Preadmission screening of adults highlights previously unrecognized carriage of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus in London: A cause for concern?

Nicholas M. Pantelides, Guduru Gopal Rao*, Andre Charlett, Angela Kearns

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

In the first study of its kind in the United Kingdom, we describe the colonization rate of ciprofloxacin-sensitive Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus (PVL-MRSA) in adult patients who were screened systematically at the time of hospital admission. We also describe the molecular characteristics of PVL-MRSA and antibiotic resistance phenotypes. A total of 55,760 specimens were screened for MRSA between April 2008 and December 2010. MRSA was identified in 1,998 specimens, and ciprofloxacin-susceptible (CSMRSA) isolates (385/1,998, or 19.3%) were subjected to PVL testing. Of these, 70 (18.1%) were identified as PVL-CSMRSA. During the study period, the MRSA colonization rate decreased from 4.6% to 2.8%. In contrast, the colonization rate of PVL-CSMRSA increased over time, rising from 0.075% in 2008 and 0.07% in 2009 to 0.22% in 2010. The mean patient age was 52 years (range, 18 to 90 years); over two-thirds were male. Seven different lineages of PVL-CSMRSA were identified. Over the 3 years, the Southwest Pacific clone (CC30) was dominant in our population. The CC5 clone was detected once in 2008 and not at all in 2009 but accounted for a third of all PVL-CSMRSA strains in 2010. This lineage was commonly associated with clindamycin resistance and, less frequently, tetracycline resistance. We conclude that there is hitherto unrecognized low-level carriage of PVL-CSMRSA among patients being admitted to hospitals in northwest London. We observed the emergence of the CC5 clone in 2010 with associated clindamycin and tetracycline resistance.

Original languageEnglish
Pages (from-to)3168-3171
Number of pages4
JournalJournal of Clinical Microbiology
Volume50
Issue number10
DOIs
Publication statusPublished - Oct 2012

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