Author/Editor		Grmek-Košnik, Irena; Dermota, Urška; Juteršek, Borut
Title		Proti meticilinu oporna bakterija Staphylococcus aureus domačega okolja (CA-MRSA)
Translated title		Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 74, št. 3
Publication year		2005
Volume		str. 159-63
Language		slo
Abstract		Background. Community acquired MRSA (CA-MRSA) infections affect patients without risk factors. CA-MRSA infections can be serious and also fatal even in previously healthy subjects. CA-MRSA differs from hospital acquired MRSA (HA-MRSA). CA-MRSA is more susceptible for non-beta-lactam antibiotics than HA-MRSA, has different PFGE subtypes, and can produce Panton-Valentine leukocidine. Methods. In Institute of Public Health Kranj we routinely perform epidemiologic survey of MRSA positive patients. We compared MRSA isolates from patients with and without risk factors for acquisition of MRSA. We tested all S. aureus for their susceptibility to antibiotics (penicillin, oxacillin, vancomycin, gentamicin, erythromycin, clindamycin, tetracycline, cipro floxacine, chloramphenicol, trimethoprim sulfamethoxazole and rifampin). All CA-MRSA isolates were tested for susceptibility to fusidic acid staphylococcal enterotoxin (SE) production. We performed macrorestriction chromosome analysis with pulse field gel electrophoresis (PFGE). We compared CA-MRSA characteristics with epidemic MRSA strains. Results. In the period from 1999 to 2004 we isolated 1439 MRSA including 10 isolates suspicious for CA-MRSA. This isolates were susceptible for more than 5 antibiotics in contrast to epidemic MRSA which were susceptible for 3 or S antibiotics. Eight of 10 CA IVIRSA produced SE C or D or no SE, in contrast to epidemic MRSA, which produced exclusively SE A. In PFGE CA-MRSA showed different patterns compared to epidemic HA-MRSA. Conclusions. With exclusion of risk factors for MRSA acquisition in patient's history testing for antibiotic susceptibility, SE production and PFGE we proved that our MRSA isolates differed from ordinary epidemic strains. We identified CA-MRSA also in Slovenia.
Summary		Izhodišča. Okužbe z MRSA se pojavljajo tudi zunaj bolnišnic. Izvirajo iz domačega okolja in prizadenejo ljudi brez dejavnikov tveganja. Okužbe z MRSA, pridobljene v domačem okolju (CA MRSA), so pri sicer zdravih ljudeh lahko resne ali celo smrtne. CA-MRSA se razlikuje od bolnišničnih sevov MRSA. CA-MRSA je bolj občutljiva za antibiotike, ki niso betalaktamski. Ima drugačne podtipe PFGE (angl. pulsed field gel electrophoresis) in vsebuje lahko Panton-Valentin levkocidin (PVL), ki ga bolnišnični sevi MRSA ne vsebujejo. Metode. V Laboratoriju za medicinsko mikrobiologijo Zavoda za zdravstveno varstvo Kranj delamo rutinsko epidemiološko analizo vseh bolnikov, pri katerih smo osamili povzročite ja MRSA. Primerjali smo značilnosti sevov MRSA, ki smo jih osamili pri bolnikih, ki so imeli dejavnike tveganja za okužbo z MRSA, in seve iz kužnin bolnikov, ki niso imeli dejavnikov tveganja za okužbo z MRSA. Vsem sevom bakterije S. aureus smo določili občutljivost za antibiotike (penicilin, oksacilin, vankomicin, gentamicin, eritromicin, klindamicin, tetraciklin, ciprofloksacin, kloramfenikol, trimetoprim s sulfametoksazolom, rifampin). Vse seve bakterije CA-MRSA smo testirali na fusidinsko kislino in preiskali, ali proizvajajo stafilokokni enterotoksin (SE). Naredili smo makrorestrikcijsko analizo kromosomov z metodo gelske elektroforeze v utripajočem polju (PFGE). Značilnosti CA-MRSA smo primerjali z bolnišničnimi sevi MRSA. (Izvleček skrajšan pri 2000 znakih).
Descriptors		STAPHYLOCOCCAL INFECTIONS STAPHYLOCOCCUS AUREUS METHICILLIN RESISTANCE COMMUNITY-ACQUIRED INFECTIONS MICROBIAL SENSITIVITY TESTS ANTIBIOTICS ELECTROPHORESIS, GEL, PULSED-FIELD