Curbing CA-MRSA in Denmark - Search and Destroy Works

Seminar

Title:  Curbing CA-MRSA in Denmark - Search and Destroy Works

Speaker: Henrik Westh

Affiliation: MRSA Knowledge Center, Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Denmark

Host: Herminia de Lencastre – Laboratório Associado

Abstract:

MRSA (methicillin resistant Staphylococcus aureus) has developed as a problem in Denmark over the last five years. To understand why, a MRSA Knowledge Center has been establish with the goal to keep MRSA at a low level (less than 1% of Staphylococcus aureus in blood cultures) by coordinating the Search and Destroy policies in Greater Copenhagen.
All MRSA isolates are extensively characterized by sequence based typing methods such as spa typing. MLST and dru-typing and important pathogenicity genes are screened for by PCR (SCCmec, PVL, ACME).
I will described how typing can focus Search and Destroy and reduce the spread of Community Acquired MRSA and stop spread of MRSA in Hospitals.
Structural differences in the SCCmec orfX region of MRSA are the cause of false negative screening samples for MRSA and current problems will be discussed.
 

Curriculum Vitae:

Positions: Consultant Microbiologist, Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark since 1997. Associate Research Professor, Copenhagen University
Responsibilities: Head of Molecular Biology, Virology and Chlamydia section. Head of Research and Development. Head of MRSA Knowledge Center,. CEO QuantiBact A/S and TinAmpA/S.
Academic degrees: Medical doctor, University of Copenhagen 1980, Specialist in Clinical Microbiology 1994, Business Economy, Copenhagen College of Business 1992, DMSc 1996.
Areas of Expertise: Expert in MRSA, Infection control, HIV and Chlamydia.
Has consulted for UNICEF (HIV-testing), for Euro Health Group (Laboratory implementation of a HIV treatment program in Mombasa, Kenya.), The Danish National Board of Health, The Danish Environmental Protection Agency, The Danish Medicines Agency, The Danish Cancer Society, CEO for QuantiBact A/S a small Biotech company based on a patent by Henrik Westh and Gorm Lisby. Chairmen of Advisory board SeqNet.org.
Major Research Focus: We have been established to control MRSA in our Region. Our research has a practical approach looking at evolution, epidemiology, typing, carriage, characteristics of patients’ illnesses and outcomes, infection-control and eradication therapies with the goal of keeping MRSA out of hospitals.
More than 80 scientific papers and book chapters and more than 175 presentations at approximately 75International congresses.
Some recent publications:
1. U. Neubel, P. Roumagnac, M. Feldkamp, J.-H- Song, K.S. Ko, Y.C. Huang, G. Coombs, M. Ip, H. Westh, R. Skov, M.J. Struelens, R.V. Goering, B. Stommenger, A. Weller, W. Witte, M. Achtman. Frequent emergence and limited geographic spread of methicillin-resistant Staphylococcus aureus. Proc Natl Acad Sci U S A. 2008;105(37):14130-5.
2. A.W. Friedrich, W. Witte, H. de Lencastre, W. Hryniewicz, J. Scheres, H. Westh, SeqNet.org participants. A European laboratory network for sequence-based typing of methicillin-resistant Staphylococcus aureus (MRSA) as a communication platform between human and veterinary medicine – an update on SeqNet.org. Eurosurveillance 2008;13(19):pii=18862.
3. M. D. Bartels, A. Nanuashvili, K. Boye, S. M. Rohde, N. Faria, N. Jashiashvili, M. Kereselidze, S. Kharebava, H. Westh. Hospital acquired Methicillin-Resistant Staphylococcus aureus in the Republic of Georgia – domination of the Brazilian clone. Accepted February 2008 European Journal of Clinical Microbiology and Infectious Diseases 2008;27(8):757-60 .
4. M. D. Bartels, K. Boye, A. R. Larsen, R. Skov, H. Westh. Rapid and genetically diverse increase of methicillin resistant Staphylococcus aureus in the community spreading into hospitals in Copenhagen, Denmark. Emerging Infectious Diseases. 2007;13:1533-40.
5. K. Boye, M.D. Bartels, I.S. Andersen J. A. Møller, H. Westh. A new multiplex PCR for easy screening of methicillin-resistant Staphylococcus aureus SCCmec types I to V. Clinical Microbiology and Infection 2007;13:725-7.
6.  M. S. Frederiksen, F. Espersen, N. Frimodt-Møller, A. G. Jensen, A. R. Larsen, L. V. Pallesen, R. Skov, H. Westh, P. Skinhøj, T. Benfield. Changing epidemiology of pediatric Staphylococcus aureus bacteremia in Denmark from 1971 through 2000. The Pediatric Infectious Disease Journal 2007;26:398-405. (
7. T. Benfield, F. Espersen, N. Frimodt-Møller, A.G. Jensen, A.R. Larsen, L.V. Pallesen, R. Skov, H. Westh, and P. Skinhøj. Increasing incidence but decreasing mortality of adult Staphylococcus aureus bacteremia from 1981 through 2000. Clincal Microbiology and Infection. 2007;13:257-63.
8. A. R. Gomes, H. Westh, H. de Lencastre. Origins and evolution of methicillin-resistant Staphylococcus aureus clonal lineages. Antimcrobial Agents Chemotherapy 2006;50:3237-44.
9. M.Aires de Sousa, K. Boye, H. de Lencastre, A. Deplano, M.C. Enright, J. Etienne, A. Friedrich, D. Harmsen, A. Holmes, X. Huijsdens, A. M. Kearns, A. Mellmann, H. Meugnier, J.K. Rasheed, E. Spalburg, B. Strommenger, M.J. Struelens, F.C. Tenover, J. Thomas, U. Vogel, H. Westh, J. Xu, W. Witte. High interlaboratory reproducibility of DNA sequence-based typing of bacteria in a multicenter study. Journal of Clinical Microbiology 2006;44:619-21.
10. N. Faria, D. C. Oliveira, H. Westh, D. L. Monnet, A. R. Larsen, R. Skov and H. de Lencastre. Community-Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA) clones circulating in Denmark. Journal of Clinical Microbiology. 2005;43:1836-42.
Advisor of PhD students
PhD, MD Margit Staum Kaltoft. Streptococcus pneumoniae in childhood. 2003.
MD, DMSc Kristian Schønning Thesis: Antibody neutralization ved HIV-1. 2003
PhD-student, MD Sidsel Böcher. The Influence of eradication of MRSA Carriage for spread of MRSA. 2005
PhD-student, MD Mette Damkjær Bartels.  Evolution of Community onset MRSA in Copenhagen. 2006
PhD students Nuno Faria and Teresa Conceicao, ITQB, Oeiras Portugal during 4 month stays in 2007 and 2008.
PhD Student Uffe Schneider. Properties of twisted intercalated nucleic acid (TINA). 2007.
International collaborating partners
Herminia de Lencastre, ITQB/UNL, Oeiras, Portugal and The Rockefeller University. Alexander Tomasz, The Rockefeller University, NY, USA. Alex Friedrich and Dag Harmsen, Münster, Germany. Wolfgang Witte, Wernigerode, Germany, Bert Niesters, Gronningen, Holland