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Incidence and characteristics of methicillin-resistant coagulase-negative Staphylococcus aureus in peritoneal dialysis-associated peritonitis in a single center using molecular methods

  • Nephrology - Original Paper
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A Correction to this article was published on 25 September 2020

This article has been updated

Abstract

Purpose

Peritonitis is a serious complication of peritoneal dialysis and coagulase-negative Staphylococcus (CNS) is the most frequent cause of peritoneal dialysis (PD)–infections in many centers. This study aimed to investigate the molecular epidemiology of CNS isolated from PD-peritonitis in a Brazilian single center, focusing on the genetic determinants conferring methicillin resistance.

Methods

Bacterial strains were isolated from peritoneal fluid of patients presenting PD-peritonitis, identified by phenotypic and molecular methods, and those identified as CNS were submitted to mecA detection, SCCmec, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).

Results

Over the 18-year period of this study (1995–2011), a total of 878 peritonitis episodes were diagnosed in this unit, 115 were caused by coagulase-negative staphylococci of which 72 by Staphylococcus epidermidis. mecA gene was detected in 55 CNS (47.8%), more frequently on the more recent years. SCCmec type III was the most frequent cassette, followed by SCCmec type IV and SCCmec type II. A diverstity of pulsotypes was observed among the S. epidermidis isolates, but five clusters (based on the 80% cutoff) were identified. Diversified sequence types (ST02, ST05, ST06, ST09, ST23, ST59 and ST371) were detected.

Conclusions

Detection of SCCmec type III among coagulase-negative Staphylococcus underscores the role of hospital environments as potential source of methicillin-resistant Staphylococcus causing peritonitis in PD patients.

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Acknowledgements

This work was supported by the São Paulo Research Foundation (FAPESP) (grants numbers 2009/15727-8 and 2009/12052-0). The funding agency played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This publication made use of the PubMLST website (https://pubmlst.org/) developed by Keith Jolley (Jolley et al. Wellcome Open Res 2018, 3:124 [version 1; referees: 2 approved]) and sited at the University of Oxford. The development of that website was funded by the Wellcome Trust.

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Authors and Affiliations

  1. Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Botucatu, São Paulo, Brazil

    Carlos Henrique Camargo, Jacqueline Costa Teixeira Caramori, Alessandro Lia Mondelli, Augusto Cezar Montelli & Pasqual Barretti

  2. Department of Microbiology and Immunology, Biosciences Institute of Botucatu, Sao Paulo State University, Botucatu, São Paulo, Brazil

    Carlos Henrique Camargo, Maria de Lourdes Ribeiro de Souza da Cunha & Augusto Cezar Montelli

  3. Bacteriology Division, Instituto Adolfo Lutz, Avenida Dr. Arnaldo, 351 - 9° Andar, Pacaembú, São Paulo, SP, Brasil

    Carlos Henrique Camargo

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  1. Carlos Henrique Camargo
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  2. Maria de Lourdes Ribeiro de Souza da Cunha
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  3. Jacqueline Costa Teixeira Caramori
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  4. Alessandro Lia Mondelli
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Correspondence to Carlos Henrique Camargo.

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Camargo, C.H., de Souza da Cunha, M.d.R., Caramori, J.C.T. et al. Incidence and characteristics of methicillin-resistant coagulase-negative Staphylococcus aureus in peritoneal dialysis-associated peritonitis in a single center using molecular methods. Int Urol Nephrol 53, 373–380 (2021). https://doi.org/10.1007/s11255-020-02605-9

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