Publication details
Characteristics of <I>Staphylococcus aureus</I> strains from 5 outbreaks of pemphigus neonatorum in the Czech Republic and Slovakia
| Authors | |
|---|---|
| Year of publication | 2008 |
| Type | Article in Proceedings |
| Conference | 13th International Symposium on Staphylococci and Staphylococcal Infections |
| MU Faculty or unit | |
| Citation | |
| Web | http://www.isssi2008.com/ |
| Field | Genetics and molecular biology |
| Keywords | Staphylococcus aureus; exfoliative toxin; pemphigus neonatorum; molecular typing; pulsed field gel electrophoresis |
| Description | Objectives: To characterize S. aureus (SAU) strains producing exfoliative toxins A (ETA) and/or B (ETB) from 5 outbreaks of pemphigus neonatorum. Methods: As many as 366 SAU strains were referred to the National Reference Laboratory for Staphylococci, NIPH, Prague, from pemphigus neonatorum outbreaks in 4 Czech (A, B, C, and D) and 1 Slovak (E) hospitals in 2006 - 2008. The strains were tested by phenotypic (RPLA, phage-typing) and genotypic methods (PFGE; prophage carriage by multiplex PCR targeting prophages significant in lysogenic conversion of ETA production). Results: As many as 118 of the 366 isolates under study were found to produce one, or two of exfoliative toxins. Hospital A. Sixty-nine SAU strains originating from an outbreak persisting for more than 6 months included 12 producers of both ETA and ETB classified into phage type (PT) 3A/3C/55 from newborns and mothers and 8 isolates from health care professionals. Hospital B. Of 35 SAU isolates, 13 were ETA producers (PT 47/75) from newborns and 3 originated from nurses. Hospital C. Altogether 146 SAU strains originated from an extended outbreak (November 2006 through August 2007). Of 36 toxigenic strains, 11 produced ETA and 25 ETA+ETB. The exfoliatin producers showed an identical PFGE pattern. Twenty-nine ETA and/or ETB producers were from newborns (blister fluid, navel swabs, impetigo, paronychia), two originated from mothers (impetigo and nasal swab), and one from a nasal swab from a nurse. The detection of 4 ETA+ETB producers from the hospital environment was of high relevance. The ETA+ETB-positive strains isolated in Hospital C showed identical PFGE patterns as did one strain, ETA+ETB producer, from the Hospital D. Hospital D. Fifty-seven SAU strains from one outbreak of pemphigus neonatorum in 2008. Nineteen strains with hyperproduction of exfoliatin B originated from children and mothers (nasal swabs and impetigo), and one such strain was isolated from children's balm. Slovak Hospital E. A long-standing outbreak has been observed since 2003. Since November 2006, 44 SAU strains were referred to NRL. Fifteen strains were identical ETA producers (PT 47/75) from newborns' blisters and 1 such strain was a nasal isolate from a nurse. Genotyping revealed that the strains isolated in Slovak hospital E in 2003 and 2006 are of the same PFGE type. A highly similar PFGE profile was identified in the causative SAU strains in hospital B. Interestingly, all studied ET-positive strains were harboring the same types of prophages (group B and Fb-like). Conclusions: Genotyping was helpful in identifying the source of infection and controlling nosocomial outbreaks of pemhigus neonatorum in newborns. |
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