Diversidade de estirpes de Staphylococcus aureus isoladas num hospital de Lisboa num período de quatro anos.

Resumo

Over a 4-year period, 2020 Staphylococcus aureus strains isolated in Santa Maria Hospital were studied, 26.3% of which were methicillin-resistant (MRSA). The main specimens from which the strains were isolated included pus, blood and sputum/bronchial secretions. Isolation in blood cultures was the most common source among patients from medical units. Antimicrobial susceptibility studies showed that while in methicillin susceptible strains sensitivity to other antimicrobial agents (apart from penicillin resistance) was the rule, in MRSA strains there was resistance to most antibiotics. Only vancomycin was active against all strains. Phage typing showed that 75.5% of the strains were typable with phages at 100 x R.T.D. Among methicillin sensitive strains, a big diversity of phage patterns was observed, including phage groups I, II, III and V, as well as with phage association D11/95. The large majority of MRSA strains were lysed by group III phages, although several distinct patterns were observed. Within these strains, lysis by groups II and V phages was not observed. Plasmid profiling was the least discriminant issue in the characterization of these micro-organisms because most of the strains harboured only one plasmid (or none). These results showed that a dominant MRSA strain did not exist in this hospital, but rather several distinct strains. The importance, as well as the difficulties in controlling the spread of MRSA strains in the present conditions of high prevalence, are highlighted.