Different evolution of S. aureus methicillin-resistant and methicillin-susceptible infections, Argentina
Danilo Barcudi,
Enrique Blasko,
María José Gonzalez,
Paula Gagetti,
Ricardo Lamberghini,
Analía Garnero,
Claudia Sarkis,
Diego Faccone,
Celeste Lucero,
Dario Tosoroni,
José L. Bocco,
Alejandra Corso,
Claudia Sola
Affiliations
Danilo Barcudi
Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI) CONICET and Universidad Nacional de Córdoba, Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Haya de La Torre y Medina Allende, Ciudad Universitaria, X5000, Córdoba, Argentina
Enrique Blasko
Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI) CONICET and Universidad Nacional de Córdoba, Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Haya de La Torre y Medina Allende, Ciudad Universitaria, X5000, Córdoba, Argentina
María José Gonzalez
Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI) CONICET and Universidad Nacional de Córdoba, Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Haya de La Torre y Medina Allende, Ciudad Universitaria, X5000, Córdoba, Argentina
Paula Gagetti
Servicio Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, Argentina
Ricardo Lamberghini
Cátedra de Infectología I, Hospital Rawson, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Bajada Pucará 2025, X5000, Córdoba, Argentina
Analía Garnero
Servicio de Infectología, Hospital de Niños de la Santísima Trinidad de Córdoba, Córdoba, Bajada Pucará 787, X 5000, ANN, Argentina
Claudia Sarkis
Hospital de Pediatría S.A.M.I.C.''Prof. Dr. Juan P. Garrahan”, Combate de los Pozos 1881, C1245, AAM, CABA, Argentina
Diego Faccone
Servicio Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, Argentina
Celeste Lucero
Servicio Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, Argentina
Dario Tosoroni
Informática Médica, Facultad de Medicina, Universidad Católica de Córdoba, Jacinto Ríos 555, X5004, ASK, Córdoba, Argentina
José L. Bocco
Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI) CONICET and Universidad Nacional de Córdoba, Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Haya de La Torre y Medina Allende, Ciudad Universitaria, X5000, Córdoba, Argentina
Alejandra Corso
Servicio Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, Argentina
Claudia Sola
Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI) CONICET and Universidad Nacional de Córdoba, Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Haya de La Torre y Medina Allende, Ciudad Universitaria, X5000, Córdoba, Argentina; Corresponding author. Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI) CONICET and Universidad Nacional de Córdoba, Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Haya de la Torre y M. Allende, 5000, Córdoba, Argentina.
Staphylococcus aureus-(SA) is widespread among healthcare-associated-(HA) and the community-associated-(CA) infections. However, the contributions of MRSA and MSSA to the SA overall burden remain unclear.In a nationally-representative-survey conducted in Argentina, 668 SA clinical isolates from 61 hospitals were examined in a prospective, cross-sectional, multicenter study in April 2015. The study aimed to analyze MRSA molecular epidemiology, estimate overall SA infection incidence (MSSA, MRSA, and genotypes) in community-onset (CO: HACO, Healthcare-Associated-CO and CACO, Community-Associated-CO) and healthcare-onset (HO: HAHO, Healthcare-associated-HO) infections, stratified by age groups. Additionally temporal evolution was estimated by comparing this study's (2015) incidence values with a previous study (2009) in the same region. Erythromycin-resistant-MSSA and all MRSA strains were genetically typed.The SA total-infections (TI) overall-incidence was 49.1/100,000 monthly-visits, 25.1 and 24.0 for MRSA and MSSA respectively (P = 0.5889), in April 2015. In adults with invasive-infections (INVI), MSSA was 15.7 and MRSA was 11.8 (P = 0.0288), 1.3-fold higher. HA SA infections, both MSSA and MRSA, surpassed CA infections by over threefold.During 2009–2015, there was a significant 23.4 % increase in the SA infections overall-incidence, mainly driven by MSSA, notably a 54.2 % increase in INVI among adults, while MRSA infection rates remained stable. The MSSA rise was accompanied by increased antimicrobial resistance, particularly to erythromycin, linked to MSSA-CC398-t1451-ermT + -IEC+-pvl- emergence. The SA-infections rise was primarily attributed to community-onset-infections (37.3 % and 62.4 % increase for TI and INVI, respectively), particularly HACO-MSSA and HACO-MRSA in adults, as well as CACO-MSSA. The main CA-MRSA-PFGE-typeN-ST30-SCCmecIVc-PVL+/− clone along with other clones (USA300-ST8-IV-LV-PVL+/−, PFGE-typeDD-ST97-IV- PVL−) added to rather than replaced CA-MRSA-PFGE-typeI-ST5-SCCmecIVa-PVL+/− clone in HA invasive-infections. They also displaced clone HA-MRSA-PFGE-typeA-ST5-SCCmecI, mainly in HAHO infections.The overall-burden of SA infections is rising in Argentina, driven primarily by community-onset MSSA, particularly in adults, linked to increased erythromycin-resistance and MSSA-CC398-t1451-ermT + -IEC+-pvl- emergence. Novel knowledge and transmission-control strategies are required for MSSA.
