Vancomycin heteroresistant community associated methicillin-resistant Staphylococcus aureus ST72-SCCmecIVa strain colonizing the nostrils of a five-year-old Spanish girl / Cepa de Staphylococcus aureus ST72-SCCmecIVa comunitaria, resistente a meticilina y heterorresistente a vancomicina, colonizadora de las fosas nasales de una niña española de 5 años de edad

BACKGROUND AND OBJECTIVES: During a community methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization study, an MRSA strain with vancomycin hetero-resistance (h-VISA) was isolated from a five year-old girl with tetralogy of Fallot without previous exposure to vancomycin. An extended nasal colonization study was performed on all her close relatives. RESULTS: Only the patient and her sister were colonized by an h-VISA MRSA strain (clone USA 700, ST72, t148, agr 1 and SCCmec IVa). Mupirocin decolonisation was effective in the elder sister. A new nasal decolonisation in the younger girl using fusidic acid was also successful. However, after decolonisation both sisters were colonized by a methicillin-susceptible S. aureus (ST30, t012 and agr 3) previously isolated from their mother's nostrils. CONCLUSION: As S. aureus have a great capacity to spread among people in close contact, knowledge of a patients' colonization status, tracing contacts, and a correct management are critical issues for the successful containment of multiresistant staphylococcio

FUNDAMENTO Y OBJETIVO: Durante un estudio comunitario de colonización nasal, hemos aislado Staphylococcus aureus resistente a la meticilina (SARM) con heterorresistencia a vancomicina (hVISA) en una niña de 5 años, que padecía una tetralogía de Fallot, que no había sido tratada previamente con vancomicina. RESULTADOS: Este hallazgo nos llevó a extender el estudio de colonización a sus familiares más cercanos. De estos, solo su hermana mayor fue colonizada por esta cepa SARM hVISA (clon USA 700, ST72, t148, agr 1 y SCCmecIVa). La descolonización con mupirocina fue eficaz en el caso de la hermana, pero un tratamiento con ácido fusídico fue necesario para eliminar la colonización nasal de la paciente. Sin embargo, después de la descolonización, ambas hermanas fueron colonizadas por una cepa de S. aureus sensible a meticilina (ST30, t012 y agr 3), que previamente había sido aislada de las fosas nasales de su madre. CONCLUSIÓN: S. aureus tiene una gran capacidad de diseminación entre personas en estrecho contacto, por lo que el conocimiento del estado de colonización de los pacientes, la evaluación de la colonización nasal de los contactos y una aproximación terapéutica correcta son esenciales para la contención de la diseminación de cepas de estafilococos multirresistentes

Detection and characterization of surface microbial contamination in emergency ambulances.

A cross-sectional study was performed in 10 emergency basic life support ambulances operating in Bilbao, Spain, to assess surface bacterial contamination. Presence of clinically relevant bacterial contamination suggests that disinfection of the studied basic life support ambulances was not optimal and represents a potential risk of infection for the patients transferred in them. It is critical to implement existing infection control and prevention protocols to resolve this issue.

Vancomycin heteroresistant community associated methicillin-resistant Staphylococcus aureus ST72-SCCmecIVa strain colonizing the nostrils of a five-year-old Spanish girl.

BACKGROUND AND OBJECTIVES: During a community methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization study, an MRSA strain with vancomycin hetero-resistance (h-VISA) was isolated from a five year-old girl with tetralogy of Fallot without previous exposure to vancomycin. An extended nasal colonization study was performed on all her close relatives. RESULTS: Only the patient and her sister were colonized by an h-VISA MRSA strain (clone USA 700, ST72, t148, agr 1 and SCCmec IVa). Mupirocin decolonisation was effective in the elder sister. A new nasal decolonisation in the younger girl using fusidic acid was also successful. However, after decolonisation both sisters were colonized by a methicillin-susceptible S. aureus (ST30, t012 and agr 3) previously isolated from their mother's nostrils. CONCLUSION: As S. aureus have a great capacity to spread among people in close contact, knowledge of a patients' colonization status, tracing contacts, and a correct management are critical issues for the successful containment of multiresistant staphylococci.

Caries and Candida colonisation in adult patients in Basque Country (Spain).

Candida albicans is one of the most frequent pathogens of the oral cavity, as a major cause of opportunistic disease. Moreover, Candida could be a cofactor of common oral diseases, such as dental caries. The aim of this study was to analyse the oral yeast colonisation in adults with dental caries and to evaluate its relationship with this clinical entity. We studied 190 patients distributed into controls (58 patients) and patients with caries (132 patients). Oral samples were collected by oral rinse and cultured in a chromogenic agar. C. albicans was the most prevalent species isolated from oral specimens in both groups. Patients with caries had a greater Candida colonisation (74 patients, 56.1%), than persons without caries (18 patients, 31%, P < 0.01). Patients with caries were significantly more colonised by non-C. albicans species than individuals without caries (P = 0.006). Moreover, the diversity of Candida species was richer in patients suffering from caries. The odds ratio of the colonisation of patients with caries was 3.144 (95% CI 1.525-5.478). There is a significant clinical correlation between dental caries and oral Candida colonisation in adults.