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. 2000 Aug;38(8):2985-8.
doi: 10.1128/JCM.38.8.2985-2988.2000.

Outbreak of methicillin-resistant Staphylococcus aureus with reduced susceptibility to glycopeptides in a Parisian hospital

F Guerin  1 , A Buu-Hoï, J L Mainardi, G Kac, N Colardelle, S Vaupré, L Gutmann, I Podglajen
Affiliations

Outbreak of methicillin-resistant Staphylococcus aureus with reduced susceptibility to glycopeptides in a Parisian hospital

F Guerin et al. J Clin Microbiol. 2000 Aug.

Abstract

Epidemiological relationships were investigated between 40 methicillin-resistant Staphylococcus aureus (MRSA) strains with decreased glycopeptide susceptibility isolated from November 1998 to March 1999 from 39 patients (17 infected and 22 colonized patients) in nine wards of the Broussais Hospital, Paris, France. Reduced glycopeptide susceptibility was readily detected on brain heart infusion (BHI) agar containing 6 microg of teicoplanin per ml and on gradient plates, but not by the standard disk diffusion method. The MICs of vancomycin and teicoplanin, determined on BHI agar, were 4 and 8 to 32 microg/ml, respectively (standard antibiotic dilution), and 4 to 8 and 8 to 32 microg/ml, respectively (E-test). All strains were resistant to macrolides, aminoglycosides, tetracycline, rifampin, sulfonamides, and pefloxacin, showed reduced susceptibility to fusidic acid and fosfomycin, and were susceptible to trimethoprim and chloramphenicol. Pulsed-field gel electrophoresis and lysotyping revealed that a multidrug-resistant MRSA clone with decreased susceptibility to glycopeptides has been discretely endemic since at least 1996 in our institution, where it was responsible for an outbreak in November and December 1998.

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Figures

FIG. 1
FIG. 1
Population analysis of S. aureus strains with decreased susceptibility to glycopeptides (strains FA27, DE17, TE40, DE18, LA36, and HA39). (A) Analysis carried out on plates with VAN; (B) analysis carried out on plates with TEC. Strains SA25923 and LO45 were fully glycopeptide susceptible.
FIG. 2
FIG. 2
PFGE profiles of S. aureus strains. Lanes: 1, MRSA1152 (Spanish isolate [1]); 2, Mu50 [Japanese isolate [6]); 3, fragment size marker (in kilobase pairs; indicated on the left margin); 4, MB52; 5, CA38; 6, OB33; 7, SI20; 8, CA02; 9, PE 41; 10, MRSA 46063. All strains except MB52 had reduced susceptibility to glycopeptides.
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