Multinational surveillance programmes for methicillin-resistant Staphylococcus aureus (MRSA) are dependent on national structures for data collection. This study aimed to capture the diversity of national MRSA surveillance programmes and to propose a framework for harmonisation of MRSA surveillance. The International Society of Antimicrobial Chemotherapy (ISAC) MRSA Working Group conducted a structured survey on MRSA surveillance programmes and organised a webinar to discuss the programmes' strengths and challenges as well as guidelines for harmonisation. Completed surveys represented 24 MRSA surveillance programmes in 16 countries. Several countries reported separate epidemiological and microbiological surveillance. Informing clinicians and national policy-makers were the most common purposes of surveillance. Surveillance of bloodstream infections (BSIs) was present in all programmes. Other invasive infections were often included. Three countries reported active surveillance of MRSA carriage. Methodology and reporting of antimicrobial susceptibility, virulence factors, molecular genotyping and epidemiological metadata varied greatly. Current MRSA surveillance programmes rely upon heterogeneous data collection systems, which hampers international epidemiological monitoring and research. To harmonise MRSA surveillance, we suggest improving the integration of microbiological and epidemiological data, implementation of central biobanks for MRSA isolate collection, and inclusion of a representative sample of skin and soft-tissue infection cases in addition to all BSI cases.

• MeSH
• antibakteriální látky farmakologie   terapeutické užití   MeSH
• epidemiologické monitorování MeSH
• infekce měkkých tkání * farmakoterapie   MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus * MeSH
• stafylokokové infekce * farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Several studies have addressed the epidemiology of community-associated Staphylococcus aureus (CA-SA) in Europe; nonetheless, a comprehensive perspective remains unclear. In this study, we aimed to describe the population structure of CA-SA and to shed light on the origin of methicillin-resistant S. aureus (MRSA) in this continent. METHODS AND FINDINGS: A total of 568 colonization and infection isolates, comprising both MRSA and methicillin-susceptible S. aureus (MSSA), were recovered in 16 European countries, from community and community-onset infections. The genetic background of isolates was characterized by molecular typing techniques (spa typing, pulsed-field gel electrophoresis and multilocus sequence typing) and the presence of PVL and ACME was tested by PCR. MRSA were further characterized by SCCmec typing. We found that 59% of all isolates were associated with community-associated clones. Most MRSA were related with USA300 (ST8-IVa and variants) (40%), followed by the European clone (ST80-IVc and derivatives) (28%) and the Taiwan clone (ST59-IVa and related clonal types) (15%). A total of 83% of MRSA carried Panton-Valentine leukocidin (PVL) and 14% carried the arginine catabolic mobile element (ACME). Surprisingly, we found a high genetic diversity among MRSA clonal types (ST-SCCmec), Simpson's index of diversity = 0.852 (0.788-0.916). Specifically, about half of the isolates carried novel associations between genetic background and SCCmec. Analysis by BURP showed that some CA-MSSA and CA-MRSA isolates were highly related, suggesting a probable local acquisition/loss of SCCmec. CONCLUSIONS: Our results imply that CA-MRSA origin, epidemiology and population structure in Europe is very dissimilar from that of USA.

• MeSH
• genetická variace * MeSH
• infekce získané v komunitě * epidemiologie   mikrobiologie   MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus * genetika   MeSH
• mikrobiální testy citlivosti MeSH
• polymerázová řetězová reakce MeSH
• populační genetika MeSH
• pulzní gelová elektroforéza MeSH
• stafylokokové infekce * epidemiologie   mikrobiologie   MeSH
• Staphylococcus aureus * genetika   MeSH
• techniky typizace bakterií metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

Thirty-eight AmpC-producing Klebsiella pneumoniae isolates identified from January to October 2006 in a large teaching hospital in the Czech Republic were analyzed. The AmpC cephalosporinase was identified as DHA-1, encoded by a plasmid-located complex class 1 integron, previously observed in a K. pneumoniae isolate from the Parisian region. The DHA-1 expression was inducible, and although in two isolates with higher resistance, the induction effect was masked at the phenotypic level. All of the isolates belonged to the international K. pneumoniae clone sequence type 11, split into two disseminated pulsed-field gel electrophoresis types. This is the first report on enterobacteriaceae with acquired AmpCs in the Czech Republic and possibly the first description of organisms with DHA-1 in the Central and Eastern Europe.

• MeSH
• antibakteriální látky farmakologie   MeSH
• bakteriální proteiny biosyntéza   genetika   MeSH
• beta-laktamasy biosyntéza   genetika   MeSH
• infekce bakteriemi rodu Klebsiella epidemiologie   mikrobiologie   MeSH
• integrony genetika   MeSH
• Klebsiella pneumoniae účinky léků   enzymologie   genetika   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• nemocnice fakultní * MeSH
• plazmidy genetika   MeSH
• pulzní gelová elektroforéza MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Resistance to carbapenems in enterobacteria is mediated by the production of several types of carbapenemases or by the decreased permeability of the outer membrane, combined with the expression of extended-spectrum beta-lactamases (ESBLs) or AmpC-like cephalosporinases. The objective of this study was to characterize carbapenem-nonsusceptible (C-NS) isolates of Klebsiella pneumoniae in the University Hospital in Plzen (Czech Republic) and compare them with carbapenem-susceptible (C-S) K. pneumoniae isolates from the same patients. Six C-NS K pneumoniae isolates from different patients were collected between January 2007 and June 2008, and from three of these patients, C-S isolates were available for the study as well. The isolates were typed by pulsed-field gel electrophoresis and multilocus sequence typing. beta-Lactamases were analyzed by isoelectric focusing, bioassay, and PCR and sequencing of bla genes. Major porin channels, OmpK35 and OmpK36, were studied by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot; porin genes were amplified and sequenced, and their expression was assessed by reverse transcriptase-PCR. The C-NS isolates belonged to three pulsotypes and to the clone ST11, produced the SHV-5 ESBL and/or DHA-1 AmpC-type cephalosporinase, did not express OmpK36, and had a reduced expression of OmpK35. The C-S isolates differed from their C-NS counterparts only by porin expression profiles.

• MeSH
• antibakteriální látky farmakologie   MeSH
• bakteriální léková rezistence MeSH
• bakteriální proteiny genetika   metabolismus   MeSH
• beta-laktamasy genetika   metabolismus   MeSH
• infekce bakteriemi rodu Klebsiella mikrobiologie   MeSH
• karbapenemy farmakologie   MeSH
• Klebsiella pneumoniae klasifikace   účinky léků   enzymologie   genetika   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• nemocnice MeSH
• techniky typizace bakterií MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• antibakteriální látky farmakologie   MeSH
• bacilární dyzentérie mikrobiologie   MeSH
• beta-laktamasy biosyntéza   MeSH
• beta-laktamová rezistence * MeSH
• cestování * MeSH
• dospělí MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• Shigella sonnei klasifikace   účinky léků   enzymologie   izolace a purifikace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• dopisy MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Asie MeSH
• Česká republika MeSH