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Antibiotic resistance, population structure and spread of Staphylococcus aureus in nursing homes in the Euregion Meuse-Rhine

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Abstract

To determine the spread of Staphylococcus aureus within and between nursing home (NH) residents in the Euregion Meuse-Rhine, a cross-border region of the Netherlands and Germany, we investigated the prevalence of antibiotic resistance, genetic background and population structure of both methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) isolates. A total of 245 S. aureus isolates were collected from NH residents. Susceptibility testing was performed with microbroth dilution. The genetic background was determined using spa typing, SCCmec typing, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Differences in the prevalence of resistance between the German and Dutch MSSA isolates were observed for the macrolides (15 % vs. 2 %, p = 0.003), clindamycin (15 % vs. 0 %, p = 0.003) and ciprofloxacin (34 % vs. 25 %). The macrolide and ciprofloxacin resistance varied between the NHs, while trimethoprim–sulfamethoxazole resistance was low in all residents. The MRSA prevalence was 3.5 % and <1 % among the German and Dutch NH residents, respectively (p = 0.005). The German MRSAs, isolated in 7 out of 10 NHs, belonged to ST22-MRSA-IV or ST225-MRSA-II. spa clonal complexes (spa-CCs) 015 and 002 were prevalent among the German MSSA isolates and spa-CCs 024 and 1716 were prevalent among the Dutch MSSA isolates. The antibiotic resistance of MSSA and the MRSA prevalence were significantly higher among the German NH residents. The spread of two MRSA clones was observed within and between the German NHs, but not between the Dutch and German NHs. Differences in the prevalence of resistance and the prevalence of MRSA between NHs on both sides of the border warrant the continuation of surveillance at a local level.

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Acknowledgments

Ethical approval for this project was granted by the Medical Ethics committee of the Maastricht University Medical Centre (MUMC), reference number: 07-4-012.4/pl. Written consent was obtained from all participants or their legal representatives.

Sponsors’ role

This project was financially supported by: Provincie Limburg, the Netherlands; Ministerium für Wirtschaft, Energie, Bauen, Wohnen und Verkehr des Landes Nordrhein-Westfalen, Germany; Ministerium der Deutschsprachige Gemeinschaft Belgiens, Belgium; Provincie Limburg, Belgium; Wallonie, Belgium; Rheinland-Westfalen, Germany; Interreg and the Euregio Maas-Rijn with support of the European Regional Development Fund (EFRO).

The funding institutions were not involved in any part of this study.

Conflict of interest

None to declare.

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Authors and Affiliations

  1. Department of Medical Microbiology, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands

    C. F. M. van der Donk & E. E. Stobberingh

  2. CAPHRI—School for Public Health and Primary Care, Department of General Practice and Department of Health Services Research, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands

    C. F. M. van der Donk, J. M. G. A. Schols & E. E. Stobberingh

  3. Vivre, Polvertorenstraat 4, 6211 LX, Maastricht, The Netherlands

    J. M. G. A. Schols

  4. Gesundheitsamt Kreisverwaltung Vulkaneifel, Berliner Straße 2, 54550, Daun, Germany

    V. Schneiders

  5. Air Umwelt Gmbh, Hexenberg 18, 52074, Aachen, Germany

    K.-H. Grimm

  6. Department of Medical Microbiology, Maastricht University Medical Centre (MUMC), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands

    E. E. Stobberingh

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  1. C. F. M. van der Donk
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  2. J. M. G. A. Schols
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  3. V. Schneiders
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  4. K.-H. Grimm
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  5. E. E. Stobberingh
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Correspondence to E. E. Stobberingh.

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van der Donk, C.F.M., Schols, J.M.G.A., Schneiders, V. et al. Antibiotic resistance, population structure and spread of Staphylococcus aureus in nursing homes in the Euregion Meuse-Rhine. Eur J Clin Microbiol Infect Dis 32, 1483–1489 (2013). https://doi.org/10.1007/s10096-013-1901-1

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  • DOI: https://doi.org/10.1007/s10096-013-1901-1

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