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Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1990 Jun;28(6):1338–1341. doi: 10.1128/jcm.28.6.1338-1341.1990

Epidemiological markers for epidemic strain and carrier isolates in an outbreak of nosocomial oxacillin-resistant Staphylococcus aureus.

A Bouvet 1, J M Fournier 1, A Audurier 1, C Branger 1, A Orsoni 1, C Girard 1
PMCID: PMC267929  PMID: 2199498

Abstract

An outbreak of nosocomial infections occurring in a postoperative intensive care unit was caused by a single strain of oxacillin-resistant Staphylococcus aureus. Six patients were infected, or colonized, by this strain, which was traced by using the following four epidemiological markers: antibiogram, bacteriophage type, capsular polysaccharide type, and esterase electrophoretic type. This strain was compared with S. aureus isolates obtained from the noses of 13 carriers from a group of 42 staff members. A good correlation in terms of phenotypic markers was found between the epidemic strain and a strain isolated from one carrier. Both exhibited the same pattern of multiple resistance as well as the same phage type, 77, capsular polysaccharide type, 5, and esterase electrophoretic type, 6. In contrast, an oxacillin-resistant strain, isolated from another carrier, differed from the epidemic strain by susceptibility to rifampin and by susceptibility to four additional bacteriophages. The other 11 strains isolated from carriers were susceptible to oxacillin and exhibited widely different phenotypes. These results confirm the interest of using several epidemiological markers to trace the spread of epidemic S. aureus strains and to delineate the carrier strains.

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Selected References

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  1. Acar J. F., Buu-Hoi A. Y. Resistance patterns of important gram-positive pathogens. J Antimicrob Chemother. 1988 Apr;21 (Suppl 100):41–47. doi: 10.1093/jac/21.suppl_c.41. [DOI] [PubMed] [Google Scholar]
  2. Arbeit R. D., Karakawa W. W., Vann W. F., Robbins J. B. Predominance of two newly described capsular polysaccharide types among clinical isolates of Staphylococcus aureus. Diagn Microbiol Infect Dis. 1984 Apr;2(2):85–91. doi: 10.1016/0732-8893(84)90002-6. [DOI] [PubMed] [Google Scholar]
  3. Archer G. L., Mayhall C. G. Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections. J Clin Microbiol. 1983 Aug;18(2):395–399. doi: 10.1128/jcm.18.2.395-399.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. BARBER M. NATURALLY OCCURING METHICILLIN-RESISTANT STAPHYLOCOCCI. J Gen Microbiol. 1964 May;35:183–190. doi: 10.1099/00221287-35-2-183. [DOI] [PubMed] [Google Scholar]
  5. Bacon A. E., Jorgensen K. A., Wilson K. H., Kauffman C. A. Emergence of nosocomial methicillin-resistant Staphylococcus aureus and therapy of colonized personnel during a hospital-wide outbreak. Infect Control. 1987 Apr;8(4):145–150. doi: 10.1017/s0195941700065802. [DOI] [PubMed] [Google Scholar]
  6. Bartzokas C. A., Paton J. H., Gibson M. F., Graham F., McLoughlin G. A., Croton R. S. Control and eradication of methicillin-resistant Staphylococcus aureus on a surgical unit. N Engl J Med. 1984 Nov 29;311(22):1422–1425. doi: 10.1056/NEJM198411293112207. [DOI] [PubMed] [Google Scholar]
  7. Boutonnier A., Nato F., Bouvet A., Lebrun L., Audurier A., Mazie J. C., Fournier J. M. Direct testing of blood culture for detection of the serotype 5 and 8 capsular polysaccharides of Staphylococcus aureus. J Clin Microbiol. 1989 May;27(5):989–993. doi: 10.1128/jcm.27.5.989-993.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Branger C., Goullet P., Boutonnier A., Fournier J. M. Correlation between esterase electrophoretic types and capsular polysaccharide types 5 and 8 among methicillin-susceptible and methicillin-resistant strains of Staphylococcus aureus. J Clin Microbiol. 1990 Jan;28(1):150–151. doi: 10.1128/jcm.28.1.150-151.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Branger C., Goullet P. Esterase electrophoretic polymorphism of methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus. J Med Microbiol. 1987 Nov;24(3):275–281. doi: 10.1099/00222615-24-3-275. [DOI] [PubMed] [Google Scholar]
  10. Branger C., Goullet P. Genetic heterogeneity in methicillin-resistant strains of Staphylococcus aureus revealed by esterase electrophoretic polymorphism. J Hosp Infect. 1989 Aug;14(2):125–134. doi: 10.1016/0195-6701(89)90115-1. [DOI] [PubMed] [Google Scholar]
  11. Cookson B. D., Phillips I. Epidemic methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother. 1988 Apr;21 (Suppl 100):57–65. doi: 10.1093/jac/21.suppl_c.57. [DOI] [PubMed] [Google Scholar]
  12. Crossley K., Landesman B., Zaske D. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. II. Epidemiologic studies. J Infect Dis. 1979 Mar;139(3):280–287. doi: 10.1093/infdis/139.3.280. [DOI] [PubMed] [Google Scholar]
  13. Fournier J. M., Bouvet A., Boutonnier A., Audurier A., Goldstein F., Pierre J., Bure A., Lebrun L., Hochkeppel H. K. Predominance of capsular polysaccharide type 5 among oxacillin-resistant Staphylococcus aureus. J Clin Microbiol. 1987 Oct;25(10):1932–1933. doi: 10.1128/jcm.25.10.1932-1933.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Fournier J. M., Hannon K., Moreau M., Karakawa W. W., Vann W. F. Isolation of type 5 capsular polysaccharide from Staphylococcus aureus. Ann Inst Pasteur Microbiol. 1987 Sep-Oct;138(5):561–567. doi: 10.1016/0769-2609(87)90041-x. [DOI] [PubMed] [Google Scholar]
  15. Fournier J. M., Vann W. F., Karakawa W. W. Purification and characterization of Staphylococcus aureus type 8 capsular polysaccharide. Infect Immun. 1984 Jul;45(1):87–93. doi: 10.1128/iai.45.1.87-93.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Goullet P. An esterase zymogram of Escherichia coli. J Gen Microbiol. 1973 Jul;77(1):27–35. doi: 10.1099/00221287-77-1-27. [DOI] [PubMed] [Google Scholar]
  17. Hochkeppel H. K., Braun D. G., Vischer W., Imm A., Sutter S., Staeubli U., Guggenheim R., Kaplan E. L., Boutonnier A., Fournier J. M. Serotyping and electron microscopy studies of Staphylococcus aureus clinical isolates with monoclonal antibodies to capsular polysaccharide types 5 and 8. J Clin Microbiol. 1987 Mar;25(3):526–530. doi: 10.1128/jcm.25.3.526-530.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kapperud G., Lassen J., Dommarsnes K., Kristiansen B. E., Caugant D. A., Ask E., Jahkola M. Comparison of epidemiological marker methods for identification of Salmonella typhimurium isolates from an outbreak caused by contaminated chocolate. J Clin Microbiol. 1989 Sep;27(9):2019–2024. doi: 10.1128/jcm.27.9.2019-2024.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Kernodle D. S., Barg N. L., Kaiser A. B. Intrinsic methicillin resistance and phage complex 94/96 of Staphylococcus aureus. J Infect Dis. 1988 Feb;157(2):396–397. doi: 10.1093/infdis/157.2.396a. [DOI] [PubMed] [Google Scholar]
  20. Lacey R. W. Mechanisms of resistance to beta-lactam antibiotics in Staphylococcus aureus. Scand J Infect Dis Suppl. 1984;42:64–71. [PubMed] [Google Scholar]
  21. Locksley R. M., Cohen M. L., Quinn T. C., Tompkins L. S., Coyle M. B., Kirihara J. M., Counts G. W. Multiply antibiotic-resistant Staphylococcus aureus: introduction, transmission, and evolution of nosocomial infection. Ann Intern Med. 1982 Sep;97(3):317–324. doi: 10.7326/0003-4819-97-3-317. [DOI] [PubMed] [Google Scholar]
  22. Maple P. A., Hamilton-Miller J. M., Brumfitt W. World-wide antibiotic resistance in methicillin-resistant Staphylococcus aureus. Lancet. 1989 Mar 11;1(8637):537–540. doi: 10.1016/s0140-6736(89)90076-7. [DOI] [PubMed] [Google Scholar]
  23. Maple P., Hamilton-Miller J., Brumfitt W. Ciprofloxacin resistance in methicillin- and gentamicin-resistant Staphylococcus aureus. Eur J Clin Microbiol Infect Dis. 1989 Jul;8(7):622–624. doi: 10.1007/BF01968141. [DOI] [PubMed] [Google Scholar]
  24. Martín-Bourgon C. Phage-typing of Staphylococcus aureus from cases of bacteraemia. J Hosp Infect. 1985 Dec;6(4):429–433. doi: 10.1016/0195-6701(85)90061-1. [DOI] [PubMed] [Google Scholar]
  25. Peacock J. E., Jr, Marsik F. J., Wenzel R. P. Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital. Ann Intern Med. 1980 Oct;93(4):526–532. doi: 10.7326/0003-4819-93-4-526. [DOI] [PubMed] [Google Scholar]
  26. Selander R. K., Caugant D. A., Ochman H., Musser J. M., Gilmour M. N., Whittam T. S. Methods of multilocus enzyme electrophoresis for bacterial population genetics and systematics. Appl Environ Microbiol. 1986 May;51(5):873–884. doi: 10.1128/aem.51.5.873-884.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Sompolinsky D., Samra Z., Karakawa W. W., Vann W. F., Schneerson R., Malik Z. Encapsulation and capsular types in isolates of Staphylococcus aureus from different sources and relationship to phage types. J Clin Microbiol. 1985 Nov;22(5):828–834. doi: 10.1128/jcm.22.5.828-834.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Standiford H. C. Methicillin-resistant Staphylococcus aureus infections: it's time to get tough. Infect Control. 1987 May;8(5):187–189. doi: 10.1017/s0195941700065917. [DOI] [PubMed] [Google Scholar]

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