JAC Advance Access published online on August 27, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn326
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Original research |
Are methicillin-resistant Staphylococcus aureus that produce Panton–Valentine leucocidin (PVL) found among residents of care homes?
1 Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK 2 Faculty of Biological Sciences, University of Leeds, Leeds LS1 9NL, UK 3 Leeds Primary Care Trust, Stockdale House, Victoria Road, Leeds LS6 1PF, UK 4 Central Lancashire Primary Care Trust, Wigan Road, Ormskirk L39 2JW, UK 5 Health Protection Agency, Yorkshire and the Humber, Bridle Path, York Road, Leeds LS15 7TR, UK
Received 5 June 2008; returned 3 July 2008; revised 16 July 2008; accepted 21 July 2008
* Correspondence address. Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK. Tel: +44-113-39-23929; Fax: +44-113-343-5649; E-mail: carolyne.smith{at}leedsth.nhs.uk
Objectives: Panton–Valentine leucocidin (PVL)-positive Staphylococcus aureus are responsible for causing skin and soft tissue infections, with the potential to cause severe invasive disease. Recently, methicillin-resistant Staphylococcus aureus (MRSA) strains that produce PVL have emerged in the community. As residents of care homes are a key group at risk of MRSA colonization and infection, we have examined the epidemiology of MRSA in three large cohorts of residents in urban care homes to establish whether PVL-positive MRSA strains are present in this setting.
Methods: Nasal swabs (n = 3037) collected from consenting residents of 69 care homes in Leeds, UK, were screened for MRSA using chromogenic agar over three periods (June–August 2005, November–December 2006 and October–November 2007). PCR amplification was used to detect genes encoding PVL. Antibiogram profile and PFGE were also used to characterize MRSA isolates (n = 601).
Results: MRSA prevalence was 21%, 20% and 19% in each cohort, respectively. The majority of the isolates were related epidemiologically to the predominant local nosocomial epidemic MRSA strain, EMRSA-15 (78%). No isolate carried the genes encoding PVL. Twelve percent of the isolates (n = 74) had increased susceptibility to non-β-lactam agents and were distributed across 31 care homes.
Conclusions: MRSA strains that produced PVL were not found to be colonizing residents of care homes between 2005 and 2007. Continued surveillance is, however, necessary to understand the interaction between MRSA in care homes and hospitals, especially to reduce the chance that the former may amplify community-associated MRSA strains.
Key Words: community , epidemiology , MRSA