Authors:Hedda Milch, Judit Pászti, Tímea Erdősi, and et al.
An account is given on the activity of the National Center for Phage Typing of Staphylococci in Hungary in the period between 1997 and 2000 related to methicillin resistant Staphylococcus aureus (MRSA) strains originating mainly from hospital infections and sporadic cases. The rate of multiresistant MRSA strains has decreased gradually from 98.1% in 1997 to 74.6% in 2000, accordingly the typability by phages showed a considerable improvement by the international basic phages. Resistance pattern of MRSA strains became narrower in the period of the examinations. With the exception of erythromycin the rate of resistance decreased probably as a consequence of the increased use of erythomycin. The typing method was completed with the phenotypic and genotypic characterization of macrolide resistance. Among 73 MRSA strains type A was the most frequent macrolide resistance group, while type B, C1 and C2 occurred rarely. Type A was frequent also among the few MSSA and CNS strains. Out of the 168 examined S. aureus strains ermA genes occurred in 81.5%; in MSSA and CNS strains ermC1 genes were frequent, both genes are responsible for the target modification. The msrA gene, encoding the increased efflux, occurred only in CNS strains. Comparing the results obtained by phenotyping (phage typing) and genotyping (AP-PCR) methods it is of note that MRSA strains which proved non-typable by phage typing gave suitable results by the AP-PCR.
Authors:Ákos Tóth, Brigitta Berta, Tamás Tirczka, Csilla Jekkel, Anita Ábrahám, Zoltán Prohászka, Zsófia Bognár, and Tímea Erdősi
A Hungarian soldier previously immunized against Neisseria meningitidis by quadrivalent polysaccharide vaccine was twice infected with meningococci within six weeks. The patient was treated with ceftriaxone during both episodes and he successfully recovered. His close contacts received rifampicin prophylaxis. An investigation was performed to characterize the genetic background of the pathogens to ascertain if the recurrent invasive meningococcal disease was caused by the same strain and to find out the reason for reinfection. Both meningococci belonged to the fine type Y:P1.5-2,10-1:F4-1:ST-23. This is the first description of the Europe-wide prevalent N. meningitidis serogroup Y in Hungary. In the first episode, we found wild-type rpoB allele in the non-culturable sample implying the susceptibility to rifampicin. The culturable isolate from the second episode proved resistant to rifampicin and had a point mutation in the rpoB gene. The rifampicin resistance might have evolved during the prophylactic treatment of contacts. Previous immunization of the patient with polysaccharide vaccine was ineffective due to his immunodeficiency, thus immunization with conjugate vaccine was proposed. We have proposed the implementation of centralized rifampicin susceptibility testing of N. meningitidis strains within a defined time frame to intervene and administer appropriate prophylaxis to close contacts.