Incidence and characteristics of methicillin-resistant coagulase-negative Staphylococcus aureus in peritoneal dialysis-a
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NEPHROLOGY - ORIGINAL PAPER
Incidence and characteristics of methicillin‑resistant coagulase‑negative Staphylococcus aureus in peritoneal dialysis‑associated peritonitis in a single center using molecular methods Carlos Henrique Camargo1,2,3 · Maria de Lourdes Ribeiro de Souza da Cunha2 · Jacqueline Costa Teixeira Caramori1 · Alessandro Lia Mondelli1 · Augusto Cezar Montelli1,2 · Pasqual Barretti1 Received: 19 April 2020 / Accepted: 6 August 2020 © Springer Nature B.V. 2020
Abstract Purpose Peritonitis is a serious complication of peritoneal dialysis and coagulase-negative Staphylococcus (CNS) is the most frequent cause of peritoneal dialysis (PD)–infections in many centers. This study aimed to investigate the molecular epidemiology of CNS isolated from PD-peritonitis in a Brazilian single center, focusing on the genetic determinants conferring methicillin resistance. Methods Bacterial strains were isolated from peritoneal fluid of patients presenting PD-peritonitis, identified by phenotypic and molecular methods, and those identified as CNS were submitted to mecA detection, SCCmec, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Results Over the 18-year period of this study (1995–2011), a total of 878 peritonitis episodes were diagnosed in this unit, 115 were caused by coagulase-negative staphylococci of which 72 by Staphylococcus epidermidis. mecA gene was detected in 55 CNS (47.8%), more frequently on the more recent years. SCCmec type III was the most frequent cassette, followed by SCCmec type IV and SCCmec type II. A diverstity of pulsotypes was observed among the S. epidermidis isolates, but five clusters (based on the 80% cutoff) were identified. Diversified sequence types (ST02, ST05, ST06, ST09, ST23, ST59 and ST371) were detected. Conclusions Detection of SCCmec type III among coagulase-negative Staphylococcus underscores the role of hospital environments as potential source of methicillin-resistant Staphylococcus causing peritonitis in PD patients. Keywords Bacterial peritonitis · mecA · Peritoneal dialysis · PFGE · Sccmec · Staphylococcus epidermidis
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11255-020-02605-9) contains supplementary material, which is available to authorized users. * Carlos Henrique Camargo [email protected]
Pasqual Barretti [email protected]
Maria de Lourdes Ribeiro de Souza da Cunha [email protected]
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Jacqueline Costa Teixeira Caramori [email protected]
Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Botucatu, São Paulo, Brazil
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Department of Microbiology and Immunology, Biosciences Institute of Botucatu, Sao Paulo State University, Botucatu, São Paulo, Brazil
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Bacteriology Division, Instituto Adolfo Lutz, Avenida Dr. Arnaldo, 351 ‑ 9° Andar, Pacaembú, São Paulo, SP, Brasil
Alessandro Lia Mondelli [email protected] Augusto Cezar Montelli [email protected]
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