INVESTIGADORES
DI GREGORIO Sabrina Noelia
congresos y reuniones científicas
Título:
Molecular Epidemiology of Community-Acquired MRSA Causing Invasive Disease in Argentina in 2010 and 2011
Autor/es:
FERNANDEZ, S.; GARDELLA, N.; DI GREGORIO, S.; LOPEZ FURST, M.; DE VEDIA, L.; STRYJEWSKI, M; GANAHA, C.; PRIETO, S.; CARBONE, E.; LISTA, N.; ROTRYING, F.; MOLLERACH, M.
Lugar:
San Francisco
Reunión:
Congreso; 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy; 2012
Resumen:
Background: Community-acquired methicillin-resistant Staphylococcus aureus
(CA-MRSA) has become a major concern worldwide. We conducted a
prospective multicenter study of invasive CA-MRSA infections to evaluate
genotype characteristics of strains causing such infections in
Argentina. Method: Patients ≥14 years-old without significant
healthcare contact presenting with invasive CA-MRSA infections defined
by positive culture recovered from normally sterile body sites between
March 2010 and December 2011 were included. Antimicrobial susceptibility
testing was performed according to CLSI. Detection of mecA, agr, Panton-Valentine (PVL) gene and SCCmec typing were done by PCR. Isolates were genotyped by spa typing, PFGE and MLST. Result: Fifty
five patients with CA-MRSA invasive infections were enrolled at 11
centers. Mean age was 34 (±15) years; 36% of patients received
antibacterials within the last 6 months. MRSA isolates were more
commonly obtained from blood (n=32), skin structures (n=14), lower
respiratory tract (n=9) and muscles (n=9). Overall 42% of patients
required ICU and 16% died. Most isolates were usually susceptible to
erythromycin (91%), clindamycin (94%), gentamicin (89%), quinolones
(96%), and all were susceptible to vancomycin, linezolid and
trimethoprim/sulfamethoxazol. Among 28 clinical isolates available for
molecular studies, 19 belonged to clone ST30, SCCmec type IVc, t019, agr III, PVL positive, and 2 to clone ST5, SCCmecIVa, t311, PVL positive, agr II . The lineage ST72, agr I (2/28) was associated with t1346 (SCCmec IV, PVL positive) and t148 (SCCmec IV variant harboring tnp20 integrated between ΔmecR1 and IS1272, PVL negative) Conclusion: This
study revealed that ST30 CA-MRSA clone has replaced ST5 clone
previously described as the most prevalent in Argentina. This is also
the first report of SCCmec IV variant containing tnp20 in our country.