Integration of molecular characterization of microorganisms in a global antimicrobial resistance surveillance program

Integration of molecular characterization of microorganisms in a global antimicrobial resistance surveillance program

Autor Pfaller, M. A. Google Scholar
Acar, J. Google Scholar
Jones, R. N. Google Scholar
Verhoef, J. Google Scholar
Turnidge, J. Google Scholar
Sader, Helio Silva Autor UNIFESP Google Scholar
Instituição Univ Iowa
Univ Paris 06
Univ Utrecht Hosp
Womens & Childrens Hosp
Universidade Federal de São Paulo (UNIFESP)
Resumo The SENTRY Antimicrobial Surveillance Program has incorporated molecular strain typing and resistance genotyping as a means of providing additional information that may be useful for understanding pathogenic microorganisms worldwide. Resistance phenotypes of interest include multidrug-resistant pathogens, extended-spectrum beta -lactamase (ESBL)-producing Enterobacteriaceae, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, and fluoroquinolone-resistant (FQR) strains of gram-negative bacilli and Streptococcus pneumoniae. Clusters of greater than or equal to2 isolates within a given resistance profile that are linked temporally and by hospital location are flagged for DNA fingerprinting. Further characterization of organisms with respect to resistance genotype is accomplished with use of polymerase chain reaction and DNA sequencing. This process has been highly successful in identifying clonal spread within clusters of multiresistant pathogens. Between 50% and 90% of MRSA clusters identified by phenotypic screening contained evidence of clonal spread. Among the Enterobacteriaceae, ESBL-producing strains of Escherichia coli and Klebsiella pneumoniae are the most common pathogens causing clusters of infection, and 50% of recognized clusters demonstrate clonal spread. Clusters of Pseudomonas aeruginosa, Acinetobacter species, and Stenotrophomonas maltophilia have been noted with clonal spread among patients with urinary tract, respiratory, and bloodstream infections. Characterization of mutations in the FQR-determining region of phenotypically susceptible isolates of E. coli and S. pneumoniae has identified first-stage mutants among as many as 40% of isolates. the ability to characterize organisms phenotypically and genotypically is extremely powerful and provides unique information that is important in a global antimicrobial surveillance program.
Idioma Inglês
Data de publicação 2001-05-15
Publicado em Clinical Infectious Diseases. Chicago: Univ Chicago Press, v. 32, p. S156-S167, 2001.
ISSN 1058-4838 (Sherpa/Romeo, fator de impacto)
Publicador Univ Chicago Press
Extensão S156-S167
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000168311200007
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