Usefulness of antimicrobial resistance pattern for detecting PVL- or TSST-1-producing meticillin-resistant Staphylococcus aureus in a French university hospital.
Several recent reports have suggested that community-associated meticillin-resistant Staphylococcus aureus (MRSA) clones, particularly those harbouring genes for Panton-Valentine leukocidin (PVL) or toxic shock syndrome toxin 1 (TSST-1), are increasingly responsible for infections in hospitals. Here, a retrospective study was carried out to investigate whether antimicrobial resistance patterns could be used to detect these pathogens in a French university hospital. Isolates were characterized by antimicrobial susceptibility testing, PCR profiling (PVL genes and tst), PFGE typing and multilocus sequence typing. Demographic and clinical data were collected from all patients. For PVL-positive MRSA, the typical antimicrobial resistance pattern (susceptible to fluoroquinolones, non-susceptible to fusidic acid, kanamycin resistant and susceptible to gentamicin and tobramycin) had a sensitivity of 77.8 % and a positive predictive value (PPV) of 100 %. For tst-positive MRSA, the antimicrobial resistance pattern (susceptible to fluoroquinolones and non-susceptible to fusidic acid) had a sensitivity of 100 % and a PPV of 72.4 %. These results suggest that phenotypic rules based on antimicrobial resistance patterns are potentially useful for the detection of PVL- and tst-positive MRSA isolates.
Gbaguidi-Haore
Houssein
H
UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.|Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France.
Thouverez
Michelle
M
UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.|Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France.
Couetdic
Gérard
G
Service de Bactériologie, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France.
Cholley
Pascal
P
UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.|Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France.
Talon
Daniel
D
UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.|Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France.
Bertrand
Xavier
X
UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.|Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001427:Bacterial Toxins / Q000096:biosynthesis* / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D004768:Enterotoxins / Q000096:biosynthesis* / Q000235:genetics*; D005098:Exotoxins / Q000096:biosynthesis* / Q000235:genetics*; D005260:Female; D005602:France / Q000453:epidemiology; D005798:Genes, Bacterial; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007956:Leukocidins / Q000096:biosynthesis* / Q000235:genetics*; D008297:Male; D016106:Methicillin Resistance / Q000235:genetics*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification / Q000378:metabolism; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D010641:Phenotype; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D018089:Superantigens / Q000096:biosynthesis* / Q000235:genetics*; D055815:Young Adult
D001427:Bacterial Toxins; D004768:Enterotoxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal