Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen in community settings. MRSA colonized individuals may contribute to its dissemination; the risk of MRSA infection is increased in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients, although the prevalence of colonization in this group is not well established. The present study addressed this issue by characterizing MRSA isolates from HIV/AIDS patients and their healthcare providers (HCPs) to determine whether transmission occurred between these two populations. A total of 24 MRSA isolates from HIV-infected patients and five from HCPs were collected between August 2011 and May 2013. Susceptibility to currently available antimicrobials was determined. Epidemiological typing was carried out by pulsed-field gel electrophoresis, multilocus sequence typing, and Staphylococcus cassette chromosome (SCCmec) typing. The presence of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) and heterogeneous daptomycin-resistant Staphylococcus aureus (hDRSA) was confirmed by population analysis profile. Isolates characterized in this study were also compared to isolates from 2009 obtained from patients at the same hospital. A variety of lineages were found among patients, including ST5-SCCmecII and ST30-SCCmecIV. Two isolates were Panton-Valentine leukocidin-positive, and hVISA and hDRSA were detected. MRSA isolates from two HCPs were not related to those from HIV/AIDS patients, but clustered with archived MRSA from 2009 with no known relationship to the current study population. ST105-SCCmecII clones that colonized professionals in 2011 and 2012 were already circulating among patients in 2009, but there is no evidence that these clones spread to or between HIV/AIDS patients up to the 7th day of their hospitalization.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen in community settings
The present study addressed this issue by characterizing MRSA isolates from HIV/AIDS patients and their healthcare providers (HCPs) to determine whether transmission occurred between these two populations
22 MRSA isolates from other patients from different wards at the same hospital collected between June and September 2009 that were archived by our group, and S. aureus strain N315 were included for determination of clonality
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen in community settings. MRSA colonized individuals may contribute to its dissemination; the risk of MRSA infection is increased in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients, the prevalence of colonization in this group is not well established. Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of nosocomial and community infections(1) It is usually present in the environment as well as in the microbiota of the superior respiratory tract and skin. Individuals with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) are at increased risk for MRSA colonization and infection mainly due to their high antibiotic use(1) and high rates of hospital readmission. These patients can harbor community-acquired MRSA, which often produces Panton-Valentine leukocidin (PVL)(1). The prevalence of MRSA colonization in this group is not well established
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