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Journal of Clinical Microbiology, September 2009, p. 2863-2871, Vol. 47, No. 9
0095-1137/09/$08.00+0     doi:10.1128/JCM.00780-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Variable-Number Tandem Repeat Analysis and Multilocus Sequence Typing Data Confirm the Epidemiological Changes Observed with Staphylococcus aureus Strains Isolated from Bloodstream Infections{triangledown}

Nathalie van der Mee-Marquet,1*,{dagger} Patrice François,2 Anne-Sophie Domelier,1 Laurence Arnault,1 Nicole Girard,1 Jacques Schrenzel,2,3 Roland Quentin,1,{dagger} and the Bloodstream Infection Study Group of the Réseau des Hygiénistes du Centre,{dagger}

Service de Bactériologie et Hygiène, Hôpital Trousseau, Centre Hospitalier Universitaire, F37044 Tours cedex, France,1 Genomic Research Laboratory,2 Clinical Microbiology Laboratory, University of Geneva Hospitals, CH-1211 Geneva 14, Switzerland3

Received 17 April 2009/ Returned for modification 25 May 2009/ Accepted 7 July 2009

Since 2000, our geographical region in France systematically surveys bloodstream infections (BSI) due to Staphylococcus aureus. This survey involves 39 health care institutions (HCIs) encompassing 6,888 short-stay beds and was performed during two 3-month periods during 2007 and 2008. The study periods of this survey identified 292 S. aureus isolates causing BSI. Extensive molecular characterization, including genotyping as well as toxin, agr, and staphylococcal cassette chromosome content determinations, allowed us to describe epidemiological evolution in comparison to that discussed in our previous study. Our main epidemiological observation shows that the incidence of BSI remained constant but that methicillin (meticillin)-resistant S. aureus strains with a wider variety of genetic backgrounds now harbor pyl, as has already been reported in different European countries. We noticed stable numbers of BSI episodes involving community-acquired methicillin-sensitive S. aureus (MSSA), whereas a drastic increase in the number of strains harboring the tst gene was recorded. The increase in the number of tst gene-harboring strains is related to known hospital-acquired MSSA isolates and appears related to epidemic episodes in specific HCIs. Monitoring the increase in prevalence of specific strains helps us understand where the standard precautions are not satisfactorily applied or do not efficiently prevent the spread of epidemic MSSA strains in these HCIs. The recent increases in incidence of these strains call for particular vigilance to avoid the spread of potentially virulent MSSA strains harboring the tst gene and for continuance of this strategy of BSI surveillance.

* Corresponding author. Mailing address: Laboratoire de Bactériologie et Hygiène, Hôpital Trousseau, 37044 Tours cedex, France. Phone: 33 234 389 430. Fax: 33 247 478 588. E-mail: n.vandermee{at}chu-tours.fr

{triangledown} Published ahead of print on 22 July 2009.

{dagger} N. van der Mee-Marquet and R. Quentin are members of the study group; additional members are listed in Acknowledgments.

Journal of Clinical Microbiology, September 2009, p. 2863-2871, Vol. 47, No. 9
0095-1137/09/$08.00+0     doi:10.1128/JCM.00780-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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