Community Strain of Methicillin-Resistant Staphylococcus aureus Involved in a Hospital Outbreak

Size: px
Start display at page:

Download "Community Strain of Methicillin-Resistant Staphylococcus aureus Involved in a Hospital Outbreak"

Transcription

1 JOURNAL OF CLINICAL MICROBIOLOGY, Sept. 1999, p Vol. 37, No /99/$ Copyright 1999, American Society for Microbiology. All Rights Reserved. Community Strain of Methicillin-Resistant Staphylococcus aureus Involved in a Hospital Outbreak F. G. O BRIEN, 1 J. W. PEARMAN, 2 M. GRACEY, 3 T. V. RILEY, 4 AND W. B. GRUBB 1 * School of Biomedical Sciences, Molecular Genetics Research Unit, Curtin University of Technology, 1 Department of Microbiology and Infectious Diseases, Royal Perth Hospital, 2 School of Public Health, Curtin University of Technology, and Office of Aboriginal Health, Health Department of Western Australia, 3 and Division of Microbiology and Infectious Diseases, Western Australian Centre for Pathology and Medical Research, Queen Elizabeth The Second Medical Centre and Department of Microbiology, The University of Western Australia, 4 Perth, Western Australia, Australia Received 8 April 1999/Returned for modification 14 May 1999/Accepted 15 June 1999 Western Australia (WA) has been able to prevent methicillin-resistant Staphylococcus aureus (MRSA) strains from outside of the state from becoming established in its hospitals. Recently, a single-strain outbreak of MRSA occurred in a WA metropolitan teaching hospital following admission of an infected patient from a remote community. The strain responsible for the outbreak was unrelated to any imported strains and spread rapidly in the hospital. Screening of two remote communities in the region from which the index case came revealed that 42% of the people in one community and 24% in the other carried MRSA. Isolates were typed by resistance pattern, plasmid analysis, contour-clamped homogeneous electric field electrophoresis, bacteriophage pattern, and coagulase gene restriction fragment length polymorphism. It was found that of the people carrying MRSA, 39% in the former community and 17% in the latter community were carrying an MRSA strain which was indistinguishable from the strain that caused the hospital outbreak. There have been an increasing number of reports of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) (4). Boyce has recently reviewed the evidence for community-acquired MRSA and pointed out the difficulties in demonstrating that the organism was not acquired as the result of a visit to a health care facility (4). He also pointed out that many community MRSA strains are not multiply resistant and that some of these may be borderline methicillin-resistant strains, which do not contain the meca gene (4). Community MRSA strains were first reported in Australia in the state of Western Australia (WA) in 1993 (32). These strains were isolated from hospital patients who resided in isolated communities hundreds of kilometers from any small town and thousands of kilometers from any urban area. The strains differed from other MRSA strains previously isolated in WA (29), based on their resistance to antimicrobial agents, plasmid content, and contour-clamped homogeneous electric field (CHEF) electrophoresis patterns (32) and have been referred to as WA MRSA (33). WA has been able to monitor MRSA in the state because of its geographical isolation. The state has a landmass of approximately one-third of Australia but a population of only 1.8 million. A total of 1.35 million of these people live in Perth, the capital city. Perth is on the shores of the Indian Ocean and is separated from the main population centers to the east by a distance of 2,000 km, which includes 1,100 km of desert. All MRSA strains isolated in WA are sent to a reference center. Initially, MRSA strains were isolated only from people who had been in hospitals outside WA and the strains were prevented from spreading in WA hospitals (17, 18). Occasionally an imported MRSA strain was not detected on a person * Corresponding author. Mailing address: School of Biomedical Sciences, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia. Phone: Fax: igrubbw@info.curtin.edu.au. resulting in a few single-strain outbreaks in hospitals, which were terminated only by a rigorous screening and containment policy (17, 18, 29). WA MRSA strains, however, had not caused outbreaks when patients carrying them were admitted to the hospital. The situation has now changed, and a community MRSA has caused a single-strain outbreak in a Perth hospital. Screening of two remote communities in the vicinity where the index patient of the outbreak lived has revealed a high prevalence of MRSA strains, many of which were indistinguishable from the outbreak strain. MATERIALS AND METHODS Screening. All consenting members of the communities were screened. The nostrils, throat, finger webs, and any skin lesions were swabbed with moistened cotton wool swabs which were placed in Amies transport medium (Interpath Services, Pty. Ltd., West Heidelberg, Australia) and transported in a cool, insulated container to the laboratory in Perth. All swabs were processed within 48 h of collection. Laboratory processing. Swabs were plated onto mannitol salt agar (MSA) (Oxoid, Basingstoke, England) and methicillin aztreonam mannitol salt agar (MAMSA) (21). MSA and MAMSA plates were incubated at 35 C for 48 and 20 h, respectively. Mannitol-fermenting colonies were cultured overnight in brain heart infusion broth (Gibco Diagnostics, Gaithersburg, Md.), presumptively identified as S. aureus by the tube coagulase test, and confirmed by PCR amplification of the nuc gene (5). One colony from each positive site was characterized. Susceptibility testing. Susceptibility testing was performed on Mueller-Hinton agar (BBL, Becton Dickinson, Cockeysville, Md.) (7) by disk diffusion according to National Committee for Clinical Laboratory Standards guidelines (15) by using antibiotic disks (Oxoid). Colonies were screened for susceptibility to oxacillin (1 g), and resistance was confirmed by PCR for meca (5). Samples with methicillin-sensitive S. aureus (MSSA) and/or MRSA colonies were recorded, and colonies were selected for further studies. MRSA colonies were tested for susceptibility to gentamicin, kanamycin, neomycin, streptomycin, erythromycin, lincomycin, chloramphenicol, minocycline, tetracycline, trimethoprim, sulfamethoxazole, fusidic acid, rifampin, novobiocin, vancomycin, mupirocin, and ciprofloxacin. Resistogram testing for susceptibility to cadmium acetate (10 2 M), mercuric chloride (0.4 M), and phenyl mercuric acetate (5 mm), all from Ajax Chemicals, Sydney, Australia, ethidium bromide (15 mm) and sodium arsenate (0.2 M) from Sigma Chemical Company, St. Louis, Mo., and propamidine 2858

2 VOL. 37, 1999 COMMUNITY METHICILLIN-RESISTANT S. AUREUS 2859 TABLE 1. Prevalence of MRSA and MSSA Parameter No. (%) for indicated community No. of persons sampled a MRSA and/or MSSA 28 (68) 48 (65) MSSA 17 (40) 45 (61) MRSA 18 (42) 18 (24) MRSA and MSSA 7 (16) 15 (20) a Total populations of X and Y were 80 and 200, respectively, at the time of screening. X Y Site of carriage TABLE 2. Sites of MRSA carriage No. of MRSA-positive persons (% of persons MRSA positive) in indicated community Throat only 3 (17) 2 (11) Nose only 3 (17) 3 (17) Skin only 4 (22) 9 (50) Nose and throat 2 (11) 2 (11) Nose and skin 3 (17) 2 (11) Nose, throat, and skin 3 (17) 0 (0) X Y isethionate (2% [wt/vol]) from May and Baker Limited, Dagenham, England, was performed as previously described (29, 30). Beta-lactamase production was detected by using Nitrocefin disks (BBL, Becton Dickinson) according to the manufacturer s instructions. MICs were determined by using the E-Test (AB Biodisk, Solna, Sweden). Isolation and analysis of plasmid DNA. MRSA plasmids were isolated by using the cetyltrimethylammonium bromide method as previously described (27) and separated by horizontal-gel electrophoresis in 0.6% (wt/vol) molecular biology-grade agarose (Promega Corporation, Madison, Wis.). Plasmid size was calculated by using the MacVector 4.0 program with the plasmids of WBG4483 used as the size standard (27). When possible, individual plasmids were digested with the restriction endonucleases EcoRI and HindIII (Promega) according to the manufacturer s directions. The fragments were separated in 1% agarose and sized by Molmatch (UV Products, Cambridge, United Kingdom). Phage DNA (Pharmacia, Uppsala, Sweden) digested with HindIII was used as the size standard. CHEF electrophoresis of chromosomal DNA. The method for preparation of agarose blocks for CHEF electrophoresis was adapted from methods previously described (8, 35). Cells from 3 ml of overnight Trypticase soy broth (Gibco Diagnostics) cultures were harvested by centrifugation (1,089 g for 10 min) and washed twice by resuspension in 5 ml of 50 mm EDTA, ph 8.0. The cell pellets were then resuspended in EC buffer (6 mm Tris, 1 M NaCl, 100 mm EDTA, 0.5% Brij 58, 0.2% sodium deoxycholate, and 0.5% sodium lauroyl sarcosine [ph 7.5]) to a final concentration of cells/ml. Fifty microliters of the cell suspension was then mixed with 50 l of lysostaphin (400 g/ml) (Sigma Chemical Company) and 100 l of molten 1% agarose (chromosomal grade; Bio-Rad Laboratories, Hercules, Calif.) held at 50 C and then loaded into agarose block formers (Bio-Rad Laboratories). The blocks were allowed to set at room temperature for 10 min and then placed in 500 l of EC buffer and incubated at 37 C for 3 to 4 h. The EC buffer was then replaced with 300 l of EST buffer (5 mm Tris, 0.5 M EDTA, and 1% sodium lauroyl sarcosine [ph 7.5]) and 30 l of proteinase K (20 mg/ml) (Boehringer, Mannheim, Germany), and the mixtures were incubated overnight at 50 C. The DNA blocks were then washed in 1 ml of 50 mm EDTA (ph 8.0) for 2 h, with gentle shaking, and the EDTA was replaced every 30 min. The prepared blocks were stored in 50 mm EDTA (ph 8.0) at 4 C until required. The agarose blocks were then washed in 1.5 ml of sterile water (18.2 M -cm resistivity at 25 C), followed by equilibration in buffer J (Promega) on ice for 30 min and then digested with 40 U of SmaI (Promega) at 22 C for 4 h. Electrophoresis was performed in 1% agarose slabs (pulsed field certified; Bio- Rad Laboratories) by using the CHEF-DRII system (Bio-Rad Laboratories) in 0.5 Tris-borate-EDTA (45 mm Tris, 45 mm boric acid, 1 mm EDTA [ph 8.0]) at 12 C, for 20 h at 200 V. The initial pulse time was 1 s, and the final pulse time was 40 s. Chromosomal banding patterns were scanned with a Fluor-S MultiImager and analyzed by Multi-Analyst/PC (Bio-Rad Laboratories). S. aureus NCTC8325 was used as the size standard (16). CHEF patterns were grouped according to the criteria of Tenover et al. (26). Phage typing. Phage typing of the index strain and all CHEF pattern 10 community isolates was performed as previously described (2) by using the Basic International set of phages and the Australian Supplementary set of phages (1, 34). Coagulase gene typing. Coagulase gene restriction fragment length polymorphism typing of the index strain and all CHEF pattern 10 community isolates was performed as previously described (9). Mixed-culture transfer. Mixed-culture transfer of plasmids was performed on representative isolates as previously described (28). Recipients were S. aureus WBG2110 (strain RN450 mutated to chromosomal streptomycin and novobiocin resistance and lysogenized with phage J) and WBG1876 (28). WBG2110 transcipients were selected on media containing streptomycin (25 g/ml) and novobiocin (5 g/ml) (Sigma Chemical Company) with either cadmium acetate (135 g/ml) or erythromycin (5 g/ml) (Sigma Chemical Company). WBG1876 transcipients were selected on media containing fusidic acid (5 g/ml) and rifampin (25 g/ml) (Sigma Chemical Company) with either sodium arsenate (31 g/ml) or cadmium acetate (135 g/ml). Plasmid curing. Plasmid curing was performed at 43.5 C as previously described (30). Isolated colonies were screened by replication onto brain heart infusion agar containing either cadmium acetate (135 g/ml) or erythromycin (5 g/ml). Colonies showing loss of resistance were further characterized by antibiogram and resistogram testing, plasmid isolation, and CHEF analysis. RESULTS The inhabitants of two remote communities, 10 km (community X) and 200 km (community Y) from a regional hospital 600 km from Perth, were screened. The people in both communities had high rates of carriage of both MSSA and MRSA (Table 1). Forty-two percent of the people in community X and 24% in community Y carried MRSA (Table 1). There was considerable variation in the number of sites from which MRSA strains were isolated (Table 2). Although only one isolate was characterized from each positive site, six persons were found to be colonized with slightly different strains isolated from different sites (Table 3). The characteristics and prevalence of the isolates in the communities are presented in Table 4. Resistance to antimicrobial agents. All the MRSA strains were meca positive, produced beta-lactamase, and were resistant to the antimicrobial agents shown in Table 4. CHEF pattern 9 and 9a isolates were all low-expression class MRSA strains (7). CHEF electrophoresis. The isolates were divided into four CHEF types, 8, 9, 10, and 12, which were regarded as epidemiologically unrelated (26). These were then divided into sub- Person TABLE 3. Persons carrying more than one type of MRSA a CHEF pattern % Similarity of CHEF types b Resistance c Plasmid size(s) (kb) X E I, F, Cd 19.6, d E I, Cd 19.6, 2.0 X Cd, Asa a Cd, Asa 24.2 Y E I 41.3, 21.6, c E I, Cd 37.8, 21.6, 2.0 Y E I, F, Cd 19.6, a M only 33.0, 21.6, 2.3 Y E I, F, Cd 19.6, Cd, Asa 24.2 Y Cd, Asa 32.0, Cd, Asa 24.2 a Resistant to all beta-lactams. b Calculated as Dice coefficients by Multi-Analyst/PC (Bio-Rad). c Abbreviations: Asa, sodium arsenate; Cd, cadmium acetate; E, erythromycin; F, fusidic acid; M, methicillin; superscript I, inducible.

3 2860 O BRIEN ET AL. J. CLIN. MICROBIOL. TABLE 4. Characteristics of community MRSA a isolates No. of persons Community CHEF pattern Resistance b Plasmid size(s) (kb) 7 X 10 E I, F, Cd 19.6, X 10d E I, Cd 19.6, X 12b E I, Cd 34.0, X 8 E I, Cd 21.8, X 9 Cd, Asa X 9a Cd, Asa X 9a Cd, Asa, 24.2 Pi 2 X 9b E I, C, Cd 19.6, 4.2, Y 10 E I, F, Cd 19.6, Y 10a E I, Cd 19.6, Y 10a Cd Y 10e E I, Cd 37.8, 21.6, Y 12 E I 41.3, 21.6, Y 12a 33.0, Y 12a Mp Y 12a Mp 33.0, 21.6, Y 12c E, Cd 37.8, 21.6, Y 9 Cd, Asa 32.0, 24.2, Y 9 Cd, Asa Y 9a Cd, Asa 24.2 a Resistant to all beta-lactams. b Abbreviations: Asa, sodium arsenate; Cd, cadmium acetate; C, chloramphenicol; E, erythromycin; F, fusidic acid; Pi, propamidine isethionate; Mp, mupirocin; superscript I, inducible. FIG. 1. CHEF patterns of community MRSA isolates. Lanes: 1, CHEF pattern 8; 2, CHEF pattern 9; 3, CHEF pattern 9a; 4, CHEF pattern 9b; 5, CHEF pattern 10; 6, CHEF pattern 10a; 7, CHEF pattern 10d; 8, CHEF pattern 10e; 9, CHEF pattern 12; 10, CHEF pattern 12a; 11, CHEF pattern 12c; 12, NCTC8325. FIG. 2. Dendrogram of WA MRSA strains isolated from communities X and Y. types which were regarded as epidemiologically related (26). CHEF pattern 9 contained two subtypes, 9a and 9b, CHEF pattern 10 had three subtypes, 10a, 10d, and 10e, and CHEF pattern 12 had three subtypes, 12a, 12b, and 12c. Representatives of the different CHEF patterns are shown in Fig. 1, and their distribution in the communities is shown in Table 4. CHEF pattern 10 was the most prevalent. A dendrogram of the CHEF patterns (Fig. 2) reveals two clusters of strains. Patterns 10, 10a, 10d, 10e, 12, 12a, 12b, and 12c clustered together with 80% similarity to each other, and CHEF patterns 9, 9a, and 9b clustered with 82% similarity to each other. However, these two clusters were only 49% similar to each other. CHEF pattern 8 was not closely related to either cluster. Plasmid content of isolates. All of the isolates contained plasmids, whose profiles are presented in Table 4. The plasmid profiles were not completely consistent with the CHEF patterns. CHEF patterns 10, 10a, and 10d carried plasmids of 19.6 and 2.0 kb, except for three CHEF pattern 10a strains that carried only the 19.6-kb plasmid. The one CHEF pattern 10e isolate carried the 2.0-kb plasmid and two different plasmids, of 37.8 and 21.6 kb. Mixed-culture transfer and curing experiments revealed that the 19.6-kb plasmid encoded beta-lactamase production and resistance to cadmium, and the 2.0-kb plasmid encoded inducible resistance to erythromycin. The plasmid profiles of CHEF patterns 12, 12a, 12b, and 12c isolates were varied, although uncharacterized plasmids of 33.0 and 21.6 kb predominated (Table 4). CHEF patterns 9 and 9a carried a 24.2-kb plasmid which encoded resistance to cadmium and arsenate. One CHEF pattern 9 isolate carried additional 32- and 2.0-kb plasmids. CHEF pattern 9b isolates carried plasmids of 19.6, 4.4, and 2.0 kb. Comparison with the hospital outbreak strain. The strain (EMRSA-WA95/1) which caused the hospital outbreak (20) was found to be indistinguishable from the most prevalent community isolate, CHEF pattern 10 (Table 5). In communities X and Y, CHEF pattern 10 was isolated from 39 and 17%, respectively, of people carrying an MRSA strain. When closely related CHEF patterns are included, 44% of the people carrying an MRSA strain in both communities were colonized by a CHEF pattern 10 or a closely related strain. DISCUSSION Although MRSA strains are endemic in the hospitals of the eastern seaboard of Australia (31), WA has been able to prevent imported strains of MRSA from becoming established in its hospitals because of its geographical isolation and because of a statewide policy to screen all patients and staff who have been in a hospital or a nursing home outside the state in the previous 12 months (17, 18). The screening policy has not prevented imported MRSA strains from causing an occasional single-strain outbreak in WA hospitals, but on every occasion the MRSA strains have been eliminated from the hospital (17 19). However, over the last decade, MRSA strains have been isolated from an increasing number of patients from remote communities who have not been hospitalized outside the State. These MRSA strains were first isolated in the Kimberley, a remote region 2,000 to 2,500 km north of Perth. They were not multiply resistant (24, 32) like the imported MRSA strains from eastern Australia, Asia, and Europe (10, 18, 23, 29, 32), and genetic studies have shown that they are distinct from them (32, 33). Consequently, they have been referred to as WA MRSA strains (23, 33). A panel of eight antibiotics (gentamicin, erythromycin, tetracyline, trimethoprim, rifampin, fusidic acid, ciprofloxacin, and mupirocin) has been used to provision-

4 VOL. 37, 1999 COMMUNITY METHICILLIN-RESISTANT S. AUREUS 2861 TABLE 5. Comparison of the most prevalent community isolate with the outbreak strain a Parameter Community isolate EMRSA-WA95/1 CHEF pattern Plasmid size in kb (phenotype) 19.6 (Cd r, Bla), 2.0 (E r ) 19.6 (Cd r, Bla), 2.0 (E r ) Resistance M, E I,F,Cd M,E I,F,Cd Phage type (100 RTD) 52A/79/6/42E/47/53/(54)/83A//56B/56C/67R 52A/79/6/42E/47/53/(54)/83A//56B/56C/67R Coagulase gene a Abbreviations: Bla, beta-lactamase; Cd, cadmium acetate; E, erythromycin; F, fusidic acid; M, methicillin; RTD, routine test dilution; RFLP, restriction fragment length polymorphism; superscript I and r, inducible and resistant, respectively. Parentheses indicate a weak reaction. ally distinguish WA MRSA strains from the multiply resistant MRSA strains. Strains resistant to no more than two of the antibiotics are regarded as nonmultiresistant, and strains resistant to three or more antibiotics are regarded as multiresistant (19, 24). WA MRSA strains cause infections but initially did not cause outbreaks in hospitals. However, the first large singlestrain hospital outbreak caused by a WA MRSA strain occurred in a Perth teaching hospital in 1995 to 1996 (20). The index case was a patient who had been transferred from a regional hospital 600 km east of Perth (20). As there was no evidence that MRSA was endemic in the regional hospital, communities X and Y in the region where the index case originated were screened for MRSA strains, and the isolates were typed and compared with the hospital outbreak strain. The carriage rates of S. aureus in communities X and Y were 68 and 65%, respectively. These rates are high based on published carriage rates (11). The carriage rates for MRSA in communities X and Y were 42 and 24%, respectively. The high rates of staphylococcal carriage may be related to a high prevalence of skin lesions in remote communities (25). However, there was no obvious explanation for the high carriage rates of MRSA. Antibiotic audits of these communities are planned to determine whether antibiotic consumption is related to the high prevalence of MRSA. The majority of people were colonized at only one site; however, the site was not the same in each person. Consequently, if only one site was swabbed, MRSA would have escaped detection in many of the people who came for screening. This result emphasizes the need to screen more than one site to reliably detect MRSA carriage. In addition to the high carriage rates of MRSA, a large number of the MRSA strains were indistinguishable from the hospital outbreak strain 39% in community X and 17% in community Y. Including closely related CHEF patterns, 44% of the MRSA strains isolated from each community were related to the hospital outbreak strain. The other MRSA strains isolated could be related to the outbreak strain, since plasmids can be lost or gained and restriction patterns can change due to transpositions, mutations, recombination, and changes in lysogeny (3, 26, 35). Likewise, although these isolates differed from other WA MRSA strains regarding CHEF pattern and plasmid content (32, 33), they could be related but have undergone changes over time. The results also demonstrated that different MRSA strains can be isolated from different sites on the same person. In some cases, the variation involved only a single CHEF fragment or a different plasmid or resistance determinant. In other cases, the differences were quite marked. Two people carried isolates which varied in resistance profile, plasmid content, and CHEF pattern. One individual had two types of MRSA which had only 52% similarity in CHEF patterns, while another carried two isolates which had 56% similarity. Whether these people acquired different MRSA strains or whether the isolates represent variations which have occurred in a strain in vivo cannot be determined. Also, it must be remembered that only one MRSA strain from each site was examined, and that if more than one isolate from each site had been examined, further variations in the isolates would likely have been detected. This situation illustrates the problems that can occur in the study of epidemiology if only one isolate from each site is typed. We have demonstrated that a community strain of MRSA was responsible for a single-strain hospital outbreak. A singlestrain outbreak in a hospital is defined as an outbreak when three or more patients are infected or colonized by isolates of MRSA which are indistinguishable by at least two typing techniques and the strain has been transmitted to at least two patients within the hospital. Epidemic strains of MRSA (EMRSA) are strains which have caused single-strain outbreaks in two or more hospitals (13). In 1995, a single-strain outbreak of MRSA occurred in a Perth metropolitan hospital (20), and the strain was subsequently found to be indistinguishable, by five typing techniques, from the predominant community strain described in this article. In 1996, a strain which was indistinguishable from this strain also caused a small outbreak in a country hospital in WA (20). Consequently, this WA MRSA strain has been called an epidemic strain and has been designated EMRSA-WA95/1 (20). Community MRSA strains with resistance profiles similar to those described for WA MRSA strains have been reported from the Northern Territory (NT) of Australia, which borders WA (12). It has been suggested that NT strains may be the same as WA strains (12), but there is no molecular evidence to support this possibility. Even more recently, community MRSA strains have been reported from the more populated eastern seaboard of Australia. However, there is no evidence that these strains are related to WA MRSA, and it has been suggested that they are related to the Western Samoan strains of New Zealand (6, 14, 22). There have been a number of reports of community MRSA from other parts of the world (4). However, it has not always been clear whether these strains have arisen in the community or are hospital strains which have spread in the community (4). Our results have demonstrated that MRSA indistinguishable from a strain that caused an outbreak in a metropolitan hospital is prevalent in remote communities. As MRSA strains are not endemic in WA hospitals, and the WA MRSA strains are quite different from any MRSA strains studied so far in Australia, the evidence suggests that they have a community origin. Further screening of other WA communities and comparing WA MRSA with the community MRSA strains which have recently been reported in other parts of Australia will help elucidate the epidemiology and origin of WA MRSA.

5 2862 O BRIEN ET AL. J. CLIN. MICROBIOL. ACKNOWLEDGMENTS This work was supported by a grant from the National Health and Medical Research Council of Australia. We acknowledge F. Quadros, senior medical officer of the regional public health unit, for his assistance, Peta Williams, Sandra Rodgers, Delia Riley, and Eleanor Sullivan for assistance in the field, Ian Kay for performing the multiplex meca/nuc PCR and coagulase gene typing, and Geoff Coombs for phage typing the isolates. Senior members of the communities are thanked for their assistance. The Health Department of Western Australia provided facilities and logistic support. REFERENCES 1. Beard-Pegler, M. A., and A. M. Vickery Lysogenicity of methicillinresistant strains of Staphylococcus aureus. J. Med. Microbiol. 20: Blair, J. E., and R. E. O. Williams Phage typing of staphylococci. Bull. W. H. O. 24: Borecka, P., S. Rosypal, R. Patucek, and J. Doskar Localization of prophages of serological group B and F on restriction fragments defined in the restriction map of Staphylococcus aureus NCTC8325. FEMS Microbiol. Lett. 143: Boyce, J. M Are the epidemiology and microbiology of methicillinresistant Staphylococcus aureus changing? JAMA 279: Brakstad, O. D., J. E. Maeland, and Y. Tveten Multiplex polymerase chain reaction for detection of genes for Staphylococcus aureus thermonuclease and methicillin resistance and correlation with oxacillin resistance. APMIS 101: Collignon, P., I. Gosbell, A. Vickery, G. Nimmo, T. Stylianopoulos, and T. Gottleib Community-acquired methicillin-resistant Staphylococcus aureus in Australia. Lancet 352: Coombs, G. W., J. W. Pearman, C. H. Khinsoe, and J. D. Boehm The problems in detecting low-expression-class methicillin resistance in Staphylococcus aureus with batches of Oxoid Mueller-Hinton agar. J. Antimicrob. Chemother. 38: Goering, R. V., and M. A. Winters Rapid method for epidemiological evaluation of gram-positive cocci by field inversion electrophoresis. J. Clin. Microbiol. 30: Goh, S.-H., S. K. Byrne, J. L. Zhang, and A. W. Chow Molecular typing of Staphylococcus aureus on the basis of coagulase gene polymorphisms. J. Clin. Microbiol. 30: Grubb, W. B Molecular epidemiology of methicillin-resistant Staphylococcus aureus, p In R. P. Novick (ed.), Molecular biology of the staphylococci. VCH Publishers, New York, N.Y. 11. Kauffman, C. A., and S. F. Bradley Epidemiology of communityacquired infection, p In K. B. Crossley and G. L. Archer (ed.), The staphylococci in human disease. Churchill Livingstone, New York, N.Y. 12. Maguire, G. P., A. D. Arthur, P. J. Boustead, B. Dwyer, and B. J. Currie Clinical experience and outcomes of community-acquired and nosocomial methicillin-resistant Staphylococcus aureus in a northern Australian hospital. J. Hosp. Infect. 38: Marples, R. R., and S. Reith Epidemic methicillin-resistant Staphylococcus aureus. CDR Weekly 6: Mitchell, J. M., D. MacCullough, and A. J. Morris MRSA in the community. N. Z. Med. J. 109: National Committee for Clinical Laboratory Standards Performance standards for antimicrobial disk susceptibility tests, 6th ed. Approved standard. M2-A6. National Committee for Clinical Laboratory Standards, Villanova, Pa. 16. Pattee, P. A., H. C. Lee, and J. P. Bannantine Genetic and physical mapping of the chromosome of Staphylococcus aureus, p In R. P. Novick (ed.), Molecular biology of the staphylococci. VCH Publishers, New York, N.Y. 17. Pearman, J. W., K. J. Christiansen, D. I. Annear, C. S. Goodwin, C. Metcalf, F. P. Donovan, K. L. Macey, L. D. Bassett, I. M. Powell, J. M. Green, W. E. Harper, and M. S. McKelvie Control of methicillin-resistant Staphylococcus aureus (MRSA) in an Australian metropolitan teaching hospital complex. Med. J. Aust. 142: Pearman, J. W., and W. B. Grubb Preventing the importation and establishment of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals in Western Australia. APUA Newsl. 11(3):1 3, Pearman, J. W., and W. B. Grubb Emerging strains of multiresistant methicillin-resistant Staphylococcus aureus threaten success of screening policy. APUA Newsl. 11(4):1 3, Pearman, J. W., P. L. Perry, G. W. Coombs, R. C. Lee, F. G. O Brien, and W. B. Grubb. Outbreak of a community strain of methicillin-resistant Staphylococcus aureus in a Western Australian metropolitan hospital. Submitted for publication. 21. Perry, P. L., G. W. Coombs, J. D. Boehm, and J. W. Pearman A rapid (20 h) solid screening medium for detecting methicillin-resistant Staphylococcus aureus. J. Hosp. Infect. 40: Riley, D., D. MacCullough, and A. J. Morris Methicillin-resistant S. aureus in the suburbs. N. Z. Med. J. 111: Riley, T. V., J. W. Pearman, and I. L. Rouse Changing epidemiology of methicillin-resistant Staphylococcus aureus in Western Australia. Med. J. Aust. 163: Riley, T. V., and I. L. Rouse Methicillin-resistant Staphylococcus aureus in Western Australia, J. Hosp. Infect. 29: Skull, S. A., V. Krause, G. Coombs, J. W. Pearman, and L. A. Roberts Investigation of a cluster of Staphylococcus aureus invasive infection in the Top End of the Northern Territory. Aust. N. Z. J. Med. 29: Tenover, F. C., R. D. Arbeit, R. V. Goering, P. A. Mickelsen, B. E. Murray, D. H. Persing, and B. Swaminathan Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J. Clin. Microbiol. 33: Townsend, D. E., N. Ashdown, S. Bolton, and W. B. Grubb The use of cetyltrimethylammonium bromide for the isolation from Staphylococcus aureus of relaxable and non-relaxable plasmid DNA for in vitro manipulation. Lett. Appl. Microbiol. 1: Townsend, D. E., N. Ashdown, L. C. Greed, and W. B. Grubb Analysis of plasmids mediating gentamicin resistance in methicillin-resistant Staphylococcus aureus. J. Antimicrob. Chemother. 13: Townsend, D. E., N. Ashdown, J. W. Pearman, D. I. Annear, and W. B. Grubb Genetics and epidemiology of methicillin-resistant Staphylococcus aureus in a Western Australian hospital. Med. J. Aust. 142: Townsend, D. E., W. B. Grubb and N. Ashdown Gentamicin resistance in methicillin-resistant Staphylococcus aureus. Pathology 15: Turnidge, J. D., G. R. Nimmo, and G. Francis Evolution of resistance in Staphylococcus aureus in Australian teaching hospitals. Med. J. Aust. 164: Udo, E. E., J. W. Pearman, and W. B. Grubb Genetic analysis of community isolates of methicillin-resistant Staphylococcus aureus in Western Australia. J. Hosp. Infect. 25: Udo, E. E., J. W. Pearman, and W. B. Grubb Emergence of high-level mupirocin resistance in methicillin-resistant Staphylococcus aureus in Western Australia. J. Hosp. Infect. 26: Vickery, A. M., and M. A. Beard-Pegler Strain differentiation in methicillin-resistant Staphylococcus aureus. Pathology 15: Wei, M. Q., F. Wang, and W. B. Grubb Use of contour-clamped homogeneous electric field (CHEF) electrophoresis to type methicillin-resistant Staphylococcus aureus. J. Med. Microbiol. 36:

Geoffrey Coombs 1, Graeme Nimmo 2, Julie Pearson 1, Samantha Cramer 1 and Keryn Christiansen 1

Geoffrey Coombs 1, Graeme Nimmo 2, Julie Pearson 1, Samantha Cramer 1 and Keryn Christiansen 1 Community Onset MRSA Infections in Australia: A Tale of Two Clones Geoffrey Coombs 1, Graeme Nimmo 2, Julie Pearson 1, Samantha Cramer 1 and Keryn Christiansen 1 Community Associated MRSA First isolated

More information

Int.J.Curr.Microbiol.App.Sci (2018) 7(8):

Int.J.Curr.Microbiol.App.Sci (2018) 7(8): International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 08 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.708.378

More information

Staphylococcus aureus Programme 2007 (SAP 2007) Hospital Survey MRSA Epidemiology and Typing Report

Staphylococcus aureus Programme 2007 (SAP 2007) Hospital Survey MRSA Epidemiology and Typing Report AGAR The Australian Group on Antimicrobial Resistance http://antimicrobial-resistance.com Staphylococcus aureus Programme 2007 (SAP 2007) Hospital Survey MRSA Epidemiology and Typing Report PREPARED BY:

More information

Population dynamics of methicillin-susceptible and -resistant Staphylococcus aureus in remote communities

Population dynamics of methicillin-susceptible and -resistant Staphylococcus aureus in remote communities Journal of Antimicrobial Chemotherapy (2009) 64, 684 693 doi:10.1093/jac/dkp285 Advance Access publication 27 August 2009 Population dynamics of methicillin-susceptible and -resistant Staphylococcus aureus

More information

EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update

EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain

More information

MRSA surveillance 2014: Poultry

MRSA surveillance 2014: Poultry Vicky Jasson MRSA surveillance 2014: Poultry 1. Introduction In the framework of the FASFC surveillance, a surveillance of MRSA in poultry has been executed in order to determine the prevalence and diversity

More information

Methicillin-resistant Staphylococcus aureus (MRSA) on Belgian pig farms

Methicillin-resistant Staphylococcus aureus (MRSA) on Belgian pig farms Methicillinresistant Staphylococcus aureus (MRSA) on Belgian pig farms Dewaele I., De Man I., Stael A., Delputte P., Butaye P., Vlaemynck G., Herman L., Heyndrickx M., Rasschaert G. 1 ILVO: Institute for

More information

Failure of Cloxacillin in a Patient with BORSA Endocarditis ACCEPTED

Failure of Cloxacillin in a Patient with BORSA Endocarditis ACCEPTED JCM Accepts, published online ahead of print on 30 December 2008 J. Clin. Microbiol. doi:10.1128/jcm.00571-08 Copyright 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All

More information

Epidemiology of MRSA in Australia

Epidemiology of MRSA in Australia Epidemiology of MRSA in Australia Graeme R Nimmo Director, Division of Microbiology Pathology Queensland Central Laboratory, Herston QLD 429 Tel: (7) 3636 8 Fax: (7) 3636 1336 Email: Graeme_Nimmo@health.

More information

Detection of Methicillin Resistant Strains of Staphylococcus aureus Using Phenotypic and Genotypic Methods in a Tertiary Care Hospital

Detection of Methicillin Resistant Strains of Staphylococcus aureus Using Phenotypic and Genotypic Methods in a Tertiary Care Hospital International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 7 (2017) pp. 4008-4014 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2017.607.415

More information

Antibiotic-resistant Staphylococcus aureus in dermatology and burn wards

Antibiotic-resistant Staphylococcus aureus in dermatology and burn wards J. clin. Path., 1977, 30, 40-44 Antibiotic-resistant Staphylococcus aureus in dermatology and burn wards G. A. J. AYLIFFE, WENDA GREEN, R. LIVINGSTON, AND E. J. L. LOWBURY From the Hospital Infection Research

More information

Community Acquisition of Gentamicin-Sensitive Methicillin-Resistant Staphylococcus aureus in Southeast Queensland, Australia

Community Acquisition of Gentamicin-Sensitive Methicillin-Resistant Staphylococcus aureus in Southeast Queensland, Australia JOURNAL OF CLINICAL MICROBIOLOGY, Nov. 2000, p. 3926 3931 Vol. 38, No. 11 0095-1137/00/$04.00 0 Copyright 2000, American Society for Microbiology. All Rights Reserved. Community Acquisition of Gentamicin-Sensitive

More information

Detection of inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in a tertiary care hospital

Detection of inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in a tertiary care hospital ISSN: 2319-7706 Volume 3 Number 9 (2014) pp. 689-694 http://www.ijcmas.com Original Research Article Detection of inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in a

More information

Microbiological Surveillance of Methicillin Resistant Staphylococcus aureus (MRSA) in Belgian Hospitals in 2003

Microbiological Surveillance of Methicillin Resistant Staphylococcus aureus (MRSA) in Belgian Hospitals in 2003 Microbiological Surveillance of Methicillin Resistant Staphylococcus aureus (MRSA) in Belgian Hospitals in 3 Final report Olivier Denis and Marc J. Struelens Reference Laboratory for Staphylococci Department

More information

MICRONAUT MICRONAUT-S Detection of Resistance Mechanisms. Innovation with Integrity BMD MIC

MICRONAUT MICRONAUT-S Detection of Resistance Mechanisms. Innovation with Integrity BMD MIC MICRONAUT Detection of Resistance Mechanisms Innovation with Integrity BMD MIC Automated and Customized Susceptibility Testing For detection of resistance mechanisms and specific resistances of clinical

More information

J H Sloos, A M Horrevorts, C P A Van Boven, L Dijkshoorn

J H Sloos, A M Horrevorts, C P A Van Boven, L Dijkshoorn 62 Leiden University Medical Center, Leiden, Netherlands J H Sloos CPAVanBoven L Dijkshoorn Red Cross/Juliana Children s Hospital, The Hague, Netherlands A M Horrevorts Correspondence to: Dr Sloos, Department

More information

Methicillin-Resistant Staphylococcus aureus

Methicillin-Resistant Staphylococcus aureus Methicillin-Resistant Staphylococcus aureus By Karla Givens Means of Transmission and Usual Reservoirs Staphylococcus aureus is part of normal flora and can be found on the skin and in the noses of one

More information

Brief Report THE DEVELOPMENT OF VANCOMYCIN RESISTANCE IN A PATIENT WITH METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTION

Brief Report THE DEVELOPMENT OF VANCOMYCIN RESISTANCE IN A PATIENT WITH METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTION Brief Report THE DEVELOPMENT OF VANCOMYCIN RESISTANCE IN A PATIENT WITH METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTION KRZYSZTOF SIERADZKI, PH.D., RICHARD B. ROBERTS, M.D., STUART W. HABER, M.D.,

More information

ESCMID Online Lecture Library. by author

ESCMID Online Lecture Library. by author Quality Assurance of antimicrobial susceptibility testing Derek Brown EUCAST Scientific Secretary ESCMID Postgraduate Education Course, Linz, 17 September 2014 Quality Assurance The total process by which

More information

Detection and Quantitation of the Etiologic Agents of Ventilator Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran

Detection and Quantitation of the Etiologic Agents of Ventilator Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran Letter to the Editor Detection and Quantitation of the Etiologic Agents of Ventilator Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran Mohammad Rahbar, PhD; Massoud Hajia, PhD

More information

Staphylococcal Cassette Chromosome mec Types and Staphylococcus aureus Isolates from Maharaj Nakorn Chiang Mai Hospital

Staphylococcal Cassette Chromosome mec Types and Staphylococcus aureus Isolates from Maharaj Nakorn Chiang Mai Hospital Staphylococcal Cassette Chromosome mec Types and Antibiogram of Methicillin-Resistant Staphylococcus aureus Isolates from Maharaj Nakorn Chiang Mai Hospital ชน ดของสแตฟฟ ลโลคอคคอล คาสเซทโครโมโซมเมค เมค

More information

Evaluation of a computerized antimicrobial susceptibility system with bacteria isolated from animals

Evaluation of a computerized antimicrobial susceptibility system with bacteria isolated from animals J Vet Diagn Invest :164 168 (1998) Evaluation of a computerized antimicrobial susceptibility system with bacteria isolated from animals Susannah K. Hubert, Phouc Dinh Nguyen, Robert D. Walker Abstract.

More information

Quality assurance of antimicrobial susceptibility testing

Quality assurance of antimicrobial susceptibility testing Quality assurance of antimicrobial susceptibility testing Derek Brown Routine quality control Repeated testing of controls in parallel with tests to ensure that the test system is performing reproducibly

More information

European Antimicrobial Resistance Surveillance System (EARSS) in Scotland: 2004

European Antimicrobial Resistance Surveillance System (EARSS) in Scotland: 2004 European Antimicrobial Resistance Surveillance System (EARSS) in Scotland: 2004 SECOND ANNUAL REPORT MJ Coyne 1, SJ Dancer 1, G Edwards 2, 3, D Morrison 2. 1 Health Protection Scotland, 2 Scottish MRSA

More information

January 2014 Vol. 34 No. 1

January 2014 Vol. 34 No. 1 January 2014 Vol. 34 No. 1. and Minimum Inhibitory Concentration (MIC) Interpretive Standards for Testing Conditions Medium: diffusion: Mueller-Hinton agar (MHA) Broth dilution: cation-adjusted Mueller-Hinton

More information

Staphylococcus aureus Programme 2012 (SAP 2012) Community Survey MRSA Epidemiology and Typing Report

Staphylococcus aureus Programme 2012 (SAP 2012) Community Survey MRSA Epidemiology and Typing Report Staphylococcus aureus Programme 2012 (SAP 2012) Community Survey MRSA Epidemiology and Typing Report PREPARED BY: Dr Geoffrey Coombs Department of Microbiology and Infectious Diseases, PathWest Laboratory

More information

Methicillin-resistant coagulase-negative staphylococci Methicillin-resistant. spa Staphylococcus aureus

Methicillin-resistant coagulase-negative staphylococci Methicillin-resistant. spa Staphylococcus aureus 126 2005 Methicillin-resistant coagulase-negative staphylococci Methicillin-resistant Staphylococcus aureus 1) 1) 1) 1) 1) 2) 3) 4) 2) 1) MBC 2) 3) 4) 17 3 28 17 8 22 Methicillin-resistant Staphylococcus

More information

PILOT STUDY OF THE ANTIMICROBIAL SUSCEPTIBILITY OF SHIGELLA IN NEW ZEALAND IN 1996

PILOT STUDY OF THE ANTIMICROBIAL SUSCEPTIBILITY OF SHIGELLA IN NEW ZEALAND IN 1996 PILOT STUDY OF THE ANTIMICROBIAL SUSCEPTIBILITY OF SHIGELLA IN NEW ZEALAND IN 996 November 996 by Maggie Brett Antibiotic Reference Laboratory ESR Communicable Disease Centre Porirua CONTENTS Page SUMMARY

More information

Staphylococcus aureus

Staphylococcus aureus J. clin. Path., 197, 23, 19-23 Stability of neomycin resistance in Staphylococcus aureus G. A. J. AYLIFFE From the Hospital Infection Research Laboratory, Summerfield Hospital, Birmingham SYNOPSIS A strain

More information

Christiane Gaudreau* and Huguette Gilbert

Christiane Gaudreau* and Huguette Gilbert Journal of Antimicrobial Chemotherapy (1997) 39, 707 712 JAC Comparison of disc diffusion and agar dilution methods for antibiotic susceptibility testing of Campylobacter jejuni subsp. jejuni and Campylobacter

More information

European Committee on Antimicrobial Susceptibility Testing

European Committee on Antimicrobial Susceptibility Testing European Committee on Antimicrobial Susceptibility Testing Routine and extended internal quality control as recommended by EUCAST Version 5.0, valid from 015-01-09 This document should be cited as "The

More information

ORIGINAL ARTICLE /j x. University, Göteborg, Sweden

ORIGINAL ARTICLE /j x. University, Göteborg, Sweden ORIGINAL ARTICLE 10.1111/j.1469-0691.2004.01002.x Antibiotic resistance in Staphylococcus aureus colonising the intestines of Swedish infants E. Lindberg 1,2, I. Adlerberth 1 and A. E. Wold 1 1 Department

More information

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST Help with moving disc diffusion methods from BSAC to EUCAST This document sets out the main differences between the BSAC and EUCAST disc diffusion methods with specific emphasis on preparation prior to

More information

Methicillin-Resistant Staphylococcus aureus Outbreak in a Veterinary Teaching Hospital: Potential Human-to-Animal Transmission

Methicillin-Resistant Staphylococcus aureus Outbreak in a Veterinary Teaching Hospital: Potential Human-to-Animal Transmission JOURNAL OF CLINICAL MICROBIOLOGY, May 1999, p. 1459 1463 Vol. 37, No. 5 0095-1137/99/$04.00 0 Copyright 1999, American Society for Microbiology. All Rights Reserved. Methicillin-Resistant Staphylococcus

More information

National MRSA Reference Laboratory

National MRSA Reference Laboratory Author: Gráinne Brennan Date: 23/02/2017 Date of Issue: 23/02/2017 National MRSA Reference Laboratory User s Manual NMRSARL Users Manual Page 1 of 12 Table of Contents Page 1. Location... 3 2. Contact

More information

Blake W. Buchan, PhD, 1 and Nathan A. Ledeboer, PhD, D(ABMM) 1,2. Abstract

Blake W. Buchan, PhD, 1 and Nathan A. Ledeboer, PhD, D(ABMM) 1,2. Abstract Microbiology and Infectious Disease / Borderline Resistant Strains of S AUREUS Identification of Two Borderline Oxacillin-Resistant Strains of Staphylococcus aureus From Routine Nares Swab Specimens by

More information

RESISTANCE OF STAPHYLOCOCCUS AUREUS TO VANCOMYCIN IN ZARQA, JORDAN

RESISTANCE OF STAPHYLOCOCCUS AUREUS TO VANCOMYCIN IN ZARQA, JORDAN RESISTANCE OF STAPHYLOCOCCUS AUREUS TO VANCOMYCIN IN ZARQA, JORDAN Hussein Azzam Bataineh 1 ABSTRACT Background: Vancomycin has been widely used in the treatment of infections caused by Methicillin-Resistant

More information

Consequences of Antimicrobial Resistant Bacteria. Antimicrobial Resistance. Molecular Genetics of Antimicrobial Resistance. Topics to be Covered

Consequences of Antimicrobial Resistant Bacteria. Antimicrobial Resistance. Molecular Genetics of Antimicrobial Resistance. Topics to be Covered Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of empiric antimicrobial therapy Increased number of hospitalizations Increased length

More information

MID 23. Antimicrobial Resistance. Consequences of Antimicrobial Resistant Bacteria. Molecular Genetics of Antimicrobial Resistance

MID 23. Antimicrobial Resistance. Consequences of Antimicrobial Resistant Bacteria. Molecular Genetics of Antimicrobial Resistance Antimicrobial Resistance Molecular Genetics of Antimicrobial Resistance Micro evolutionary change - point mutations Beta-lactamase mutation extends spectrum of the enzyme rpob gene (RNA polymerase) mutation

More information

Antimicrobial Resistance

Antimicrobial Resistance Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of empiric antimicrobial therapy Increased number of hospitalizations Increased length

More information

Antimicrobial Resistance Acquisition of Foreign DNA

Antimicrobial Resistance Acquisition of Foreign DNA Antimicrobial Resistance Acquisition of Foreign DNA Levy, Scientific American Horizontal gene transfer is common, even between Gram positive and negative bacteria Plasmid - transfer of single or multiple

More information

Evaluation of MicroScan MIC Panels for Detection of

Evaluation of MicroScan MIC Panels for Detection of JOURNAL OF CLINICAL MICROBIOLOGY, May 1988, p. 816-820 Vol. 26, No. 5 0095-1137/88/050816-05$02.00/0 Copyright 1988, American Society for Microbiology Evaluation of MicroScan MIC Panels for Detection of

More information

Tel: Fax:

Tel: Fax: CONCISE COMMUNICATION Bactericidal activity and synergy studies of BAL,a novel pyrrolidinone--ylidenemethyl cephem,tested against streptococci, enterococci and methicillin-resistant staphylococci L. M.

More information

European Committee on Antimicrobial Susceptibility Testing

European Committee on Antimicrobial Susceptibility Testing European Committee on Antimicrobial Susceptibility Testing Routine and extended internal quality control for MIC determination and disk diffusion as recommended by EUCAST Version 8.0, valid from 018-01-01

More information

North West Neonatal Operational Delivery Network Working together to provide the highest standard of care for babies and families

North West Neonatal Operational Delivery Network Working together to provide the highest standard of care for babies and families Document Title and Reference : Guideline for the management of multi-drug resistant organisms (MDRO) Main Author (s) Simon Power Ratified by: GM NSG Date Ratified: February 2012 Review Date: March 2017

More information

Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2008

Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2008 Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2008 Each year ESR conducts a one-month survey of methicillin-resistant Staphylococcus aureus (MRSA) to provide ongoing information

More information

Acquisition of antibiotic resistance by

Acquisition of antibiotic resistance by Acquisition of antibiotic resistance by Staphylococcus aureus in skin patients JAY NAIDOO AND W. C. NOBLE Journal of Clinical Pathology, 1978, 31, 1187-1192 From the Department of Bacteriology, Institute

More information

of Staphylococcus aureus

of Staphylococcus aureus APPLIED MICROBTOLOGY, Dec. 97, p. -7 Copyright ( 97 American Society for Microbiology Vol., No. 6. Printed in U.S.A. Bacteriophage Types and Antibiotic Susceptibility of Staphylococcus aureus J. KLASTERSKY,

More information

Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2015

Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2015 Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2015 Helen Heffernan and Sarah Bakker Nosocomial Infections Laboratory, Institute of Environmental Science and Research Limited (ESR);

More information

Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance. evolution of antimicrobial resistance

Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance. evolution of antimicrobial resistance Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance evolution of antimicrobial resistance Mechanism of bacterial genetic variability Point mutations may occur in a nucleotide base pair,

More information

*Corresponding Author:

*Corresponding Author: Original Research Article DOI: 10.18231/2394-5478.2017.0098 Prevalence and factors associated with the nasal colonization of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus among

More information

Antimicrobial susceptibility testing of Campylobacter jejuni and C. coli

Antimicrobial susceptibility testing of Campylobacter jejuni and C. coli Antimicrobial susceptibility testing of Campylobacter jejuni and C. coli CRL Campylobacter Workshop The 7th -8th of Oct. 2008 National Veterinary Institute Uppsala, Sweden Legislation The Commission has

More information

Nature and Science, 5(3), 2007, Olowe, Eniola, Olowe, Olayemi. Antimicrobial Susceptibility and Betalactamase detection of MRSA in Osogbo.

Nature and Science, 5(3), 2007, Olowe, Eniola, Olowe, Olayemi. Antimicrobial Susceptibility and Betalactamase detection of MRSA in Osogbo. Antimicrobial Susceptibility and Beta-lactamase Olowe O.A., Eniola K.I.T., Olowe R.A., Olayemi A.B Olowe O.A: Department of Medical Microbiology and Parasitology, P.M.B. 4400. Ladoke Akintola University

More information

Determination of antibiotic sensitivities by the

Determination of antibiotic sensitivities by the Journal of Clinical Pathology, 1978, 31, 531-535 Determination of antibiotic sensitivities by the Sensititre system IAN PHILLIPS, CHRISTINE WARREN, AND PAMELA M. WATERWORTH From the Department of Microbiology,

More information

Molecular epidemiology of community-acquired methicillin-resistant Staphylococcus aureus bacteremia in a teaching hospital

Molecular epidemiology of community-acquired methicillin-resistant Staphylococcus aureus bacteremia in a teaching hospital Epidemiology J Microbiol Immunol of MRSA Infect. bacteremia 2007;40:310-316 Molecular epidemiology of community-acquired methicillin-resistant Staphylococcus aureus bacteremia in a teaching hospital Chih-Yu

More information

Antibiotic Susceptibility Pattern of Vibrio cholerae Causing Diarrohea Outbreaks in Bidar, North Karnataka, India

Antibiotic Susceptibility Pattern of Vibrio cholerae Causing Diarrohea Outbreaks in Bidar, North Karnataka, India International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 4 Number 9 (2015) pp. 957-961 http://www.ijcmas.com Original Research Article Antibiotic Susceptibility Pattern

More information

Community-onset Staphylococcus aureus infections presenting to general practices in South-eastern Australia

Community-onset Staphylococcus aureus infections presenting to general practices in South-eastern Australia Epidemiol. Infect. (2014), 142, 501 511. Cambridge University Press 2013 doi:10.1017/s0950268813001581 Community-onset Staphylococcus aureus infections presenting to general practices in South-eastern

More information

SCOTTISH MRSA REFERENCE LABORATORY

SCOTTISH MRSA REFERENCE LABORATORY Title SCOTTISH MRSA REFERENCE LABORATORY LABORATORY PROCEDURE NUMBER / VERSION User Manual DATE OF ISSUE 17/05/2014 REVIEW INTERVAL AUTHORISED BY AUTHOR 2 Years Dr. B. Jones B. Cosgrove COPY 1 of 1 Master

More information

56 Clinical and Laboratory Standards Institute. All rights reserved.

56 Clinical and Laboratory Standards Institute. All rights reserved. Table 2C 56 Clinical and Laboratory Standards Institute. All rights reserved. Table 2C. Zone Diameter and Minimal Inhibitory Concentration Breakpoints for Testing Conditions Medium: Inoculum: diffusion:

More information

aureus isolated from hospital inpatients, 2009:

aureus isolated from hospital inpatients, 2009: Antibiotic susceptibility of Staphylococcus aureus, 2009 Antimicrobial susceptibility of Staphylococcus aureus isolated from hospital inpatients, 2009: Report from the Australian Group on Antimicrobial

More information

STAPHYLOCOCCI: KEY AST CHALLENGES

STAPHYLOCOCCI: KEY AST CHALLENGES Romney Humphries, PhD D(ABMM) Section Chief, UCLA Clinical Microbiology Los Angeles CA rhumphries@mednet.ucla.edu STAPHYLOCOCCI: KEY AST CHALLENGES THE CHALLENGES detection of penicillin resistance detection

More information

Lab Exercise: Antibiotics- Evaluation using Kirby Bauer method.

Lab Exercise: Antibiotics- Evaluation using Kirby Bauer method. Lab Exercise: Antibiotics- Evaluation using Kirby Bauer method. OBJECTIVES 1. Compare the antimicrobial capabilities of different antibiotics. 2. Compare effectiveness of with different types of bacteria.

More information

against Clinical Isolates of Gram-Positive Bacteria

against Clinical Isolates of Gram-Positive Bacteria ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Feb. 993, p. 366-370 Vol. 37, No. 0066-0/93/00366-05$0.00/0 Copyright 993, American Society for Microbiology In Vitro Activity of CP-99,9, a New Fluoroquinolone,

More information

Active Bacterial Core Surveillance Site and Epidemiologic Classification, United States, 2005a. Copyright restrictions may apply.

Active Bacterial Core Surveillance Site and Epidemiologic Classification, United States, 2005a. Copyright restrictions may apply. Impact of routine surgical ward and intensive care unit admission surveillance cultures on hospital-wide nosocomial methicillin-resistant Staphylococcus aureus infections in a university hospital: an interrupted

More information

Routine internal quality control as recommended by EUCAST Version 3.1, valid from

Routine internal quality control as recommended by EUCAST Version 3.1, valid from Routine internal quality control as recommended by EUCAST Version.1, valid from 01-01-01 Escherichia coli Pseudomonas aeruginosa Staphylococcus aureus Enterococcus faecalis Streptococcus pneumoniae Haemophilus

More information

Staphylococcus aureus Programme 2008 (SAP 2008) Community Survey Antimicrobial Susceptibility Report

Staphylococcus aureus Programme 2008 (SAP 2008) Community Survey Antimicrobial Susceptibility Report AGAR The Australian Group on Antimicrobial Resistance http://antimicrobial-resistance.com Staphylococcus aureus Programme 2008 (SAP 2008) Community Survey Antimicrobial Susceptibility Report PREPARED BY:

More information

SCOTTISH MRSA REFERENCE LABORATORY

SCOTTISH MRSA REFERENCE LABORATORY Title SCOTTISH MRSA REFERENCE LABORATORY LABORATORY PROCEDURE NUMBER / VERSION User Manual DATE OF ISSUE 20/01/2017 REVIEW INTERVAL AUTHORISED BY AUTHOR 1 Year Dr. B. Jones Dr E. Dickson COPY 1 of 1 Master

More information

Quality Control Testing with the Disk Antibiotic Susceptibility Test of Bauer-Kirby-Sherris-Turck

Quality Control Testing with the Disk Antibiotic Susceptibility Test of Bauer-Kirby-Sherris-Turck Quality Control Testing with the Disk Antibiotic Susceptibility Test of Bauer-Kirby-Sherris-Turck DONNA J. BLAZEVIC, M.P.H., MARILYN H. KOEPCKE, B.S., A JOHN M. MATSEN, M.D. Departments of Laboratory Medicine

More information

Characterisation of Staphylococcus aureus nasal and skin carriage among patients undergoing haemodialysis treatment

Characterisation of Staphylococcus aureus nasal and skin carriage among patients undergoing haemodialysis treatment NEW MICROBIOLOGICA, 30, 149-154, 2007 Characterisation of Staphylococcus aureus nasal and skin carriage among patients undergoing haemodialysis treatment Agnieszka Bogut 1, Maria Kozioł-Montewka 1, Iwona

More information

Antimicrobial Resistance

Antimicrobial Resistance Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of Change in the approach to the administration of empiric antimicrobial therapy Increased

More information

Eradicating Carrier State of Methicillin-Resistant Staphylococcus

Eradicating Carrier State of Methicillin-Resistant Staphylococcus ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Sept. 1990, p. 1655-1659 0066-4804/90/091655-05$02.00/0 Copyright 1990, American Society for Microbiology Vol. 34, No. 9 Efficacy of Short Courses of Oral Novobiocin-Rifampin

More information

Gram-positive cocci Staphylococci and Streptococcia

Gram-positive cocci Staphylococci and Streptococcia Medical microbiology Laboratory Lab 8 Gram-positive cocci Staphylococci and Streptococcia Lecturer Maysam A Mezher Gram positive cocci 1-Staphylococcus. 2-Streptococcus. 3-Micrococcus The medically important

More information

Performance Information. Vet use only

Performance Information. Vet use only Performance Information Vet use only Performance of plates read manually was measured in three sites. Each centre tested Enterobacteriaceae, streptococci, staphylococci and pseudomonas-like organisms.

More information

Methicillin and Clindamycin resistance in biofilm producing staphylococcus aureus isolated from clinical specimens

Methicillin and Clindamycin resistance in biofilm producing staphylococcus aureus isolated from clinical specimens Original article Methicillin and Clindamycin resistance in biofilm producing staphylococcus aureus isolated from clinical specimens Pankaj A. Joshi, Dhruv K.Mamtora,. Neeta PJangale., Meena N.Ramteerthakar,

More information

Volume-7, Issue-2, April-June-2016 Coden IJABFP-CAS-USA Received: 5 th Mar 2016 Revised: 11 th April 2016 Accepted: 13 th April 2016 Research article

Volume-7, Issue-2, April-June-2016 Coden IJABFP-CAS-USA Received: 5 th Mar 2016 Revised: 11 th April 2016 Accepted: 13 th April 2016 Research article Volume-7, Issue-2, April-June-2016 Coden IJABFP-CAS-USA Copyrights@2016 Received: 5 th Mar 2016 Revised: 11 th April 2016 Accepted: 13 th April 2016 Research article A STUDY ON ANTIBIOTIC SUSCEPTIBILITY

More information

CHAPTER 1 INTRODUCTION

CHAPTER 1 INTRODUCTION 1 CHAPTER 1 INTRODUCTION The Staphylococci are a group of Gram-positive bacteria, 14 species are known to cause human infections but the vast majority of infections are caused by only three of them. They

More information

Microbiology : antimicrobial drugs. Sheet 11. Ali abualhija

Microbiology : antimicrobial drugs. Sheet 11. Ali abualhija Microbiology : antimicrobial drugs Sheet 11 Ali abualhija return to our topic antimicrobial drugs, we have finished major group of antimicrobial drugs which associated with inhibition of protein synthesis

More information

BMR Microbiology. Research Article

BMR Microbiology. Research Article www.advancejournals.org Open Access Scientific Publisher Research Article A STUDY OF METICILLIN RESISTANT PATTERN ON CLINICAL ISOLATES OF Staphylococcus aureus IN TERTIARY CARE HOSPITALS OF POKHARA Suresh

More information

Prevalence of Metallo-Beta-Lactamase Producing Pseudomonas aeruginosa and its antibiogram in a tertiary care centre

Prevalence of Metallo-Beta-Lactamase Producing Pseudomonas aeruginosa and its antibiogram in a tertiary care centre International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 4 Number 9 (2015) pp. 952-956 http://www.ijcmas.com Original Research Article Prevalence of Metallo-Beta-Lactamase

More information

Antimicrobial susceptibility testing of Campylobacter jejuni and C. coli. CRL Training course in AST Copenhagen, Denmark 23-27th Feb.

Antimicrobial susceptibility testing of Campylobacter jejuni and C. coli. CRL Training course in AST Copenhagen, Denmark 23-27th Feb. Antimicrobial susceptibility testing of Campylobacter jejuni and C. coli CRL Training course in AST Copenhagen, Denmark 23-27th Feb. 2009 Methodologies E-test by AB-biodisk A dilution test based on the

More information

Int.J.Curr.Microbiol.App.Sci (2018) 7(1):

Int.J.Curr.Microbiol.App.Sci (2018) 7(1): International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 01 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.701.080

More information

Prevalence and Drug Resistance Patterns of Staphylococcus Aureus in Lactating Dairy Cow s Milk in Wolayta Sodo, Ethiopia

Prevalence and Drug Resistance Patterns of Staphylococcus Aureus in Lactating Dairy Cow s Milk in Wolayta Sodo, Ethiopia Cronicon OPEN ACCESS EC VETERINARY SCIENCE Research Article Prevalence and Drug Resistance Patterns of Staphylococcus Aureus in Lactating Dairy Cow s Milk in Wolayta Sodo, Ethiopia Fitsum Tessema* Areka

More information

EUCAST recommended strains for internal quality control

EUCAST recommended strains for internal quality control EUCAST recommended strains for internal quality control Escherichia coli Pseudomonas aeruginosa Staphylococcus aureus Enterococcus faecalis Streptococcus pneumoniae Haemophilus influenzae ATCC 59 ATCC

More information

WHY IS THIS IMPORTANT?

WHY IS THIS IMPORTANT? CHAPTER 20 ANTIBIOTIC RESISTANCE WHY IS THIS IMPORTANT? The most important problem associated with infectious disease today is the rapid development of resistance to antibiotics It will force us to change

More information

Antimicrobial Resistance and Molecular Epidemiology of Staphylococcus aureus in Ghana

Antimicrobial Resistance and Molecular Epidemiology of Staphylococcus aureus in Ghana Antimicrobial Resistance and Molecular Epidemiology of Staphylococcus aureus in Ghana Beverly Egyir, PhD Noguchi Memorial Institute for Medical Research Bacteriology Department, University of Ghana Background

More information

Changing epidemiology of methicillin-resistant Staphylococcus aureus colonization in paediatric intensive-care units

Changing epidemiology of methicillin-resistant Staphylococcus aureus colonization in paediatric intensive-care units Washington University School of Medicine Digital Commons@Becker Open Access Publications 2012 Changing epidemiology of methicillin-resistant Staphylococcus aureus colonization in paediatric intensive-care

More information

Decrease of vancomycin resistance in Enterococcus faecium from bloodstream infections in

Decrease of vancomycin resistance in Enterococcus faecium from bloodstream infections in AAC Accepted Manuscript Posted Online 30 March 2015 Antimicrob. Agents Chemother. doi:10.1128/aac.00513-15 Copyright 2015, American Society for Microbiology. All Rights Reserved. 1 2 Decrease of vancomycin

More information

Utilization of PFGE as a Powerful Discriminative Tool for the Investigation of Genetic Diversity among MRSA Strains

Utilization of PFGE as a Powerful Discriminative Tool for the Investigation of Genetic Diversity among MRSA Strains Iran J Public Health, Vol. 46, No.3, Mar 2017, pp.351-356 Original Article Utilization of PFGE as a Powerful Discriminative Tool for the Investigation of Genetic Diversity among MRSA Strains Solmaz OHADIAN

More information

Burn Infection & Laboratory Diagnosis

Burn Infection & Laboratory Diagnosis Burn Infection & Laboratory Diagnosis Introduction Burns are one the most common forms of trauma. 2 million fires each years 1.2 million people with burn injuries 100000 hospitalization 5000 patients die

More information

Isolation of MRSA from the Oral Cavity of Companion Dogs

Isolation of MRSA from the Oral Cavity of Companion Dogs InfectionControl.tips Join. Contribute. Make A Difference. https://infectioncontrol.tips Isolation of MRSA from the Oral Cavity of Companion Dogs By: Thomas L. Patterson, Alberto Lopez, Pham B Reviewed

More information

There are two international organisations that set up guidelines and interpretive breakpoints for bacteriology and susceptibility

There are two international organisations that set up guidelines and interpretive breakpoints for bacteriology and susceptibility ANTIMICROBIAL SUSCEPTIBILITY TESTING ON MILK SAMPLES Method and guidelines There are two international organisations that set up guidelines and interpretive breakpoints for bacteriology and susceptibility

More information

Antibiotic Reference Laboratory, Institute of Environmental Science and Research Limited (ESR); August 2017

Antibiotic Reference Laboratory, Institute of Environmental Science and Research Limited (ESR); August 2017 Antimicrobial susceptibility of Shigella, 2015 and 2016 Helen Heffernan and Rosemary Woodhouse Antibiotic Reference Laboratory, Institute of Environmental Science and Research Limited (ESR); August 2017

More information

Identification of Methicillin Resistant Staphylococcus aureus

Identification of Methicillin Resistant Staphylococcus aureus American Journal of Infectious Diseases 4 (2): 156-161, 2008 ISSN 1553-6203 2008 Science Publications Identification of Methicillin Resistant Staphylococcus aureus (MRSA) and Methicillin Resistant Coagulase-Negative

More information

Clonal dissemination of epidemic methicillin-resistant Staphylococcus aureus in Belgium and neighboring countries

Clonal dissemination of epidemic methicillin-resistant Staphylococcus aureus in Belgium and neighboring countries ORIGINAL ARTICLE Clonal dissemination of epidemic methicillin-resistant Staphylococcus aureus in Belgium and neighboring countries A. Deplano 1, W. Witte 2, W. J. Van Leeuwen 3, Y. Brun 4 and M. J. Struelens

More information

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University

More information

Staphylococcus aureus nasal carriage in diabetic patients in a tertiary care hospital

Staphylococcus aureus nasal carriage in diabetic patients in a tertiary care hospital Available online at www.scholarsresearchlibrary.com Scholars Research Library Der Pharmacia Lettre, 15, 7 (7):23-28 (http://scholarsresearchlibrary.com/archive.html) ISSN 0975-5071 USA CODEN: DPLEB4 Staphylococcus

More information

An Approach to Linezolid and Vancomycin against Methicillin Resistant Staphylococcus Aureus

An Approach to Linezolid and Vancomycin against Methicillin Resistant Staphylococcus Aureus Article ID: WMC00590 ISSN 2046-1690 An Approach to Linezolid and Vancomycin against Methicillin Resistant Staphylococcus Aureus Author(s):Dr. K P Ranjan, Dr. D R Arora, Dr. Neelima Ranjan Corresponding

More information

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine 2012 ANTIBIOGRAM Central Zone Former DTHR Sites Department of Pathology and Laboratory Medicine Medically Relevant Pathogens Based on Gram Morphology Gram-negative Bacilli Lactose Fermenters Non-lactose

More information

Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2014

Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2014 Annual survey of methicillin-resistant Staphylococcus aureus (MRSA), 2014 Helen Heffernan, Sarah Bakker, Kristin Dyet, Deborah Williamson Nosocomial Infections Laboratory, Institute of Environmental Science

More information

Scholars Research Library

Scholars Research Library Journal of Microbiology and Biotechnology Research Scholars Research Library J. Microbiol. Biotech. Res., 2012, 2 (2):258-264 (http://scholarsresearchlibrary.com/archive.html) ISSN : 2231 3168 CODEN (USA)

More information