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      Determinación de la resistencia a meticilina y eritromicina de cepas de Staphylococcus aureus aisladas en un hospital del estado Zulia Translated title: Determination of methicillin and erythromycin resistance of Staphylococcus aureus strains isolated at a hospital in Zulia State

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          Abstract

          Staphylococcus aureus resistente a meticilina (SARM) está asociado a diversos procesos infecciosos y su creciente resistencia representa un grave problema de salud publica. Los objetivos de este trabajo fueron: detectar fenotípica y genotípicamente la resistencia a meticilina y eritromicina en 60 cepas SARM y confirmar la resistencia a meticilina. Ésta última fue confirmada por concentración inhibitoria mínima (CIM), prueba de descarte, resistencia a cefoxitina (FOX), detección de PBP2a, producción de β-lactamasa y detección del gen mecA (PCR). Para la resistencia a eritromicina se utilizó el método de difusión en disco, CIM, resistencia inducible a clindamicina (D-test) y detección de los genes ermA, ermB, ermC y msrA (PCR). Los métodos de CIM, descarte, FOX y PBP2a, mostraron en cada prueba una sensibilidad y valor predictivo de 100% y 98,3% respectivamente. Una cepa fue mecA negativo, negativa para PBP2a y β-lactamasa positiva y se consideró “borderline”. Treinta y cinco (58,3%) SARM fueron resistentes a eritromicina y mostraron los fenotipos MS B (6/17,1%), cMLS B (25/71,4%) y iMLS B (4/11,4%), siendo estas últimas D-test positivo. El gen ermA fue el más frecuente. La resistencia a eritromicina encontrada constituye un problema serio, por ser una de las alternativas para su tratamiento.

          Translated abstract

          Methicillin resistant Staphylococcus aureus strains (MRSA) are associated to diverse infectious processes and their growing resistance represents a serious public health problem. The objectives of this study were to detect methicillin and erythromycin resistance of 60 MRSA strains phenotypically and genotypically, and confirm methicillin resistance. This last one was confirmed by the minimal inhibitory concentration (MIC) method, screening test, cefoxitin resistance (FOX), PBP2a detection, β-lactamase production, and mecA gene detection (PCR). For erythromycin resistance, the disk diffusion method, MIC, inducible clindamycin resistance (D-test), and ermA, ermB, ermC, and msrA gene detection (PCR) were used The MIC, discard test, FOX, and PBP2a methods showed in each test a sensitivity and predictive value of 100% and 98% respectively. One strain was mecA negative, PBP2a negative, and β-lactamase positive and it was considered “borderline”. Thirty five (58.3%) were erythromycin resistant and showed MS B (6/17.1%), eML.S B (25/71.4%) and iML.S B (4/11.4%); these last ones were D-test positive. ermA gene was the most frequent. The erythromycin resistance found contitutes a serious problem since it is one of the treatment alternatives.

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          Most cited references63

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          Invasive methicillin-resistant Staphylococcus aureus infections in the United States.

          As the epidemiology of infections with methicillin-resistant Staphylococcus aureus (MRSA) changes, accurate information on the scope and magnitude of MRSA infections in the US population is needed. To describe the incidence and distribution of invasive MRSA disease in 9 US communities and to estimate the burden of invasive MRSA infections in the United States in 2005. Active, population-based surveillance for invasive MRSA in 9 sites participating in the Active Bacterial Core surveillance (ABCs)/Emerging Infections Program Network from July 2004 through December 2005. Reports of MRSA were investigated and classified as either health care-associated (either hospital-onset or community-onset) or community-associated (patients without established health care risk factors for MRSA). Incidence rates and estimated number of invasive MRSA infections and in-hospital deaths among patients with MRSA in the United States in 2005; interval estimates of incidence excluding 1 site that appeared to be an outlier with the highest incidence; molecular characterization of infecting strains. There were 8987 observed cases of invasive MRSA reported during the surveillance period. Most MRSA infections were health care-associated: 5250 (58.4%) were community-onset infections, 2389 (26.6%) were hospital-onset infections; 1234 (13.7%) were community-associated infections, and 114 (1.3%) could not be classified. In 2005, the standardized incidence rate of invasive MRSA was 31.8 per 100,000 (interval estimate, 24.4-35.2). Incidence rates were highest among persons 65 years and older (127.7 per 100,000; interval estimate, 92.6-156.9), blacks (66.5 per 100,000; interval estimate, 43.5-63.1), and males (37.5 per 100,000; interval estimate, 26.8-39.5). There were 1598 in-hospital deaths among patients with MRSA infection during the surveillance period. In 2005, the standardized mortality rate was 6.3 per 100,000 (interval estimate, 3.3-7.5). Molecular testing identified strains historically associated with community-associated disease outbreaks recovered from cultures in both hospital-onset and community-onset health care-associated infections in all surveillance areas. Invasive MRSA infection affects certain populations disproportionately. It is a major public health problem primarily related to health care but no longer confined to intensive care units, acute care hospitals, or any health care institution.
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            Performance Standars for antimicrobial disks susceptibility tests

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              Performance standards for antimicrobial susceptibility testing

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                Author and article information

                Journal
                rsvm
                Revista de la Sociedad Venezolana de Microbiología
                Rev. Soc. Ven. Microbiol.
                Organo Oficial de la Sociedad Venezolana de Microbiología. (Caracas, DF, Venezuela )
                1315-2556
                December 2012
                : 32
                : 2
                : 88-94
                Affiliations
                [01] Maracaibo orgnameUniversidad del Zulia orgdiv1Escuela de Bioanálisis orgdiv2Facultad de Medicina Venezuela
                [02] Maracaibo orgnameHospital Universitario de Maracaibo orgdiv1Centro de Referencia Bacteriológica Servicio Autónomo Venezuela
                Article
                S1315-25562012000200003 S1315-2556(12)03200203
                f2ef897d-5400-419d-af43-97ff04b8ad78

                http://creativecommons.org/licenses/by/4.0/

                History
                : 10 September 2011
                : 10 May 2012
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 44, Pages: 7
                Product

                SciELO Venezuela

                Categories
                Artículos Originales

                erythromycin,methicillin,phenotypic and genotypic,Staphylococcus aureus,eritromicina,meticilina,resistencia fenotípica y genotípica

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