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Rev. Soc. Bras. Med. Trop ; 49(1): 51-56, Jan.-Feb. 2016. graf
Article Dans Anglais | LILACS | ID: lil-776534

Résumé

Abstract INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.


Sujets)
Humains , Infections à staphylocoques , Infections à VIH/microbiologie , Infection croisée/transmission , Transmission de maladie infectieuse du professionnel de santé au patient/statistiques et données numériques , Staphylococcus aureus résistant à la méticilline/génétique , Antibactériens/pharmacologie , Infections à staphylocoques/microbiologie , Tests de sensibilité microbienne , Infection croisée/microbiologie , Techniques de typage bactérien , Électrophorèse en champ pulsé , Épidémiologie moléculaire , Staphylococcus aureus résistant à la méticilline/isolement et purification , Typage par séquençage multilocus , Centres de soins tertiaires
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