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Kawamura K, Kitaoka K, Kimura K, Wachino JI, Kondo T, Iinuma Y, Murakami N, Fujimoto S, Arakawa Y. Spread of seb-Positive Methicillin-Resistant Staphylococcus aureus SCC mec Type II-ST764 Among Elderly Japanese in Nonacute Care Settings. Microb Drug Resist 2019; 25:915-924. [PMID: 30897025 DOI: 10.1089/mdr.2018.0337] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
We investigated the prevalence and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) among 356 residents of nine long-term care facilities (LTCFs) in Japan during 2015 and 2017. In total, 800 specimens were tested and 39 MRSA isolates were recovered from 31 (8.71%) residents. PCR-based open reading frame typing (POT) and pulsed-field gel electrophoresis typing were performed for the 39 MRSA isolates; five of them showing identical pulsotypes, and POT scores were excluded in further analysis. Staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing, and toxin gene detection were performed for one representative MRSA isolate per resident. Among the 34 unrelated MRSA isolates, 15 (44.1%) and 19 (55.9%) were of SCCmec types II and IV, respectively, and belonged to seven sequence types (STs). Among the 15 SCCmec II isolates, 11 (73.3%), 3, and 1 belonged to ST764 (clonal complex [CC]5), ST5 (CC5), and ST630 (CC8), respectively. Among the 19 SCCmec IV isolates, 13 (68.4%), 3, 2, and 1 belonged to ST1 (CC1), ST474 (CC1), ST8 (CC8), and ST380 (CC8), respectively. Among the 14 CC5 lineage-SCCmec II isolates, one ST5 isolate and 7 of the 11 ST764 isolates (63.6%) carried seb gene, and 14 (87.5%) of 16 CC1 lineage-SCCmec IV isolates had sea gene (p < 0.05). The results indicate that the seb-positive SCCmec type II-ST764 clone has spread in Japanese LTCF environments. As LTCF residents have multiple comorbidities and increased susceptibility to infections, it is necessary to monitor MRSA colonization in LTCFs through periodic screening to prevent dissemination.
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Affiliation(s)
- Kumiko Kawamura
- 1 Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kazuki Kitaoka
- 2 Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kouji Kimura
- 2 Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Jun-Ichi Wachino
- 2 Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takaaki Kondo
- 1 Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshitsugu Iinuma
- 3 Department of Infectious Diseases, Kanazawa Medical University, Ishikawa, Japan
| | - Nobuo Murakami
- 4 Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Shuhei Fujimoto
- 5 Department of Bacteriology and Bacterial Infection, Division of Host Defense Mechanism, Tokai University School of Medicine, Kanagawa, Japan
| | - Yoshichika Arakawa
- 2 Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Qiao F, Huang W, Cai L, Zong Z, Yin W. Methicillin-resistant Staphylococcus aureus nasal colonization and infection in an intensive care unit of a university hospital in China. J Int Med Res 2018; 46:3698-3708. [PMID: 29911488 PMCID: PMC6136027 DOI: 10.1177/0300060518777812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective This study was performed to determine the prevalence and risk factors associated with nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization upon intensive care unit (ICU) admission and during the ICU stay in mainland China. Methods A prospective observational study was performed in a 50-bed general ICU of a 4300-bed teaching hospital in China from 2011 to 2013. Nasal swabs for MRSA detection were obtained upon ICU admission and at discharge for patients having stayed in the ICU for longer than 3 days. Results In total, 115 patients (4.1%; 95% confidence interval [CI], 3.4-4.9) were already colonized with MRSA on ICU admission, and another 185 patients (10.7%; 95% CI, 9.3-12.2) acquired MRSA during their ICU stay. Development of an MRSA infection was significantly more likely in patients with than without MRSA colonization on ICU admission (odds ratio [OR], 2.8; 95% CI, 1.1-7.3). Patients who acquired MRSA had significantly prolonged lengths of stay in the ICU (23.3 days) and higher hospital bills (135,171 RMB; about 19,590 USD) than those who tested negative for MRSA. Conclusion The MRSA colonization rate among ICU patients in mainland China is high. Patients with MRSA-positive nasal swabs are more likely to develop MRSA infections.
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Affiliation(s)
- Fu Qiao
- 1 Infection Prevention and Control Department, West China Hospital, Sichuan University, Chengdu, China
| | - Wenzhi Huang
- 1 Infection Prevention and Control Department, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Cai
- 2 Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiyong Zong
- 1 Infection Prevention and Control Department, West China Hospital, Sichuan University, Chengdu, China.,3 Department of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - Weijia Yin
- 1 Infection Prevention and Control Department, West China Hospital, Sichuan University, Chengdu, China
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Morinaga Y, Yamano S, Akamatsu N, Kaku N, Nagaoka K, Migiyama Y, Harada Y, Hosogaya N, Yamamoto Y, Tasaki O, Yanagihara K, Kohno S. Active Surveillance of Methicillin-Resistant Staphylococcus aureus Using a Fully Automated Molecular Test in an Emergency Medical Center. Jpn J Infect Dis 2015; 68:376-80. [PMID: 25766607 DOI: 10.7883/yoken.jjid.2014.352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevention and control of methicillin-resistant Staphylococcus aureus (MRSA) are important, particularly in emergency units. The active surveillance of MRSA was prospectively performed at the emergency medical center of Nagasaki University Hospital. After obtaining nasal swab specimens, a fully automated molecular test (FAMT) and a culture-screening method were utilized for MRSA detection. A total of 150 patients were enrolled in the study, and 366 nasal swab specimens were obtained. MRSA was detected by culture in 11 (7.3%) patients including one new acquisition and by the FAMT in 34 (22.7%) patients including 13 new acquisitions. The sensitivity, specificity, positive predictive value, and negative predictive value of the FAMT at the patient level were 86.7, 85.2, 39.4, and 98.3%, respectively, when compared with the culture-based results. An FAMT can effectively detect MRSA colonization, which may remain undetected with the conventional method, and it may be useful in detecting newly acquired MRSAs.
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Affiliation(s)
- Yoshitomo Morinaga
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
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