Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors
Objective: Substantial rise in the annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) was reported in Southwest Finland (12.4–24.9/100,000 people) between 2007 and 2016. To understand the implications of these changes to the management of MRSA, we sought to analyse the antimicrob...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524004557 |
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| author | Jaakko Silvola Kirsi Gröndahl-Yli-Hannuksela Tiina Hirvioja Kaisu Rantakokko-Jalava Mari Kanerva Kari Auranen Harri Marttila Jenna Junnila Jaana Vuopio |
| author_facet | Jaakko Silvola Kirsi Gröndahl-Yli-Hannuksela Tiina Hirvioja Kaisu Rantakokko-Jalava Mari Kanerva Kari Auranen Harri Marttila Jenna Junnila Jaana Vuopio |
| author_sort | Jaakko Silvola |
| collection | DOAJ |
| description | Objective: Substantial rise in the annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) was reported in Southwest Finland (12.4–24.9/100,000 people) between 2007 and 2016. To understand the implications of these changes to the management of MRSA, we sought to analyse the antimicrobial resistance (AMR) trends of MRSA in relation with patient characteristics. Methods: Antimicrobial susceptibility was determined for 10 clinically relevant antimicrobials. Strains with resistance to ≥2 antimicrobials were defined multi-resistant. The isolates were spa-typed and clustered. AMR trends and risk factors were identified by associating resistant phenotypes with patient demographics. Results: A total of 983 new MRSA cases were identified between 2007 and 2016. After 2011, significant increasing trends were observed in the proportion of isolates resistant to clindamycin (13.9%–31.5%, P < 0.001), erythromycin (19.4%–35.4%, P < 0.001) and tetracycline (16.7%–32%, P < 0.001). The proportion of multi-resistant isolates more than doubled from 14.8% to 39.2%. The increasing AMR trend was reflected in the increase of new strain types and the decrease of previously dominant, non-multi-resistant strains. Patient risk factors associated with (P < 0.001) the acquisition of multi-resistant strains included community acquisition, livestock contact, hospital care abroad and immigrant status. Conclusions: Notable increasing AMR trends among MRSA isolates were observed in Southwest Finland, 2007–2016. The shift in patient demographics to younger age groups and community acquisition contributed to the increase in multi-resistant strains. Immigration, contact with hospital environment abroad and contact with livestock were identified as essential risk factors of multi-resistance. The increased level of co-resistance has persisted after 2016. |
| format | Article |
| id | doaj-art-79fea8b4771549a4a5b50a817f3af5c5 |
| institution | Kabale University |
| issn | 2213-7165 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj-art-79fea8b4771549a4a5b50a817f3af5c52025-02-08T05:00:26ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-01-01404752Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factorsJaakko Silvola0Kirsi Gröndahl-Yli-Hannuksela1Tiina Hirvioja2Kaisu Rantakokko-Jalava3Mari Kanerva4Kari Auranen5Harri Marttila6Jenna Junnila7Jaana Vuopio8Institute of Biomedicine, University of Turku, Turku, Finland; Corresponding author. Mailing address: Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10 D, 20520 Turku, Finland.Institute of Biomedicine, University of Turku, Turku, FinlandDepartment of Hospital Hygiene & Infection Control, Turku University Hospital, Turku, FinlandClinical Microbiology Laboratory, Turku University Hospital, Turku, FinlandDepartment of Hospital Hygiene & Infection Control, Turku University Hospital, Turku, FinlandDepartment of Mathematics and Statistics and Department of Clinical Medicine, University of Turku, Turku, FinlandDepartment of Hospital Hygiene & Infection Control, Turku University Hospital, Turku, FinlandInstitute of Biomedicine, University of Turku, Turku, FinlandInstitute of Biomedicine, University of Turku, Turku, Finland; Clinical Microbiology Laboratory, Turku University Hospital, Turku, Finland; Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, FinlandObjective: Substantial rise in the annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) was reported in Southwest Finland (12.4–24.9/100,000 people) between 2007 and 2016. To understand the implications of these changes to the management of MRSA, we sought to analyse the antimicrobial resistance (AMR) trends of MRSA in relation with patient characteristics. Methods: Antimicrobial susceptibility was determined for 10 clinically relevant antimicrobials. Strains with resistance to ≥2 antimicrobials were defined multi-resistant. The isolates were spa-typed and clustered. AMR trends and risk factors were identified by associating resistant phenotypes with patient demographics. Results: A total of 983 new MRSA cases were identified between 2007 and 2016. After 2011, significant increasing trends were observed in the proportion of isolates resistant to clindamycin (13.9%–31.5%, P < 0.001), erythromycin (19.4%–35.4%, P < 0.001) and tetracycline (16.7%–32%, P < 0.001). The proportion of multi-resistant isolates more than doubled from 14.8% to 39.2%. The increasing AMR trend was reflected in the increase of new strain types and the decrease of previously dominant, non-multi-resistant strains. Patient risk factors associated with (P < 0.001) the acquisition of multi-resistant strains included community acquisition, livestock contact, hospital care abroad and immigrant status. Conclusions: Notable increasing AMR trends among MRSA isolates were observed in Southwest Finland, 2007–2016. The shift in patient demographics to younger age groups and community acquisition contributed to the increase in multi-resistant strains. Immigration, contact with hospital environment abroad and contact with livestock were identified as essential risk factors of multi-resistance. The increased level of co-resistance has persisted after 2016.http://www.sciencedirect.com/science/article/pii/S2213716524004557MRSAS. aureusAntimicrobial resistancespa typingSouthwest FinlandEpidemiology |
| spellingShingle | Jaakko Silvola Kirsi Gröndahl-Yli-Hannuksela Tiina Hirvioja Kaisu Rantakokko-Jalava Mari Kanerva Kari Auranen Harri Marttila Jenna Junnila Jaana Vuopio Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors Journal of Global Antimicrobial Resistance MRSA S. aureus Antimicrobial resistance spa typing Southwest Finland Epidemiology |
| title | Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors |
| title_full | Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors |
| title_fullStr | Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors |
| title_full_unstemmed | Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors |
| title_short | Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors |
| title_sort | increasing trend of antimicrobial resistance among methicillin resistant staphylococcus aureus strains in southwest finland 2007 2016 an analysis of shifting strain dynamics and emerging risk factors |
| topic | MRSA S. aureus Antimicrobial resistance spa typing Southwest Finland Epidemiology |
| url | http://www.sciencedirect.com/science/article/pii/S2213716524004557 |
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