Journal
JOURNAL OF INFECTION
Volume 80, Issue 1, Pages 24-37Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2019.10.001
Keywords
MRSA; MRSA carriage; CA-MRSA; Hospital-acquired infections; ST5-IV; ST30-IV; Argentina
Categories
Funding
- National Council for Scientific Research and Technology of Argentina (CONICET-PIP)
- Agencia Nacional de Promocion Cientifica y Tecnologica (ANPCyT) [PICT 2012-2284, PICT 2017-0554]
- Secretaria de Ciencia y Tecnica-Universidad Nacional de Cordoba (SECyT-UNC)
- ANPCyT
- CONICET
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Dissemination of methicillin-resistant-Staphylococcus aureus/(MRSA) is a worldwide concern both in hospitals [healthcare-associated-(HA)-MRSA] and communities [community-associated-(CA)-MRSA]. Knowledge on when and where MRSA colonization is acquired and what clones are involved is necessary, to focus efforts for prevention of hospital-acquired MRSA-infections. Methods: A prospective/longitudinal cohort study was performed in eight Argentina hospitals (Cordoba/ October-December/2014). Surveillance cultures for MRSA (nose-throat-inguinal) were obtained on admission and at discharge. MRSA strains were genetically typed as CA-MRSA =(G) and HA-MRSA(G) genotypes. Results: Overall, 1419 patients were screened and 534 stayed at hospital for >= 3 days. S. aureus admission prevalence was 30.9% and 4.2% for MRSA. Overall MRSA acquisition rate was 2.3/1000 patient-days-at-risk with a MRSA acquisition prevalence of 1.96% (95%CI: 1.0%-3.4%); 3.2% of patients were discharged back to community with MRSA. CA-MRSA(G) accounted for 84.6% of imported, 100.0% of hospital-acquired and 94% of discharged MRSA strains. Most imported and acquired MRSA strains belonged to two major epidemic CA-MRSA clones spread in Argentina: PFGEtypeI-ST5-IVa-t311-PVL+ and PFGEtypeN/ST30-IVc-t019-PVL+. Conclusions: CA-MRSA clones, particularly ST5-IV-PVL+ and ST30-IV-PVL+, with main reservoir in the community, not only enter but also are truly acquired within hospital, causing healthcare-associated- hospital-onset infections, having a transmission capacity greater or similar than HA-MRSA G . This information is essential to develop appropriate MRSA infection prevention-control programs, considering hospital and community. (C) 2019 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
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