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01.12.2014 | original article

Emergency (clonal spread) of methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum (ESBL) – and AmpC beta-lactamase-producing Gram-negative bacteria infections at Pediatric Department, Bosnia and Herzegovina

verfasst von: Prof. Selma Uzunović, Prof. Branka Bedenić, Prof. Ana Budimir, Farah Kamberović, Amir Ibrahimagić, B.Sc, Dr. Sabina Delić-Bikić, Sara Sivec, Dr. Tomislav Meštrović, Dijana Varda Brkić, Michelle I. A. Rijnders, Ph.D, Prof. Ellen E. Stobberingh

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 23-24/2014

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Abstract

Purpose

Aim of this study was to investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum (ESBL) and plasmid-mediated AmpC beta-lactamase producing Gram-negative bacteria in children.

Methods

Antibiotic susceptibility of MRSA and beta-lactamase producing Gram-negative bacteria was determined by disc diffusion and broth microdilution methods according to CLSI guidelines. Methicillin resistance was confirmed by the presence of mecA gene by PCR. The genetic characterization of S. aures was performed using spa-typing and the algorithm based upon repeat pattern (BURP). Double-disk synergy test was used to screen for ESBL production. PCR was used to detect _blaESBL alleles. Genetic relatedness of the strains was tested by pulsed-field gel electrophoresis (PFGE).

Results

Among 23 MRSA, 12 (52.2 %) were obtained from newborns. MLST CC152 (spa-CC 355–595) (Balkan clone) was the most prevalent, 20 (87 %) cases. Among 24 beta-lactamase producing Gram-negative bacteria, 10 (41.7 %) were obtained from each newborns and one-year-old children; 14 (58.3 %) were from urine. Among 11 Klebsiella strains isolated from urine eight (73 %) produced CTX-M-15, and one CTX-M-3 beta-lactamase. Twenty (83 %) of CTX-M producers were coproduced by other types of beta-lactamases. Fifteen (65.2 %) MRSA isolates were clonally related. Five clones among 13 K. pneumoniae isolates were detected by PFGE suggesting clonal spread of β-lactamase producing Gram-negative bacteria.

Conclusion

Pediatric infections caused by clonal spread of MRSA and beta-lactamase-producing Gram-negative bacteria are of major concern. Proper infection control measures should be implemented in order to avoid the transmission and major outbreaks.

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Mollema FPN, Richards JH, Behrendt M, Vaessen N, Lodder W, Hendriks W, Verbrugh HA, Vos MC. Transmission of methicillin-resistant Staphylococcus aureus to household contacts. J Clin Microbiol. 2010;48(1):202–7.PubMedCentralPubMedCrossRef

Regev-Yochay G, Rubinstein E, Barzilai A, Carmeli Y, Kuint J, Etienne J, Blech M, Smollen G, Maayan-Metzger A, Leavitt A, Rahav G, Keller N. Methicillin-resistant Staphylococcus aureus in neonatal intensive care unit. Emerg Infect Dis. 2005;11(3):453–56.PubMedCentralPubMedCrossRef

Donker GA, Deurenberg RH, Driessen C, Sebastian S, Nys S, Stobberingh EE. The population structure of Staphylococcus aureus among general practice patients from The Netherlands. Clin Microbiol Infect. 2009;15(2):137–43.PubMedCrossRef

Jacoby GA. Extended-spectrum beta-lactamases and other enzymes providing resistance to oxyimino-beta-lactams. Infect Dis Clin North Am. 1997;11(4):875–87.PubMedCrossRef

Lartigue M-F, Zinsius C, Wenger A, Bille J, Poirel, L, Nordmann P. Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland. Antimicrob Agents Chemother. 2007;51(8):2855–60.PubMedCentralPubMedCrossRef

Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev. 2005;18(4):657–86.PubMedCentralPubMedCrossRef

Woodford N, Ward ME, Kaufmann ME, Turton J, Fagan EJ, James D, Johnson AP, Pike R, Warner M, Cheasty T, Pearson A, Harry S, Leach JB, Loughrey A, Lowes JA, Warren RE, Livermore DM. Community and hospital spread of Escherichia coli producing CTX-M extended-spectrum β-lactamases in the UK. J Antimicrob Chemother. 2004;54(4):735–43.PubMedCrossRef

Literacka E, Bedenić B, Baraniak A, Fiett J, Tonkić M, Jajić-Bencić I, Gniadkowski M. Bla_CTX-M genes in Escherichia coli from Croatian hospitals are located in new (bla_CTX-M-3) and widely spread (bla_CTX-M-3a, bla_CTX-M-15) genetic structures. Antimicrob Agents Chemother. 2009;53(4):1630–5.PubMedCentralPubMedCrossRef

Eisner A, Fagan EJ, Feierl G, Kessler HH, Marth E, Livermore DM, Woodford N. Emergence of Enterobacteriaceae isolates producing CTX-M extended-spectrum β-lactamase in Austria. Antimicrob Agents Chemother. 2006;50(2):785–7.PubMedCentralPubMedCrossRef

10.

Mugnaioli C, Luzzaro F, De Luca F, Brigante G, Perilli M, Amicosante G, Stefani S, Toniolo A, Rossolini G-M. CTX-M-type extended-spectrum β-lactamases in Italy: molecular epidemiology of an emerging countrywide problem. Antimicrob Agents Chemother. 2006;50(2):2700–6.PubMedCentralPubMedCrossRef

11.

Perez-Perez FJ, Hanson ND. Detection of plasmid-mediated AmpC β-lactamase genes in clinical isolates by using multiplex PCR. J Clin Microbiol. 2002;40(6):2153–62.PubMedCentralPubMedCrossRef

12.

Andriatahina T, Randrianirina F, Hariniana ER, Talarmin A, Raobijaona H, Buisson Y, Richard V. High prevalence of fecal carriage of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a pediatric unit in Madagascar. BMC Infect Dis. 2010;10:204.PubMedCentralPubMedCrossRef

13.

Moland ES, Hanson ND, Black JA, Hossain A, Song W, Thomson KS. Prevalence of newer β-lactamases in gram-negative clinical isolates collected in the United States from 2001–2002. J Clin Microbiol. 2006;44(9):3318–24.PubMedCentralPubMedCrossRef

14.

Uzunović-Kamberović S, Rijnders MIA, Stobberingh EE, Ibrahimagić A, Kamberović F, Ille T. Molecular characterization of methicillin-susceptible and methicillin-resistant Staphylococcus aureus in inpatients and outpatients in Bosnia and Herzegovina. Wien Med Wochenschr. 2013;163(1–2):13–20.PubMedCrossRef

15.

Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. Tenth Informational Supplement M100-S18. Wayne PA, USA:CLSI;2009.

16.

Melles DC, Gorkink RFJ, Boelens HAM, Snijders SV, Peeters JK, Moorhouse MJ, van der Spek PJ, van Leeuwen WB, Simons G, Verbrugh HA. Natural population dynamics and expansion of pathogenic clones of Staphylococcus aureus. J Clin Investig. 2004;114(12):1732–40.PubMedCentralPubMedCrossRef

17.

Strommenger B, Braulke C, Heuck D, Harmsen D, Friedrich AW, Witte W. Assignment of Staphylococcus isolates to group by spa typing, SmaI macrorestriction analyisis, and multilocus sequence typing. J Clin Microbiol. 2006; 4(7):2533–40.CrossRef

18.

Ruppitsch W, Indra A, Stoger A, Mayer B, Stadlbauer S, Wewalka G, Allerberger F. Clasifying spa types in complexes improves interpretation of typing results for methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 2006;44(7):2442–8.PubMedCentralPubMedCrossRef

19.

Jarlier V, Nicolas MH, Fournier G, Philippon A. Extended broad-spectrum β-lactamases conferring transferable resistance to newer β-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility patterns. Rev Infect Dis. 1988;10(4):867–78.PubMedCrossRef

20.

Elwell LP, Falkow S. The characterization of R plasmids and the detection of plasmid-specified genes. In: Lorian V. Antibiotics in laboratory medicine. 2nd ed. Baltimore: Williams and Wilkins;1986. p. 683–721.

21.

Arlet G, Brami G, Decre D, Flippo A, Gaillot O, Lagrange PH, Philippon A. Molecular characterization by PCR restriction fragment polymorphism of TEM β-lactamases. FEMS Microbiol Lett. 1995;134(2–3):203–8.PubMed

22.

Kaufman ME. Pulsed-field gel electrophoresis. In: Woodfor N, Johnsons A, editors. Molecular biology. Protocols and clinical applications. 1st ed. New York: Humana Press Inc. 1998. P. 33–51.

23.

Tenover FC, Arbeit RD, Goerling RV, Mickelsen PA, Murray BE, Persing DH, Swiminathan B. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis; criteria for bacterial strain typing. J Clin Microbiol. 1995;33(9):2233–9.PubMedCentralPubMed

24.

O’Brien FG, Coombs GW, Pearman JW, Gracey M, Moss F, Christiansen KJ, Grubb WB. Population dynamics of methicillin-susceptible and -resistant Staphylococcus aureus in remote communities. J Antimicrob Chemother. 2009;64(4):684–93.PubMedCentralPubMedCrossRef

25.

Ugolotti E, Bandettini R, Marchese A, Gualco L, Vanni I, Borzi L, Di Marco E, Castagnola E, Melioli G, Biassoni R. Molecular characterization of hospital-acquired methicillin-resistant Staphylococcus aureus strains in pediatric outbreaks using variable tandem repeat analysis with spa and ClfB typing. Diagn Microbiol Infect Dis. 2011;69(2):213–7.PubMedCrossRef

26.

Cirkovic I, Sorum M, Radenkovic D, Svabic Vlahovic M, Larsen AR. National surveillance reveals the first findings of Panton Valentine leukocidin positive methicillin-resistant Staphylococcus aureus in Serbia. J Med Microbiol. 2013;62:(Pt 2) 342–4.PubMedCrossRef

27.

Al Naiemi N, Bart A, de Jong MD, Vandenbroucke-Grauls CM, Rietra PJ, Debets-Ossenkopp JY, Wever PC, Spanjaard L, Bos AJ, Duim B. Widely distributed and predominant CTX-M extended-spectrum β-lactamases in Amsterdam, The Netherlands. J Clin Microbiol. 2006;44(8):3012–4.PubMedCentralPubMedCrossRef

28.

Uzunovic-Kamberovic S, Bedenic B, Vranes J. Predominance of SHV-β- lactamase in enteric bacteria causing community-acquired urinary tract infections in Bosnia and Herzegovina. Clin Microbiol Infect. 2007;3(8):820–3.CrossRef

29.

Wang A, Yang Y, Lu Q, Wang Y, Chen Y, Deng L, Ding H, Deng Q, Wang L, Shen X. Occurrence of qnr-positive clinical isolates in Klebsiella pneumoniae producing ESBL or AmpC-type β-lactamase from five pediatric hospitals in China. FEMS Microbiol Lett. 2008;283(1):112–6.PubMedCrossRef

Titel: Emergency (clonal spread) of methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum (ESBL) – and AmpC beta-lactamase-producing Gram-negative bacteria infections at Pediatric Department, Bosnia and Herzegovina
verfasst von: Prof. Selma Uzunović
Prof. Branka Bedenić
Prof. Ana Budimir
Farah Kamberović
Amir Ibrahimagić, B.Sc
Dr. Sabina Delić-Bikić
Sara Sivec
Dr. Tomislav Meštrović
Dijana Varda Brkić
Michelle I. A. Rijnders, Ph.D
Prof. Ellen E. Stobberingh
Publikationsdatum: 01.12.2014
Verlag: Springer Vienna
Erschienen in: Wiener klinische Wochenschrift / Ausgabe 23-24/2014
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI: https://doi.org/10.1007/s00508-014-0597-2

Springer Medizin Österreich

Abstract

Purpose

Methods

Results

Conclusion

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