Methicillin-resistant and vancomycin-intermediate Staphylococcus aureus colonizing patients and intensive care unit environment: virulence profile and genetic variability

APMIS. 2019 Nov;127(11):717-726. doi: 10.1111/apm.12989.

Abstract

This study aims to determine the prevalence of Staphylococcus aureus colonizing patients and ICU environment of a teaching hospital, the virulence and antimicrobial susceptibility profile of the isolates, and to evaluate the genetic relationship among them. A total of 536 swabs (134 of patients and 402 of ICU environment) were collected and analyzed to detect S. aureus. The antimicrobial susceptibility of the isolates was determined by disk diffusion test, and the detection of the mecA and virulence factors genes was performed by PCR, in addition to SCCmec typing. The genetic similarity of the isolates was determined by PFGE. Staphylococcus aureus was isolated in 12.7% of the swabs. The prevalence of colonization was 13.4% in patients and 12.4% in the environmental samples. The multidrug resistance was determined in 82.4% of the isolates. The prevalence of methicillin-resistant S. aureus was 20.6%, with 50.0% classified as SCCmec IV. The intermediate resistance to vancomycin was detected in 5.9% and 4.4% of the isolates obtained from patients and environment, respectively. Identical isolates obtained from different patients and sources were grouped into several clusters. The results showed dissemination of multidrug-resistant strains between patients and fomites and the persistence of MRSA and VISA isolates in the ICU environment.

Keywords: Methicillin-resistant Staphylococcus aureus; colonization; inanimate surfaces; intensive care units; vancomycin-intermediate Staphylococcus aureus.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / genetics
  • Drug Resistance, Bacterial
  • Female
  • Genetic Variation
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Male
  • Methicillin / pharmacology
  • Methicillin Resistance*
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / genetics*
  • Methicillin-Resistant Staphylococcus aureus / growth & development
  • Methicillin-Resistant Staphylococcus aureus / pathogenicity*
  • Microbial Sensitivity Tests
  • Phylogeny
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / genetics*
  • Staphylococcus aureus / growth & development
  • Staphylococcus aureus / pathogenicity*
  • Vancomycin / pharmacology
  • Virulence
  • Virulence Factors / genetics

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Virulence Factors
  • Vancomycin
  • Methicillin