Skip to main content

Advertisement

SpringerLink
Log in

Epidemiological typing of MRSA isolates from blood cultures taken in Irish hospitals participating in the European Antimicrobial Resistance Surveillance System (1999–2003)

  • Article
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

Between 1999 and 2003, meticillin-resistant Staphylococcus aureus (MRSA) isolates recovered from blood cultures in Irish hospitals that participate in the European Antimicrobial Resistance Surveillance System were investigated by epidemiological typing using antibiogram–resistogram (AR) typing, biotyping, and DNA macrorestriction digestion using SmaI followed by pulsed-field gel electrophoresis (PFGE). PFGE patterns were assigned five-digit pulsed-field type (PFT) numbers, and PFTs of apparently related patterns were abbreviated to two-digit PFT groups (PFGs). AR and PFGE typing results were combined to produce AR-PFG types. Representative isolates of each AR-PFG type recovered in 2002 were typed by multilocus sequence typing and staphylococcal cassette chromosome (SCC) mec analysis. Isolates from 1999 and 2000 were also typed by phage typing. The extent to which epidemiological types of MRSA from blood cultures could be extrapolated to the total MRSA population was investigated by comparing results obtained with isolates from the total MRSA population versus those obtained with blood cultures during three study periods. Over the 5 years from 1999 to 2003, 1,580 blood culture isolates from 1,495 patients were analysed. Typeability and discriminatory indices were as follows: AR typing, 1 and 0.97; phage typing, 0.29 and 0.89; PFGE, 0.99 and 0.95; AR-PFG typing, 1 and 0.95. The most frequently occurring AR-PFG types were 06-01, 07-02, 13-00, and 14-00 and were exhibited by 57, 7, 14, and 12% of isolates, respectively. During the study period, the distribution of AR-PFG type changed markedly, with the prevalence of one type (AR-PFG 06-01) increasing by 880%, from 22% (39/181) in 1999 to 80% (343/430) in 2003. Investigation of whether epidemiological types among blood culture isolates of MRSA were representative of the total MRSA population showed that there was no significant difference in most instances. MLST and SCCmec typing showed that AR-PFG types 06-01, 07-02, 13-00, and 14-00 were ST22–MRSA-IV, ST36–MRSA-II, ST8–MRSA-IID, and ST8–MRSA-IIE, respectively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. British Society for Antimicrobial Chemotherapy, Hospital Infection Society and the Infection Control Nurses’ Association (1998) Revised guidelines for the control of methicillin-resistant Staphylococcus aureus infection in hospitals. J Hosp Infect 39:253–290; published erratum appears in J Hosp Infect (1999) 42:83

    Article  Google Scholar 

  2. Anonymous (2000) North/South Study of MRSA in Ireland 1999. Irish Department of Health and Children, Dublin. http://www.doh.ie/publications/mrsa99.html. Cited 17 May 2005

  3. Murphy OM, Murchan S, Whyte D, Humphreys H, Rossney A, Clarke P, Cunney R, Keane C, Fenelon LE, O’Flanagan D (2005) Impact of the European Antimicrobial Resistance Surveillance System on the development of a national programme to monitor resistance in Staphylococcus aureus and Streptococcus pneumoniae in Ireland, 1999–2003. Eur J Clin Microbiol Infect Dis 24:480–483

    Article  PubMed  CAS  Google Scholar 

  4. Rossney AS, Coleman DC, Keane CT (1994) Antibiogram–resistogram typing scheme for methicillin-resistant Staphylococcus aureus. J Med Microbiol 41:430–440

    PubMed  CAS  Google Scholar 

  5. Rossney AS, Coleman DC, Keane CT (1994) Evaluation of an antibiogram–resistogram typing scheme for methicillin-resistant Staphylococcus aureus. J Med Microbiol 41:441–447

    Article  PubMed  CAS  Google Scholar 

  6. Rossney AS, Keane CT (2002) Strain variation in the MRSA population over a 10-year period in one Dublin hospital. Eur J Clin Microbiol Infect Dis 21:123–126

    Article  PubMed  CAS  Google Scholar 

  7. Rossney A, McDonald P, Humphreys H, Glynn G, Keane CT (2003) Antimicrobial resistance and epidemiological typing of methicillin-resistant Staphylococcus aureus in Ireland (North and South), 1999. Eur J Clin Microbiol Infect Dis 22:379–381

    Article  PubMed  CAS  Google Scholar 

  8. Enright MC, Robinson DA, Randle G, Feil EJ, Grundmann H, Spratt BG (2002) The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA). Proc Natl Acad Sci USA 99:7687–7692

    Article  PubMed  CAS  Google Scholar 

  9. Shore A, Rossney AS, Keane CT, Enright MC, Coleman DC (2005) Seven novel variants of the staphylococcal chromosomal cassette mec in methicillin-resistant Staphylococcus aureus isolates from Ireland. Antimicrob Agents Chemother 49:2070–2083

    Article  PubMed  CAS  Google Scholar 

  10. Rossney AS (1995) Methicillin-resistant Staphylococcus aureus in four Dublin hospitals (1988–1994). [PhD thesis] Department of Microbiology, University of Dublin, Trinity College, Dublin

  11. Coia JE, Thomson-Carter F, Baird D, Platt DJ (1990) Characterisation of methicillin-resistant Staphylococcus aureus by biotyping, immunoblotting and restriction enzyme fragmentation patterns. J Med Microbiol 31:125–132

    PubMed  CAS  Google Scholar 

  12. de Lencastre H, Couto I, Santos I, Melo-Cristino J, Torres-Pereira A, Tomasz A (1994) Methicillin-resistant Staphylococcus aureus disease in a Portuguese hospital: characterization of clonal types by a combination of DNA typing methods. Eur J Clin Microbiol Infect Dis 13:64–73

    Article  PubMed  Google Scholar 

  13. MacKenzie FM, Greig P, Morrison D, Edwards G, Gould IM (2002) Identification and characterization of teicoplanin-intermediate Staphylococcus aureus blood culture isolates in NE Scotland. J Antimicrob Chemother 50:689–697

    Article  PubMed  CAS  Google Scholar 

  14. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, Swaminathan B (1995) Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239

    PubMed  CAS  Google Scholar 

  15. van Belkum A, van Leeuwen W, Kaufmann ME, Cookson B, Forey F, Etienne J, Goering R, Tenover F, Steward C, O’Brien F, Grubb W, Tassios P, Legakis N, Morvan A, El Solh N, de Ryck R, Struelens M, Salmenlinna S, Vuopio-Varkila J, Kooistra M, Talens A, Witte W, Verbrugh H (1998) Assessment of resolution and intercenter reproducibility of results of genotyping Staphylococcus aureus by pulsed-field gel electrophoresis of SmaI macrorestriction fragments: a multicenter study. J Clin Microbiol 36:1653–1659

    PubMed  Google Scholar 

  16. Rossney A (2003) A new strain of MRSA imported from Singapore. Epi-Insight 4:1–4

    Google Scholar 

  17. Blair JE, Williams REO (1961) Phage typing of staphylococci. Bull World Health Organ 24:771–784

    Google Scholar 

  18. Struelens MJ (1996) Consensus guidelines for appropriate use and evaluation of microbial epidemiologic typing systems. Clin Microbiol Infect 2:2–11

    PubMed  Google Scholar 

  19. Hunter PR (1990) Reproducibility and indices of discriminatory power of microbial typing methods. J Clin Microbiol 28:1903–1905

    PubMed  CAS  Google Scholar 

  20. Robinson DA, Enright MC (2004) Multilocus sequence typing and the evolution of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect 10:92–97

    Article  PubMed  CAS  Google Scholar 

  21. Ito T, Katayama Y, Hiramatsu K (1999) Cloning and nucleotide sequence determination of the entire mec DNA of pre-methicillin-resistant Staphylococcus aureus N315. Antimicrob Agents Chemother 43:1449–1458

    PubMed  CAS  Google Scholar 

  22. Oliveira DC, de Lencastre H (2002) Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 46:2155–2161

    Article  PubMed  CAS  Google Scholar 

  23. Agresti A (1998) Beta distribution. In: Armitage P, Colton T (eds) Encyclopedia of biostatistics. Wiley, Chichester, pp 298–299

    Google Scholar 

  24. Johnson AP, Aucken HM, Cavendish S, Ganner M, Wale MC, Warner M, Livermore DM, Cookson BD (2001) Dominance of EMRSA-15 and -16 among MRSA causing nosocomial bacteraemia in the UK: analysis of isolates from the European Antimicrobial Resistance Surveillance System (EARSS). J Antimicrob Chemother 48:143–144

    Article  PubMed  CAS  Google Scholar 

  25. Witte W, Enright M, Schmitz FJ, Cuny C, Braulke C, Heuck D (2001) Characteristics of a new epidemic MRSA in Germany ancestral to United Kingdom EMRSA-15. Int J Med Microbiol 290:677–682

    PubMed  CAS  Google Scholar 

  26. Pearman JW, Coombs GW, Grubb WB, O’Brien F (2001) A British epidemic strain of methicillin-resistant Staphylococcus aureus (UK EMRSA-15) in Western Australia. Med J Aust 174:662

    Google Scholar 

  27. Robinson DA, Enright MC (2003) Evolutionary models of the emergence of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 47:3926–3934

    Article  PubMed  CAS  Google Scholar 

  28. Ender M, McCallum N, Adhikari R, Berger-Bachi B (2004) Fitness cost of SCCmec and methicillin resistance levels in Staphylococcus aureus. Antimicrob Agents Chemother 48:2295–2297

    Article  PubMed  CAS  Google Scholar 

  29. Laurent F, Lelievre H, Cornu M, Vandenesch F, Carret G, Etienne J, Flandrois JP (2001) Fitness and competitive growth advantage of new gentamicin-susceptible MRSA clones spreading in French hospitals. J Antimicrob Chemother 47:277–283

    Article  PubMed  CAS  Google Scholar 

  30. Harmsen D, Claus H, Witte W, Rothganger J, Turnwald D, Vogel U (2003) Typing of methicillin-resistant Staphylococcus aureus in a university hospital setting by using novel software for spa repeat determination and database management. J Clin Microbiol 41:5442–5448

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The efforts of the laboratories that participate in the EARSS project and the Irish EARSS Steering Committee are gratefully acknowledged. M.L. was supported by a Health Research Board grant (grant no. RP51/2001). We thank Dr. Fred Tenover, Centers for Disease Control and Prevention, Atlanta, Georgia, for the very helpful suggestion of using 5-digit labels for PFGE patterns.

Author information

Authors and Affiliations

  1. National MRSA Reference Laboratory, St. James’s Hospital, James’s St., Dublin, 8, Ireland

    A. S. Rossney, M. J. Lawrence, P. M. Morgan, M. M. Fitzgibbon, C. T. Keane & B. O’Connell

  2. Microbiology Research Unit, School of Dental Science, University of Dublin, Trinity College, Dublin, Ireland

    A. Shore & D. C. Coleman

Authors
  1. A. S. Rossney
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. J. Lawrence
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. M. Morgan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. M. Fitzgibbon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Shore
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. C. Coleman
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. T. Keane
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. B. O’Connell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. S. Rossney.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rossney, A.S., Lawrence, M.J., Morgan, P.M. et al. Epidemiological typing of MRSA isolates from blood cultures taken in Irish hospitals participating in the European Antimicrobial Resistance Surveillance System (1999–2003). Eur J Clin Microbiol Infect Dis 25, 79–89 (2006). https://doi.org/10.1007/s10096-006-0091-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-006-0091-5

Keywords

Search

Navigation