Pomen uporabe PFGE v endemskih pogojih pojavljanja MRSA = Prudent use of PFGE in endemic situations caused by MRSA
Žohar Čretnik, Tjaša ...
An endemic pattern of methicillin-resistant Staphylococcus aureus (MRSA) occurrence is the most frequently observed epidemiological situation in healthcare institutions all over the world. The most ...successful containment strategy in an endemic situation is yet to be discovered. Because not much is known about the genetic structure of isolates that form an endemic, the real nature of this epidemiologic state is not understood and we are thus mostly unsuc cessful in resolving it. Molecular typing methods are needed to gain insight into this problem. As hundreds of isolates are usually isolated in such circumstances, two of the most important questions that were addressed inour study were: firstly, how extensive routine typing is needed to be able to detect epidemic MRSA strains that are introduced into health care institutions, and, secondly, how to select a representative set of isolates tofollow major changes in the genetic structure of MRSA isolates present in a selected institution. Invasive isolates were selected as a representative group and compared with non-invasive isolates of MRSA. The gold standard molecular typing method for MRSA, pulsed field gel electrophoresis (PFGE), wasused. All isolates from blood cultures (72 isolates) and 150 non-invasive, randomly selected isolates, recovered every two years from different clinical samples, were analyzed. In this analysis, 23 PFGE genotypes were detected. Genotype T with its 17 different subtypes prevailed in 1993. As much as 86.7% of non-invasive isolates, as well as the only isolate from blood culture, belonged to this genotype. However, it was no longer present in 1995. GenotypeB with its 12 subtypes appeared in 1994. The proportion of isolates characterized as genotype B reached 100% among invasive isolates in 1994, and 60% among non-invasive isolates in 1997. Genotype A with its 18 subtypes was detected in 1995. (Abstract truncated at 2000 characters)
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