title: Molecular analysis of methicillin-resistant Staphylococcus aureus dissemination among healthcare professionals and/or HIV patients from a tertiary hospital.
abstract: BACKGROUND
  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.
authors.affiliation: Programa de Pós-Graduação Strictu Sensu em Ciências-Opção Biomolecular, Instituto de Física de São Carlos, Universidade de São Paulo, São Carlos, São Paulo, Brazil.
authors.forename: Jessica Baleiro
authors.initials: JB
authors.lastname: Okado
authors.affiliation: Laboratório de Epidemiologia e Microbiologia Molecular (LEMiMo), Instituto de Física de São Carlos, Universidade de São Paulo, São Carlos, São Paulo, Brazil.
authors.forename: Simoni Camila
authors.initials: SC
authors.lastname: Bogni
authors.affiliation: Programa de Pós-Graduação Strictu Sensu em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Lílian Andreia Fleck
authors.initials: LA
authors.lastname: Reinato
authors.affiliation: Escola de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Martinez
authors.affiliation: Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Elucir
authors.initials: E
authors.lastname: Gir
authors.affiliation: Laboratório de Epidemiologia e Microbiologia Molecular (LEMiMo), Instituto de Física de São Carlos, Universidade de São Paulo, São Carlos, São Paulo, Brazil.
authors.forename: Ilana Lopes Baratella da Cunha
authors.initials: IL
authors.lastname: Camargo
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000382:microbiology / Q000635:transmission*; D016521:Electrophoresis, Gel, Pulsed-Field; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000706:statistics & numerical data*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D013203:Staphylococcal Infections / Q000382:microbiology / Q000635:transmission*; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents