The occurrence of abscess disease, caseous lymphadenitis, and pulmonary adenomatosis in sheep in Denmark is reported for the first time. Subcutaneous abscesses were observed in imported 4- to 5-month-old lambs of the Lacaune breed 10 days after arrival in Denmark. Abscesses were mostly located in the head, neck and shoulder regions close to the regional lymph nodes. Bacteriological examinations revealed growth of Staphylococcus aureus ssp. anaerobius in all animals with subcutaneously located abscesses containing a viscous white-yellow odourless mass. In addition, Corynebacterium pseudotuberculosis was isolated from abscesses in one animal and lesions consistent with pulmonary adenomatosis were found in four animals.
Staphylococcus aureus nasal carriers risk autoinfection; however, knowledge about the factors that make specific strains successful colonizers is limited. This study was undertaken to identify the most successful S. aureus clones in nasal carriers and compare their distribution among host groups. The population structure of S. aureus isolates from healthy adults was investigated by spa typing 1,981 isolates from persistent and intermittent nasal carriers participating in a health survey. In the baseline screening (1,113 isolates), the most common spa types were t012 (8.4%), t084 (7.6%), and t065 (4.9%). Three large spa clonal complexes (spa CC012, spa CC065, and spa CC084) comprised 62.4% of the isolates. In multivariate models adjusted for age and smoking status, male sex was associated with higher risk for spa type t084 (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.06 to 2.77), and lower risk of spa type t012 (OR, 0.60; 95% CI, 0.39 to 0.92) colonization. The prevalence of spa type t012 decreased significantly with increasing age (P = 0.03), with a prevalence almost twice as high in the youngest group (age 30 to 44 years, prevalence = 11.1%) as in the oldest group (age, 60 to 87 years; prevalence = 5.6%). Among baseline isolates, spa type t084 had a twofold-higher prevalence among intermittent carriers than among persistent carriers (10.6% versus 5.5%; P = 0.04). In summary, the two most prevalent spa types found in this study were significantly associated with age and/or gender. This may provide valuable clues to the multifactorial mechanisms, among them bacterial factors, involved in nasal colonization with S. aureus.
To investigate the prevalence of concurrent methicillin-resistant Staphylococcus aureus (MRSA) colonization in people and pets in the same household with a person or pet with an MRSA infection and to compare MRSA isolates by use of molecular techniques.
24 dogs, 10 cats, and 56 humans in part 1 and 21 dogs, 4 cats, and 16 humans in part 2 of the study.
In both parts of the study, nasal swab specimens were collected from humans and nasal and rectal swab specimens were collected from household pets. Selective culture for MRSA was performed, and isolates were typed via pulsed-field gel electrophoresis (PFGE) and spa typing. Households were defined as positive when MRSA was isolated from at least 1 person (part 1) or 1 pet (part 2).
In part 1, 6 of 22 (27.3%) households were identified with MRSA colonization in a person. In these households, 10 of 56 (17.9%) humans, 2 of 24 (8.3%) dogs, and 1 of 10 (10%) cats were colonized with MRSA. In part 2, only 1 of 8 households was identified with MRSA colonization in a pet. Most MRSA isolates obtained from humans and pets in the same household were indistinguishable by use of PFGE.
The high prevalence of concurrent MRSA colonization as well as identification of indistinguishable strains in humans and pet dogs and cats in the same household suggested that interspecies transmission of MRSA is possible. Longitudinal studies are required to identify factors associated with interspecies transmission.
To report a multi-institution outbreak caused by a single strain of methicillin-resistant Staphylococcus aureus (MRSA).
Between September 19 and November 20, 1996 an index case and five secondary cases of nosocomial MRSA occurred on a 26 bed adult plastic surgery/burn unit (PSBU) at a tertiary care teaching hospital. Between November 11 and December 23, 1996, six additional cases were identified at a community hospital. One of the community hospital cases was transferred from the PSBU. All strains were identical by pulsed-field gel electrophoresis. MRSA may have contributed to skin graft breakdown in one case, and delayed wound healing in others. Patients required 2 to 226 isolation days.
A hand held shower and stretcher for showering in the hydrotherapy room of the PSBU were culture positive for the outbreak strain, and the presumed means of transmission. Replacement of stretcher showering with bedside sterile burn wound compresses terminated the outbreak. The PSBU was closed to new admissions and transfers out for 11 days during the investigation. Seven of 12 patients had effective decolonization therapy.
Environmental contamination is a potential source of nosocomial MRSA transmission on a burn unit. Notification among institutions and community care providers of shared patients infected or colonized with an antimicrobial resistant microorganism is necessary.
Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) represent an increasing problem in Norway, also in nursing homes and other institutions for long-term care. We describe an outbreak of MRSA in a nursing home in Oslo 2004-5.
The nursing home has six wards with 185 beds. The building is old, all rooms have toilets and sinks, but showers are shared. Standard screening procedures were carried out according to the national MRSA guide and by using the nursing home's infection control programme. Later on we used more extensive screening of staff and patients.
The outbreak started in a ward for short-term care, but spread to a ward for patients with dementia after some months. Ten patients, seven staff members and two relatives of infected persons were diagnosed with MRSA. All bacteria probably belonged to the same strain. Four staff members and five patients who were infected had pre-existing wounds or eczema. The nursing home was declared free of MRSA 20 months after the outbreak started, but one member of staff remained a carrier for two years, and one patient became a chronic carrier of MRSA. During the first six months, infected patients were restricted to their rooms, and standard eradication procedures were carried out for five days. Later on, we introduced cohort isolation for infected, exposed and recently treated patients, a different screening routine, a prolonged eradication procedure, restrictions on staff working elsewhere and more stringent precautions for visitors.
An old building and insufficient isolation procedures during the first phase of the outbreak contributed to spreading MRSA and prolonging the outbreak. Cohort isolation seemed to be the most important measure to control the outbreak. All nursing homes should have a designated single patient room for contact precautions. Long-term carriers of MRSA in nursing homes represent a big challenge.
To investigate antimicrobial susceptibility in Staphylococcus pseudintermedius and the occurrence of methicillin-resistant S. pseudintermedius (MRSP), to explore the molecular structure of the MRSP population and to analyse risk factors for MRSP.
Susceptibility data for clinical S. pseudintermedius isolates in 2011-15 were analysed using WHONET. All MRSP isolates in 2010-14 ( n? = ? 362) were typed using PFGE. Representative isolates ( n ?= ? 87) of clusters were analysed using MLST and staphylococcal cassette chromosome mec (SCC mec ) typing. Risk factors were analysed using logistic regression.
Of the clinical S. pseudintermedius ( n ?= ? 1958; 98% from dogs), 14% were MRSP. Resistance to other antimicrobials varied between 12% and 39%. No trends were observed over time. Among clinical specimens (from infection sites) and screening specimens (from potential carriers), respectively, 2.5% (267/10?813) and 9% (211/2434) revealed MRSP. MLST revealed 42 different STs, including 19 new ones. Clonal complexes 71, 45 and 258 were the most common, but the MRSP population diversified over the years. A clinical S. pseudintermedius isolate was more likely to be MRSP if the patient was on antimicrobials at the time of sampling or was male. The presence of MRSP in screening specimens was more likely if the patient was on multiple antimicrobials at the time of sampling. Specimens from private clinics (versus the Veterinary Teaching Hospital of the University of Helsinki) had a higher likelihood of MRSP in both analyses.
Resistance to antimicrobials among S. pseudintermedius in Finland is high, emphasizing the importance of infection control measures and susceptibility testing prior to therapy. The diverse MRSP population indicates non-clonal spread.
A total of 879 Staphylococcus aureus clinical isolates from 17 medical institutions in different regions of Russia were tested. Susceptibility to 18 antimicrobials was determined by agar dilution in accordance with the NCCLS recommendations. The most potent antimicrobials were glycopeptides, linezolid, and fusidic acid, to which no resistance was found. Other antimicrobials with low frequency of non-susceptibility were mupirocin (0.3%), trimethoprim/sulfamethoxazole (0.8%), quinupristin/dalfopristin (1.8%) and rifampicin (7.0%). Fluoroquinolones displayed moderate activity (5.8% of non-susceptible strains to moxifloxacin, 9.1% to levofloxacin, 13.1% to ciprofloxacin). High rates of non-susceptibility were found to clindamycin (27.1%), gentamicin (30.7%), tetracycline (37.1%), erythromycin (39.6%) and chloramphenicol (43.1%). The prevalence of oxacillin-resistant S. aureus (ORSA) was 33.5% and varied from 0% to 89.5% in different hospitals. ORSA were isolated most frequently in the burn units (77.5%), intensive care units (54.8%), trauma and orthopedics units (42.1%). This is the first multicenter study published of antimicrobial resistance of S. aureus in Russia which meets international standards.
The primary aim of this study was to determine antimicrobial resistance in coagulase-negative staphylococci (CoNS) from healthy adults in the community. Healthy adults (n = 114) were swabbed on six body sites; both armpits, both knee pits and both sides of the groin. Species determination was performed using Matrix Assisted Laser Desorption Ionization - Time of Flight (MALDI-TOF) and susceptibility testing for 11 relevant antimicrobials was performed by the disc diffusion method and minimal inhibitory concentration gradient test. In total, 693 CoNS isolates were identified. Susceptibility testing was done on 386 isolates; one CoNS from each species found on each participant from the different body sites. The prevalence of antimicrobial resistance in the CoNS isolates were; erythromycin (24.6%), fusidic acid (19.9%), tetracycline (11.4%), clindamycin (7.8%), gentamicin (6.2%) and cefoxitin (4.1%). Multidrug resistance was observed in 5.2% of the isolates. Staphylococcus epidermidis and S. hominis were the first and second most prevalent species on all three body sites. We conclude that CoNS isolates from healthy adults in the community have a much lower prevalence of antimicrobial resistance than reported in nosocomial CoNS isolates. Still, we believe that levels of resistance in community CoNS should be monitored as the consumption of antimicrobials in primary care in Norway is increasing.
During the 1950s, Staphylococcus aureus became a major source of hospital infections and death, particularly in neonates. This situation was further complicated by the fact that Staphylococcus quickly gained resistance to most antibiotics. Controlling these infections was a pressing concern for hospital workers, especially bacteriologists who tackled it through the use of a new epidemiologic tool: phage typing. This article argues that during the mid- to late 1950s a series of staphylococcal hospital and nursery epidemics united phage typers, brought international recognition to the usefulness of their technique, and, in the process, contributed to the establishment of the new field of infection control. Through the use of this new tool, phage typers established themselves as experts in infection control and, in some places, became essential members of newly formed infection-control committees. The nursery epidemics represent a particularly important test for phage typing and infection control, for this staphylococcal strain (80/81) was especially virulent and spread rapidly beyond the hospital to the wider community. The epidemiologic information provided by phage typers was vital for devising practical advice on how to control this deadly strain of Staphylococcus and also for transforming the role of the hospital bacteriologist from mere technician into infection-control expert.