Hostname: page-component-77c89778f8-m42fx Total loading time: 0 Render date: 2024-07-20T15:35:21.087Z Has data issue: false hasContentIssue false
  • English
  • Français

Spread of Clones of Multidrug-Resistant, Coagulase-Negative Staphylococci Within a University Hospital

Published online by Cambridge University Press:  21 June 2016

Tor Monsen ,
Carina Karlsson  and
Johan Wiström
Tor Monsen*
Affiliation:
Department of Clinical Bacteriology, University Hospital of Umeà, Umeà, Sweden
Carina Karlsson
Affiliation:
Department of Clinical Bacteriology, University Hospital of Umeà, Umeà, Sweden
Johan Wiström
Affiliation:
Department of Infectious Diseases, University Hospital of Umeà, Umeà, Sweden
*
Department of Clinical Bacteriology, University Hospital of Umeà, SE 901 85 Umeà, Swedentor.monsen@climi.umu.se
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To detect putative clonal dissemination of multidrug-resistant, coagulase-negative staphylococci (CNS) in a university hospital in northern Sweden.

Methods:

All consecutive routine clinical samples from our hospital were screened during two periods (November and December 2001 and September and October 2002) for the presence of multidrug-resistant (defined as resistant to oxacillin, clindamycin, co-trimoxazole, gentamicin, and fusidic acid, but susceptible to vancomycin) isolates of CNS. Genetic similarity between isolates was analyzed using pulsed-field gel electrophoresis (PFGE) and a computer program.

Results:

Seventy multidrug-resistant isolates from 62 patients were identified, 28 during the 2001 period and 42 during the 2002 period. All isolates except one, which was Staphylococcus haemolyticus, were identified as S. epidermidis. Multidrug-resistant CNS were isolated in samples obtained from 24 different wards. Two subgroups (group A and group B) of S. epidermidis that differed by approximately 40% in PFGE band similarity were identified. Group A consisted of 44 isolates with a PFGE band similarity of greater than 70% that included 6 subgroups consisting of 3 to 16 isolates that expressed a 100% similarity. These isolates were identified during both sampling periods in cultures performed in 18 different wards. A clonal origin could not be excluded for some of the remaining 26 isolates belonging to group B, but none had identical PFGE patterns, suggesting a more diverse origin.

Conclusion:

The results of this study suggest clonal spread of multidrug-resistant CNS within our hospital and that some clones are endemic in the hospital environment.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 1 , January 2005 , pp. 76 - 80
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Rupp, ME, Archer, GL. Coagulase-negative staphylococci: pathogens associated with medical progress. Clin Infect Dis 1994;19:231–243.Google Scholar
2.von Eiff, C, Proctor, RA, Peters, G. Coagulase-negative staphylococci: pathogens have a major role in nosocomial infections. Postgrad Med 2001;110:63-64, 69-70, 73–76.Google Scholar
3.Karchmer, AW. Nosocomial bloodstream infections: organisms, risk factors, and implications. Clin Infect Dis 2000;31(suppl 4):S139–S143.Google Scholar
4.Livermore, DM. Antibiotic resistance in staphylococci. Int J Antimicrob Agents 2000;16(suppl 1):S3–S10.Google Scholar
5.Monsen, T, Rönnmark, M, Olofsson, C, Wiström, J. Antibiotic susceptibility of staphylococci isolated in blood cultures in relation to antibiotic consumption in hospital wards. Scand J Infect Dis 1999;31:399–404.Google Scholar
6.Diekema, DJ, Pfaller, MA, Schmitz, FJ, et al.Survey of infections due to staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific Region for the SENTRY antimicrobial surveillance program, 1997-1999. Clin Infect Dis 2001;32(suppl 2):S114–S132.Google Scholar
7.Mossad, SB, Serkey, JM, Longworth, DL, Cosgrove, DM 3rd, Gordon, SM. Coagulase-negative staphylococcal sternal wound infections after open heart operations. Ann Thorac Surg 1997;63:395–401.Google Scholar
8.Jarlov, JO, Homy, N. Coagulase-negative staphylococci in a major Danish university hospital: diversity in antibiotic susceptibility between wards. APMIS 1998;106:411–416.Google Scholar
9.Monsen, T, Olofsson, C, Rönnmark, M, Wiström J. Clonal spread of staphylococci among patients with peritonitis associated with continuous ambulatory peritoneal dialysis. Kidney Int 2000;57:613–618.Google Scholar
10.Spare, MK, Tebbs, SE, Lang, S, et al.Genotypie and phenotypic properties of coagulase-negative staphylococci causing dialysis catheter-related sepsis. J Hosp Infect 2003;54:272–278.Google Scholar
11.Vermont, CL, Hartwig, NG, Fleer, A, et al.Persistence of clones of coagulase-negative staphylococci among premature neonates in neonatal intensive care units: two-center study of bacterial genotyping and patient risk factors. J Clin Microbiol 1998;36:2485–2490.Google Scholar
12.Kloos, WE, Bannerman, TL. Staphylococcus and Micrococcus. In: Murray, PR, Baron, EJ, Pfaller, MA, Tenover, FC, Yolken, RH, eds. Manual of Clinical Microbiology, ed. 7. Washington, DC: American Society for Microbiology; 1999:264–283.Google Scholar
13.Monsen, T, Rönnmark, M, Olofsson, C, Wiström, J. An inexpensive and reliable method for routine identification of staphylococcal species. Eur J Clin Microbiol Infect Dis 1998;17:327–335.Google Scholar
14.Monsen, T, Persson, S, Edebro, H, Granstrom, S, Wistrom, J. Mueller-Hinton agar is superior to PDM blood agar for detection of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect 2003;9:61–64.Google Scholar
15.Lyytikainen, O, Valtonen, V, Sivonen, A, Ryhanen, R, Vuopio-Varkila, J. Molecular epidemiology of Staphylococcus epidermidis isolates in a hematological unit during a 4-month survey. Scand J Infect Dis 1995;27:575–580.Google Scholar
16.Tegnell, A, Saeedi, B, Isaksson, B, Granfeldt, H, Ohman, L. A clone of coagulase-negative staphylococci among patients with post-cardiac surgery infections. J Hosp Infect 2002;52:37–42.Google Scholar
17.Worthington, T, Lambert, PA, Elliott, TS. Is hospital-acquired intravascular catheter-related sepsis associated with outbreak strains of coagulase-negative staphylococci? J Hosp Infect 2000;46:130–134.Google Scholar
18.Spiliopoulou, I, Santos Sanches, I, Bartzavali, C, et al.Application of molecular typing methods to characterize nosocomial coagulase-negative staphylococci collected in a Greek hospital during a three-year period (1998-2000). Microb Drug Resist 2003;9:273–282.Google Scholar
19.Krediet, TG, Jones, ME, Janssen, K, Gerards, LJ, Fleer, A. Prevalence of molecular types and mecA gene carriage of coagulase-negative staphylococci in a neonatal intensive care unit: relation to nosocomial septicemia. J Clin Microbiol 2001;39:3376–3378.Google Scholar
20.Boisson, K, Thouverez, M, Talon, D, Bertrand, X. Characterisation of coagulase-negative staphylococci isolated from blood infections: incidence, susceptibility to glycopeptides, and molecular epidemiology. Eur J Clin Microbiol Infect Dis 2002;21:660–665.Google Scholar
21.Biavasco, F, Vignaroli, C, Varaldo, PE. Glycopeptide resistance in coagulase-negative staphylococci. Eur J Clin Microbiol Infect Dis 2000;19:403–417.Google Scholar
22.Villari, P, Sarnataro, C, Iacuzio, L. Molecular epidemiology of Staphylococcus epidermidis in a neonatal intensive care unit over a three-year period. J Clin Microbiol 2000;38:1740–1746.Google Scholar