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Journal of Clinical Microbiology, December 2004, p. 5650-5657, Vol. 42, No. 12
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.12.5650-5657.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Epidemiology and Typing of Staphylococcus aureus Strains Isolated from Bloodstream Infections

Nathalie van der Mee-Marquet,1,2* Anne-Sophie Domelier,2 Nicole Girard,2 Roland Quentin,1 and the Bloodstream Infection Study Group of the Relais d'Hygiène du Centre{dagger}

Departement de Microbiologie Médicale et Moléculaire, UFR Médecine,1 Service de Bactériologie et d'Hygiène, Hôpital Trousseau, Centre Hospitalier Universitaire, Tours, France2

Received 1 April 2004/ Returned for modification 28 June 2004/ Accepted 24 August 2004

We carried out an epidemiological study covering 2,365,067 patient days of hospitalization between 2000 and 2003. During this time, 413 Staphylococcus aureus bloodstream infections occurred. This corresponds to 15% of the 2,676 bloodstream infections observed during this period in the 31 hospitals in our region of France, which has 2.5 million inhabitants. The incidence of nosocomial S. aureus bloodstream infections was 0.11 per 1,000 days of hospitalization. The prevalence of methicillin-resistant S. aureus (MRSA) strains, of which 13% were nonmultiresistant MRSA (NORSA), was 33%, and this percentage was stable over the 4 years. In contrast, the prevalence of S. aureus strains susceptible to methicillin but resistant to quinolones or susceptible to methicillin but multiresistant to antibiotics (EMSSA strains) increased from 4% in 2000 to 23% in 2003. As previously reported, MRSA strains were mostly recovered from nosocomial bloodstream infections, whereas NORSA strains—generally considered to be responsible for community-acquired infections—were always isolated from nosocomial bloodstream infections. Pulsed-field gel electrophoresis (PFGE) analysis of 109 MRSA strains and 15 EMSSA strains demonstrated clonal diffusion of the three major French MRSA clones and revealed considerable genetic heterogeneity among EMSSA strains. Although no epidemiologically related NORSA strains clustered in particular PFGE groups, the distribution of MRSA strains isolated from bloodstream infections according to the portal of entry (vascular devices, pulmonary, and urinary) was not random for the major PFGE clones, suggesting that each MRSA lineage displays particular virulence features.

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

{dagger} Contributing members of the Bloodstream Infection Study Group of the Relais d'Hygiène du Centre are listed in Acknowledgments.

Journal of Clinical Microbiology, December 2004, p. 5650-5657, Vol. 42, No. 12
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.12.5650-5657.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

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