Comparison of molecular epidemiology of bloodstream methicillin-resistant Staphylococcus aureus isolates between a new and an old hospital in central Taiwan

Int J Infect Dis. 2019 Feb:79:162-168. doi: 10.1016/j.ijid.2018.12.002. Epub 2018 Dec 7.

Abstract

Objective: To compare the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) isolates between an old, urban hospital and a new, rural hospital over the same time period.

Methods: The molecular characteristics of 398 MRSA bloodstream isolates collected between 2007 and 2013 from two hospitals in Taiwan were analyzed retrospectively; 202 isolates were from the old hospital and 196 from the new hospital (opened in 2007).

Results: The rate of resistance to multiple antibiotics was significantly higher in the old hospital (93%) than in the new hospital (81%) (p<0.001). Genetic community-associated MRSA carrying staphylococcal cassette chromosome (SCC) type IV or V accounted for 58% of all MRSA isolates in the new hospital, significantly higher than the rate in the old hospital (p=0.018). The rate of spa t037-SCCmec III MRSA was significantly lower in the new hospital than in the old hospital (p=0.02). A significant decreasing trend in spa t002-SCCmec II MRSA isolates was observed in the old hospital (p=0.006), while the proportion of spa t037-SCCmec III MRSA decreased significantly in the new hospital (41.7% to 26.1%, p=0.022).

Conclusions: The rate of multiple antibiotic resistance and the molecular characteristics of MRSA differed significantly between the old and new hospitals and changed over time.

Keywords: Bloodstream infection; Methicillin-resistant Staphylococcus aureus; Sequence type; Taiwan; spa type.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Erythromycin / therapeutic use
  • Fluoroquinolones
  • Hospitals
  • Humans
  • Linezolid / therapeutic use
  • Methicillin-Resistant Staphylococcus aureus / genetics*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Microbial Sensitivity Tests
  • Molecular Epidemiology
  • Retrospective Studies
  • Staphylococcal Infections / epidemiology*
  • Taiwan / epidemiology
  • Teicoplanin / therapeutic use
  • Vancomycin / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Teicoplanin
  • Erythromycin
  • Vancomycin
  • Linezolid