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Ribotyping of Nosocomial Methicillin-Resistant Staphylococcus aureus Isolates From a Canadian Hospital

Published online by Cambridge University Press:  02 January 2015

Swapan K. Nath ,
Barb Shea ,
Susan Jackson  and
Coleman Rotstein
Swapan K. Nath
Affiliation:
Department of Laboratory Medicine, McMaster University, Hamilton, Ontario, Canada Department of Pathology, McMaster University, Hamilton, Ontario, Canada
Barb Shea
Affiliation:
Department of Laboratory Medicine, McMaster University, Hamilton, Ontario, Canada
Susan Jackson
Affiliation:
Hamilton Regional Public Health Laboratory, McMaster University, Hamilton, Ontario, Canada Department of Pathology, McMaster University, Hamilton, Ontario, Canada
Coleman Rotstein*
Affiliation:
Division of Infectious Diseases, McMaster Medical Unit, Henderson General Hospital, McMaster University, Hamilton, Ontario, Canada Department of Medicine, McMaster University, Hamilton, Ontario, Canada
*
Division of Infectious Diseases, McMaster Medical Unit, Henderson General Hospital, Hamilton, Ontario, Canada L8V 1C3
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Abstract

Objective:

To evaluate the clonality of methicillin-resistant Staphylococcus aureus (MRSA) strains among hospitalized patients.

Setting:

University-affiliated, 465-bed tertiary-care teaching hospital with adjacent cancer clinic in Hamilton, Ontario, Canada.

Design:

Thirty-five colonized and 30 infected patients from January 2, 1992, through August 31, 1993, were investigated retrospectively. Analysis by restriction fragment-length polymorphisms of ribosomal RNA genes (ie, ribotyping) of 103 nosocomial isolates of MRSA from these 65 patients and of 25 selected unrelated strains was completed. Ribotyping results were compared with the phage typing data obtained prospectively during the course of prospective MRSA surveillance.

Results:

HindIII ribotyping was more discriminating than phage typing when epidemiologically unrelated strains were differentiated by these methods (19 different ribotypes versus 14 phage types; P< .005). Two early index cases were identified. Isolates from the index cases were two different strains, identified by ribotyping analysis as ribotype A (clonal group 1) and ribotype B (clonal group 2), respectively. These two ribotypes were not found when typing the unrelated control strains. Thirty-six colonized and infected patients (55%) had clonal group 1 isolates, and 20 (31%) had clonal group 2 isolates. These two clones emerged in the hospital in January and February 1992 and dominated the entire investigated period. There also were six patients with an additional clonal group (group 4) that emerged and disappeared in the second quarter of 1993.

Conclusions:

This study highlights the utility of ribotyping in investigating nosocomial MRSA. Three MRSA clones caused nosocomial colonization or infection in patients at this hospital. Two of these MRSA clones, once introduced, were maintained among our patients throughout the study period.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 12 , December 1995 , pp. 717 - 724
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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