Changing Italian nosocomial-community trends and heteroresistance in Staphylococcus aureus from bacteremia and endocarditis

被引:36
作者
Campanile, F. [1 ]
Bongiorno, D. [1 ]
Falcone, M. [2 ]
Vailati, F. [5 ]
Pasticci, M. B. [4 ]
Perez, M. [1 ]
Raglio, A. [5 ]
Rumpianesi, F. [3 ]
Scuderi, C. [1 ]
Suter, F. [6 ]
Venditti, M. [2 ]
Venturelli, C. [3 ]
Ravasio, V. [5 ]
Codeluppi, M. [3 ]
Stefani, S. [1 ]
机构
[1] Univ Catania, Microbiol Sect, Dept Biomed Sci, I-95124 Catania, I, Italy
[2] Policlin Umberto 1, Dept Publ Hlth & Infect Dis, Rome, Italy
[3] Policlin Hosp Modena, Microbiol & Virol Lab, Modena, Italy
[4] Univ Perugia, Dept Expt Med & Biochem Sci, Infect Dis Sect, I-06100 Perugia, Italy
[5] AO Osped Riuniti, USC Microbiol & Virol, Bergamo, Italy
[6] AO Osped Riuniti, USC Malattie Infett, Bergamo, I, Italy
关键词
BLOOD-STREAM INFECTIONS; METHICILLIN-RESISTANT; RISK-FACTORS; VANCOMYCIN; MRSA; CLONES; MULTICENTER; MORTALITY; CRITERIA; PATIENT;
D O I
10.1007/s10096-011-1367-y
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Bloodstream infections due to Staphylococcus aureus (BSI) are serious infections both in hospitals and in the community, possibly leading to infective endocarditis (IE). The use of glycopeptides has been recently challenged by various forms of low-level resistance. This study evaluated the distribution of MSSA and MRSA isolates from BSI and IE in 4 Italian hospitals, their antibiotic susceptibility-focusing on the emergence of hVISA-and genotypic relationships. Our results demonstrate that the epidemiology of MRSA is changing versus different STs possessing features between community-acquired (CA)- and hospital-acquired (HA)-MRSA groups; furthermore, different MSSA isolated from BSI and IE were found, with the same backgrounds of the Italian CA-MRSA. The hVISA phenotype was very frequent (19.5%) and occurred more frequently in isolates from IE and in both the MSSA and MRSA strains. As expected, hVISA were detected in MRSA with vancomycin minimum inhibitory concentrations (MICs) of 1-2 mg/l, frequently associated with the major SCCmec I and II nosocomial clones; this phenotype was also detected in some MSSA strains. The few cases of MR-hVISA infections evaluated in our study demonstrated that 5 out of 9 patients (55%) receiving a glycopeptide, died. Future studies are required to validate these findings in terms of clinical impact.
引用
收藏
页码:739 / 745
页数:7
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