Περίληψη:
Background: Staphylococcus aureus is a common pathogen causing hospital
acquired infections (HAIs) in neonates. In this study, the epidemiology
of methicillin-resistant S. aureus (MRSA) colonization and infections in
a 30-bed, level III university-affiliated neonatal intensive care unit
(NICU) located in a children’s hospital was retrospectively investigated
for the period 2014-2018. Methods: Genes encoding Panton-Valentine
Leukocidin (lukS/lukF-PV, PVL), toxic shock syndrome toxin (tst),
exfoliative toxins (eta, etb), and the resistance genes mecA, mecC and
fusB, were defined in 46 representative strains by PCRs. Relatedness of
strains was assessed by MLST. Results: Of 1538 neonates, 77 (5%) had a
positive culture for MRSA (23/77 were NICU-acquired and 54/77 imported
cases). Four MRSA bacteremias occurred. Most isolates were
multi-resistant. One major clone was identified, ST225, among 40 tested
neonatal strains (23/40, 58%). Of these, 14/23 were imported from the
same maternity hospital (MH). Another clone, ST217, was predominant
(4/6) among health care workers (HCWs), found colonized. Four isolates
classified as ST80 were PVL-positive. Additional four strains carried
tst (10%), belonging to ST30 and ST225 (two strains each), and two etb.
The implicated MH was notified for the problem, decolonization treatment
was successfully performed in HCWs and neonates. Strengthening of
infection control measures with emphasis on hand hygiene was applied.
Conclusions: Uncovering reservoirs for on-going MRSA transmission in
NICUs has proved challenging. Well known nosocomial MRSA clones are
being constantly introduced and transmitted via MHs and HCWs. Effective
infection prevention and control requires constant vigilance.
Συγγραφείς:
Doudoulakakis, Anastassios
Spiliopoulou, Iris
Giormezis,
Nikolaos
Syridou, Garyfallia
Nika, Angeliki
Bozavoutoglou,
Elisavet
Militsopoulou, Maria
Kalogeras, Georgios
Tsolia,
Maria
Lebessi, Evangelia
