Epidemiology and antimicrobial susceptibility trends of methicillin-resistant Staphylococcus aureus in a tertiary hospital


  • Thiago César Nascimento Federal University of Juiz de Fora
  • Vânia Lúcia Silva Federal University of Juiz de Fora
  • Márcia Lucas Araújo Federal University of Juiz de Fora
  • Marina Barros Campos Federal University of Juiz de Fora
  • Alessandra Barbosa Ferreira-Machado Federal University of Juiz de Fora
  • Dennis Carvalho Ferreira Estácio de Sá University
  • Murilo Gomes Oliveira Federal University of Juiz de Fora
  • Cláudio Galuppo Diniz Federal University of Juiz de Fora




(Staphylococcus aureus, antimicrobial susceptibility, methicillin-resistance).


Introduction: Staphylococcus aureus is a major cause of health care associated infections worldwide.

Objective: The aim of this work was to evaluate epidemiological characteristics and antimicrobial susceptibility of Methicillin-resistant S. aureus (MRSA) strains isolates from infections in a Brazilian tertiary hospital.

Methods: Clinical and epidemiological data of the patients were collected. Bacterial strains were isolated and identified using the classical identification tests. Antimicrobial susceptibility assays were performed using the disc-diffusion method.

Findings: A total of 590 samples of S. aureus were isolated from patients and 42.5% were characterized as MRSA. Considering the clinical specimens, most of samples were isolated from blood and tracheal secretion, catheter tip, surgical site swabs, wound secretion, exudates and urine. Overall, a high frequency of resistance was observed against ciprofloxacin, clindamycin, erythromycin, amikacin, gentamicin, trimethoprim-sulfamethoxazole, tetracycline and chloramphenicol. Association between death and multidrug-resistance in elderly patients, and death and occurrence of bacteremia by multidrug-resistant MRSA was observed.

Conclusions: Our data are highly relevant for surveillance systems and to map on a wider scale the dynamics of circulation of MRSA and raise discussions on containment strategies and rational use of empiric chemotherapy.

Author Biographies

Thiago César Nascimento, Federal University of Juiz de Fora

Department of Parasitology, Microbiology and Immunology

Nursing School, Department of Basic Nursing


Vânia Lúcia Silva, Federal University of Juiz de Fora

Department of Parasitology, Microbiology and Immunology

Márcia Lucas Araújo, Federal University of Juiz de Fora

Department of Parasitology, Microbiology and Immunology

Marina Barros Campos, Federal University of Juiz de Fora

Department of Parasitology, Microbiology and Immunology

Alessandra Barbosa Ferreira-Machado, Federal University of Juiz de Fora

Department of Parasitology, Microbiology and Immunology

Dennis Carvalho Ferreira, Estácio de Sá University

School of Dentistry

Murilo Gomes Oliveira, Federal University of Juiz de Fora

Department of Pharmaceutical Sciences

Cláudio Galuppo Diniz, Federal University of Juiz de Fora

Department of Parasitology, Microbiology and Immunology


Boucher HW, Corey GR. Epidemiology of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 2008; 46:344-9.

Morton AP, Clements AC, Doidge SR, Stackelroth J, Curtis M, Whitby M. Surveillance of healthcare-acquired infections in Queensland, Australia: data and lessons from the first 5 years. Infect Control Hosp Epidemiol 2008;29:695-701.

Rosenthal VD, Maki DG, Mehta A, Alvarez-Moreno C, Leblebicioglu H, Hiquera F, et al. International Nosocomial Infection Control Consortium report, data summary for 2002-2007, issued January 2008. Am J Infect Control 2008;36:627-37.

Ito T, Okuma K, Ma XX, Yuzama H, Hiramatsu K. Insights on antibiotic resistance of Staphylococcus aureus from its whole genome: genomic island SCC. Drug Resist. Updat 2003;6:41-52.

Chambers HF. The changing epidemiology of Staphylococcus aureus? Emerg.Infect. Dis 2001;7:178-82.

Haley CC, Mittal D, Laviolette A. Methicillin-resistant Staphylococcus aureus infection or colonization present at hospital admission: multivariable risk factor screening to increase efficiency of surveillance culturing. J Clin Microbiol 2007;45:3031-38.

Gorwitz RJ, Kruszon-Moran D, McAllister SK. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and update. J Infect Dis 2008;197:1226-34.

Conterno LO, Wey SB, Castelo A. Risk factors for mortality in Staphylococcus aureus bacteremia. Infect Control Hosp Epidemiol 1998;19:32-7.

Guilarde AO, Turchi MD, Martelli CM, Primo MG. Staphylococcus aureus bacteraemia: incidence, risk factors and predictors for death in a Brazilian teaching hospital. J Hosp Infect 2006; 63:330-6.

Bannerman TL, Peacock SJ. Staphylococcus, Micrococcus and other catalase-positive cocci. In: Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA, editors. Manual of clinical microbiology. 9th ed. Washington [DC]: ASM Press; 2007. pp 390-411.

Clinical Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twentieth informational supplement. CLSI document M100eMS20. Wayne [PA]. Clinical Laboratory Standards Institute; 2010.

Azeez-Akande O. Global trend of methicillin-resistant Staphylococcus aureus and emerging challenges for control. Afr J Cln Exper Microbiol 2010;1:150-8.

Kuehnert MJ, Hill HA, Kupronis BA, Tokars JI, Solomon SL, Jernigan DB. Methicillin-resistant Staphylococcus aureus hospitalizations, United States. Emerg Infect Dis 2005;11:868-72.

Huang H, Flynn NM, King JH, Monchaud C, Morita M, Cohen SH. Comparisons of Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) and Hospital-Associated MSRA Infections in Sacramento, California. J Clin Microbiol 2006;44:2423-7.

High K. Infection as a cause of age-related morbidity and mortality. Ageing Res Rev 2004;3:1-14.

Selvey LA, Whitby M, Johnson B. Nosocomial methicillin-resistant Staphylococcus aureus bacteremia: is it any worse than nosocomial methicillin sensitive Staphylococcus aureus bacteremia? Infect Control Hosp Epidemiol 2000;21:645-8.

Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillin-resistant and methicillin susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 2003;36:53-9.

European Antimicrobial Resistance Surveillance System (EARSS). 2005 < http://www.rivm.nl/earss/database.html>

National Nosocomial Infections Surveillance (NNIS) System Report. Data summary from january 1992 through june 2004. Am J Infect Control 2004;32:470-85.

Diekema DJ, Pfaller MA, Scmitz FJ, Smayevsky J, Bell J, Jones RN, et al. Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific Region for the SENTRY antimicrobial surveillance program, 1997-1999. Clin Infect Dis 2001;32:114-32.

Sader HS, Jones RN, Gales AC, Silva JB, Pignatari AC, Sentry Participants Group. Sentry antimicrobial surveillance program report: latinamerican and brazilian results for 1997 through 2001. Braz J Infect Dis 2004;8:25-79.

Gales AC, Sader HS, Ribeiro J, Zoccoli C, Barth A, Pignatari AC. Antimicrobial susceptibility of gram-positive bacteria isolated in brazilian hospitals participating in the SENTRY program (2005-2008). Braz J Infect Dis 2009;13:90-8.

Klevens RM, Edwards JR, Tenover FC, McDonald LC, Horan T, Gaynes R. Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003. Clin Infect Dis 2006;42:389-91.

Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA, et al. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol 2008;29:996-1011.

Huang SS, Platt R. Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clin Infect Dis 2003;36:281-5.

Carnicer-Pont D, Bailey KA, Mason BW, Walker AM, Evans MR, Salmon RL. Risk factors for hospital-acquired methicillin-resistant Staphylococcus aureus bacteraemia: a case-control study. Epidemiol Infect 2006;134:1167-73.

Aksoy DY, Unal S. New antimicrobial agents for the treatment of Gram-positive bacterial infections. Clin Microbiol Infect 2008;14:411-20.

Fundação de Amparo à Pesquisa de Minas Gerais (FAPEMIG)

Streit JM, Jones RN, Sader HS, Fritsche TR. Assessment of pathogen occurrences and resistance profiles among infected patients in the intensive care unit: report from the Sentry antimicrobial surveillance program (North America, 2001). Intern J Antimcrob Agents 2004;24:111-8.

Hiramatsu K, Cui L, Kuroda M, Ito T. The emergence and evolution of methicillin-resistant Staphylococcus aureus. Trends Microbiol 2001;9:486-93.

Rybak MJ. The pharmacokinetic and pharmacodynamic properties of vancomycin. Clin Infect Dis 2006;42:35-9.







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