Emergence of EMRSA-15 in a university hospital, Canary Islands
Abstract number: 1733_1068
Montesinos I., Delgado T., Castro B., Cuervo M., Lecuona M., Ramos M., Sierra A.
Objectives: Since 2000, the rate of MRSA infections has increased at the University Hospital of Canary Islands (HUC) coinciding with the emergence and spread of EMRSA-16 clone and replacement of the Iberian one. In 2003, a new digestion profile by PFGE was observed. The aim of this study is the characterisation of this new PFGE type emerged in the HUC.
Methods: Between 2003 to 2004 29 MRSA isolates showed this new PFGE profile and were obtained from clinical samples from hospitalised patients and out-patients at the HUC. Susceptibility testing and bacterial identification were performed using VITEK 2 System (bioMérieux, France) and susceptibility testing for vancomycin, teicoplanin, linezolid and quinupristin-dalfopristin was assessed with E-test (AB BIODISK, Sweden). Molecular typing was performed by PFGE, MLST, SCCmec typing and protein A gen amplification (spa).
Results: All MRSA isolates studied were susceptible to gentamicin, tetracycline, rifampim, trimethoprim-sulfamethoxazole and tobramycin. They were all resistant to ciprofloxacin and 45% of them were susceptible to clindamycin and erythromycin. All of them were also susceptible to vancomycin, teicoplanin, linezolid and quinupistrin-dalfopristin by E-test. The SmaI digestion patterns obtained by PFGE were different to those obtained previously and included 4 PFGE subtypes. The sequence type of this clone was 22 by MLST and it revealed cassette IV by SCCmec typing, this corresponding with the pandemic clone EMRSA-15. The number of repeats obtained by spa typing was also different to those obtained up to date. Thirteen isolates had 17 repeats, five had 16 repeats and one of them 18 repeats. The first isolation of EMRSA-15 appeared in the HUC in April, 2003 isolated from a patient hospitalised in internal medicine with a respiratory colonisation. In 2003 and 2004 the 10% and the 13% of the MRSA isolated in the HUC were EMRSA-15 respectively.
Conclusions: Starting 2000, EMRSA-16 emerged at our hospital and soon became the predominant clone. In April 2003, a new MRSA clone, EMRSA-15, appeared in this changing panorama of MRSA clones at HUC. The EMRSA-15 and EMRSA-16 are the two predominant clones circulating in the UK.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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