title: Staphylococcus aureus as source of catheter-related bloodstream infection evaluated by PFGE and rep-PCR typing in a Brazilian hospital.
abstract: Staphylococci are a common cause of catheter-related bloodstream infection (CR-BSI), and epidemiological typing is an important tool for effective infection control. This study evaluated by PFGE and rep-PCR whether Staphylococcus aureus strains isolated from skin and catheter tips were related to specimens isolated from blood. A prospective observational study, carried out in a clinical surgical ward at a Brazilian hospital between September 2000 and November 2002, investigated non-tunneled central venous catheters from 179 patients. S. aureus isolates were mainly obtained from blood (41.4%), while coagulase-negative staphylococci strains were more often isolated from the skin at the catheter insertion site (49.7%) and from the catheter tip (57.5%). Among the 21 strains isolated from 9 patients at 2 or 3 sites simultaneously, 9 were methicillin-resistant S. aureus (MRSA) and 12 were methicillin-susceptible S. aureus (MSSA). Seven patients harbored the same S. aureus strain isolated from the skin, blood and/or catheter tip cultures. MRSA isolates belonged to one PFGE pattern (type A- subtypes A(1), A(2) and A(3)), and to two rep-PCR patterns (a and b). MSSA isolates were distinguished in five PFGE (B to F) and in three rep-PCR (c, d and e) patterns. Both PFGE and rep-PCR methods indicated that the skin at the catheter insertion site was the origin of CR-BSI caused by S. aureus.
authors.affiliation: Laboratório de Microbiologia, Area de Imunologia, Microbiologia e Parasitologia, Universidade Federal de Uberlândia, Minas Gerais, Brazil.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Sadoyama
authors.forename: Kátia Regina Netto Dos
authors.initials: KR
authors.lastname: Santos
authors.forename: Anike Pereira
authors.initials: AP
authors.lastname: Brilhante
authors.forename: Paulo Pinto Gontijo
authors.initials: PP
authors.lastname: Filho
mesh_terms: D016470:Bacteremia / Q000382:microbiology; D015373:Bacterial Typing Techniques; D001938:Brazil / Q000453:epidemiology; D002404:Catheterization / Q000009:adverse effects; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003030:Coagulase; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D004866:Equipment Contamination; D006801:Humans; D007362:Intensive Care Units; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D003030:Coagulase