%0 Journal Article %J Eur J Clin Microbiol Infect Dis %D 2012 %T Previous healthcare exposure is the main antecedent for methicillin-resistant Staphylococcus aureus carriage on hospital admission in Belgium. %A Vandendriessche, S %A Hallin, M %A Boudewijn Catry %A Jans, B %A Deplano, A %A Nonhoff, C %A Roisin, S %A de Mendonça, R %A Struelens, M J %A Denis, O %K ADOLESCENT %K Adult %K Aged %K Aged, 80 and over %K Bacterial Toxins %K Belgium %K Carrier State %K Child %K Child, Preschool %K Cluster Analysis %K Diagnostic Tests, Routine %K Exotoxins %K Female %K hospitals %K Humans %K Infant %K Infant, Newborn %K Leukocidins %K Male %K Methicillin-Resistant Staphylococcus aureus %K middle aged %K Molecular Epidemiology %K Molecular Typing %K prevalence %K Risk Factors %K Staphylococcal Infections %K Young adult %X

This study aimed to estimate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage upon hospital admission and to study the molecular epidemiology of MRSA in order to assess the proportion of Panton-Valentine leukocidin (PVL)-positive community-associated (CA) and livestock-associated (LA) MRSA strains. Epidemiological data on MRSA carriage upon hospital admission (2006-2009) were collected in a compulsory, continuous, national MRSA surveillance in Belgian acute-care hospitals. Additionally, 328 MRSA strains in 2005 and 314 strains in 2008 were collected in a separate, multicenter microbiological survey. Spa-typing, SCCmec-typing and MLST were performed; toxin genes were detected by PCR. The overall prevalence of MRSA carriage upon hospital admission was 8.9 cases/1,000 admissions between 2006 and 2009. Of MRSA carriers, 37.5% had a known MRSA history, 39.4% had stayed in a care facility, 12.2% reported no contact with healthcare. Over 90% of MRSA belonged to five healthcare-associated clones. Of these, MRSA spa-CC038-ST45-IV was in decline, mainly in favor of spa-CC008-ST8-IV. MRSA spa-CC002-ST5-IV, spa-CC002-ST5-II and spa-CC032-ST22-IV remained relatively stable. The proportion of PVL-positive CA-MRSA and LA-MRSA ST398 was below 2% of all MRSA. The extra-hospital MRSA reservoir in Belgium mainly consists of persons with previous healthcare exposure. PVL-positive CA-MRSA and LA-MRSA strains remained infrequent among hospitalized patients.

%B Eur J Clin Microbiol Infect Dis %V 31 %P 2283-92 %8 2012 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22382816?dopt=Abstract %& 2283 %R 10.1007/s10096-012-1567-0