Current Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Elderly French People: Troublesome Clones on the Horizon.

Détails

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Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_8EC85DD76934
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Current Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Elderly French People: Troublesome Clones on the Horizon.
Périodique
Frontiers in microbiology
Auteur(s)
Rondeau C., Chevet G., Blanc D.S., Gbaguidi-Haore H., Decalonne M., Dos Santos S., Quentin R., van der Mee-Marquet N.
ISSN
1664-302X (Print)
ISSN-L
1664-302X
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
7
Pages
31
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
In 2015, we conducted at 44 healthcare facilities (HCFs) and 21 nursing homes (NHs) a 3-month bloodstream infection (BSI) survey, and a 1-day prevalence study to determine the rate of carriage of methicillin-resistant Staphylococcus aureus (MRSA) in 891 patients and 470 residents. We investigated the molecular characteristics of the BSI-associated and colonizing MRSA isolates, and assessed cross-transmission using double-locus sequence typing and pulsed-field gel electrophoresis protocol.
The incidence of MRSA-BSI was 0.040/1000 patient-days (19 cases). The prevalence of MRSA carriage was 4.2% in patients (n = 39) and 8.7% in residents (n = 41) (p < 0.001). BSI-associated and colonizing isolates were similar: none were PVL-positive; 86.9% belonged to clonal complexes 5 and 8; 93.9% were resistant to fluoroquinolones. The qacA/B gene was carried by 15.8% of the BSI-associated isolates [3/3 BSI cases in intensive care units (ICUs)], and 7.7% of the colonizing isolates in HCFs. Probable resident-to-resident transmission was identified in four NHs.
Despite generally reassuring results, we identified two key concerns. First, a worryingly high prevalence of the qacA/B gene in MRSA isolates. Antisepsis measures being crucial to prevent healthcare-associated infections, our findings raise questions about the potential risk associated with chlorhexidine use in qacA/B(+) MRSA carriers, particularly in ICUs. Second, NHs are a weak link in MRSA control. MRSA spread was not controlled at several NHs; because of their frequent contact with the community, conditions are favorable for these NHs to serve as reservoirs of USA300 clone for local HCFs.

Mots-clé
Staphylococcus aureus MRSA, bloodstream infection, carriage, elderly, qacA/B
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/01/2016 10:59
Dernière modification de la notice
08/05/2019 21:53
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