare-onset CA-MRSAGinfections. Most CA-MRSAGbelonged to two major clones:PFGE-type N-ST30-SCCmecIVc-t019-PVL+and PFGE-type I-ST5-IV-SCCmecIVa-t311-PVL+(45% each). TheST5-IV-PVL+/ST30-IV-PVL+clones have caused 31%/33% of all infections, 20%/4% of HAHO-, 43%/23% ofHACO- and 35%/60% of CACO- infections, with significant differences by age groups (children/adults)and geographical regions. Importantly, an isolate belonging to USA300-0114-(ST8-SCCmecIVa-spat008-PVL+-ACME+) was detected for the first time in Argentina. Most of HA-MRSAG(66%) were related to theCordobes/Chilean clone-(PFGE-type A-ST5-SCCmecI-t149) causing 18% of all infections (47% of HAHO-and 13% of HACO-infections).