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microorganisms-10-02401.pdf (2.46 MB)

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2022-12-03

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cc by (c) Vázquez Sánchez, Daniel Antonio et al., 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/192290

Molecular Epidemiology, Antimicrobial Susceptibility, and Clinical Features of Methicillin-Resistant Staphylococcus aureus Bloodstream Infections over 30 Years in Barcelona, Spain (1990–2019)

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https://doi.org/10.3390/microorganisms10122401

Resum

Methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA-BSI) are a significant cause of mortality. We analysed the evolution of the molecular and clinical epidemiology of MRSA-BSI (n = 784) in adult patients (Barcelona, 1990-2019). Isolates were tested for antimicrobial susceptibility and genotyped (PFGE), and a selection was sequenced (WGS) to characterise the pangenome and mechanisms underlying antimicrobial resistance. Increases in patient age (60 to 71 years), comorbidities (Charlson's index > 2, 10% to 94%), community-onset healthcare-associated acquisition (9% to 60%), and 30-day mortality (28% to 36%) were observed during the 1990-1995 and 2014-2019 periods. The proportion of catheter-related BSIs fell from 57% to 20%. Current MRSA-BSIs are caused by CC5-IV and an upward trend of CC8-IV and CC22-IV clones. CC5 and CC8 had the lowest core genome proportions. Antimicrobial resistance rates fell, and only ciprofloxacin, tobramycin, and erythromycin remained high (>50%) due to GyrA/GrlA changes, the presence of aminoglycoside-modifying enzymes (AAC(6 ')-Ie-APH(2 '')-Ia and ANT(4 ')-Ia), and mph(C)/msr(A) or erm (C) genes. Two CC22-IV strains showed daptomycin resistance (MprF substitutions). MRSA-BSI has become healthcare-associated, affecting elderly patients with comorbidities and causing high mortality rates. Clonal replacement with CC5-IV and CC8-IV clones resulted in lower antimicrobial resistance rates. The increased frequency of the successful CC22-IV, associated with daptomycin resistance, should be monitored.

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Staphylococcus aureus, Epidemiologia molecular, Agents antiinfecciosos, Resistència als medicaments

Matèries (anglès)

Staphylococcus aureus, Molecular epidemiology, Anti-infective agents, Drug resistance

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Patologia i Terapèutica Experimental)

Citació

VÁZQUEZ SÁNCHEZ, Daniel antonio, GRILLO, Sara, CARRERA SALINAS, Anna, GONZÁLEZ DÍAZ, Aida, CUERVO REQUENA, Guillermo, GRAU, Inmaculada, CAMOEZ, Mariana, MARTÍ MARTÍ, Sara, BERBEL, Dàmaris, TUBAU, Fe, ARDANUY TISAIRE, María carmen, PUJOL, Miquel, CÀMARA, Jordi, DOMÍNGUEZ LUZÓN, Ma. ángeles (maría ángeles). Molecular Epidemiology, Antimicrobial Susceptibility, and Clinical Features of Methicillin-Resistant Staphylococcus aureus Bloodstream Infections over 30 Years in Barcelona, Spain (1990–2019). _Microorganisms_. 2022. Vol. 10, núm. 12, pàgs. 2401. [consulta: 23 de gener de 2026]. ISSN: 2076-2607. [Disponible a: https://hdl.handle.net/2445/192290]

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