scholarly journals Australian Group on Antimicrobial Resistance (AGAR) Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP) Annual Report 2019

2020 ◽  
Vol 44 ◽  
Author(s):  
Geoffrey W Coombs ◽  
Denise A Daley ◽  
Shakeel Mowlaboccus ◽  
Stanley Pang
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Beta Lactam ◽  
Methicillin Resistant ◽  
Linezolid Resistance ◽  
Resistance Patterns ◽  
Australian Community ◽  
Healthcare Associated ◽  
Community Onset ◽  
Outcome Programme

From 1 January to 31 December 2019, 39 institutions around Australia participated in the Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2019 was to determine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to methicillin and on characterising the molecular epidemiology of the methicillin-resistant isolates. A total of 3,157 S. aureus bacteraemia episodes were reported, of which 79.8% were community-onset. 18.5% of S. aureus were methicillin resistant. The 30-day all-cause mortality associated with methicillin-resistant SAB was 14.0%, which was not significantly different from the 14.3% mortality associated with methicillin-susceptible SAB (p = 0.9). With the exception of the β-lactams and erythromycin, antimicrobial resistance in methicillin-susceptible S. aureus was rare. However, in addition to the β-lactams, approximately 36% of methicillin-resistant S. aureus (MRSA) were resistant to ciprofloxacin, 34% to erythromycin, 13% to tetracycline, 9% to gentamicin and 4% to co-trimoxazole. When applying the EUCAST breakpoints, teicoplanin resistance was detected in two S. aureus isolates. Resistance was not detected for vancomycin and linezolid. Resistance to non-beta-lactam antimicrobials was largely attributable to two healthcare-associated MRSA clones: ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). ST22-IV [2B] (EMRSA-15) is the predominant healthcare-associated clone in Australia. Eighty percent of methicillin-resistant SAB, however, were due to community-associated clones. Although polyclonal, approximately 71.4% of community-associated clones were variously characterised as ST93-IV [2B] (Queensland CA-MRSA), ST5-IV [2B], ST45-VT [5C2&5], ST1-IV [2B], ST30-IV [2B], ST78-IV [2B] and ST8-IV [2B]. Community-associated MRSA (CA-MRSA), in particular the ST45-VT [5C2&5] clone, have acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. The multiresistant ST45-VT [5C2&5] clone accounted for 12.7% of CA-MRSA. As CA-MRSA is well established in the Australian community, it is important that antimicrobial resistance patterns in community- and healthcare-associated SAB are monitored, as this information will guide therapeutic practices in treating S. aureus sepsis.

scholarly journals Australian Group on Antimicrobial Resistance (AGAR) Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP) Annual Report 2018

2020 ◽  
Vol 44 ◽  
Author(s):  
Geoffrey W Coombs ◽  
Denise A Daley ◽  
Shakeel Mowlaboccus ◽  
Yung Thin Lee ◽  
Stanley Pang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Beta Lactam ◽  
Methicillin Resistant ◽  
Linezolid Resistance ◽  
Resistance Patterns ◽  
Australian Community ◽  
Healthcare Associated ◽  
Community Onset ◽  
Outcome Programme

From 1 January to 31 December 2018, thirty-six institutions around Australia participated in the Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2018 was to determine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to methicillin, and to characterise the molecular epidemiology of the methicillin-resistant isolates. A total of 2,673 S. aureus bacteraemia episodes were reported, of which 78.9% were community-onset. A total of 17.4% of S. aureus isolates were methicillin resistant. The 30-day all-cause mortality associated with methicillin-resistant SAB was 17.1% which was not significantly higher than the 13.6% mortality associated with methicillin-susceptible SAB (p = 0.1). With the exception of the β-lactams and erythromycin, antimicrobial resistance in methicillin-susceptible S. aureus was rare. However in addition to the β-lactams approximately 42% of methicillin-resistant S. aureus (MRSA) were resistant to erythromycin, 36% to ciprofloxacin and approximately 13% resistant to co-trimoxazole, tetracycline and gentamicin. When applying the EUCAST breakpoints teicoplanin resistance was detected in two S. aureus isolates. Resistance was not detected for vancomycin and linezolid. Resistance to non-beta-lactam antimicrobials was largely attributable to two healthcare-associated MRSA clones: ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). The ST22-IV [2B] (EMRSA-15) clone is the predominant healthcare-associated clone in Australia. Seventy-eight percent of methicillin-resistant SAB episodes in 2018 were due to community-associated clones. Although polyclonal, approximately 76.3% of community-associated clones were characterised as ST93-IV [2B] (Queensland CA-MRSA), ST5-IV [2B], ST45-VT [5C2&5], ST1-IV [2B], ST30-IV [2B], ST78-IV [2B] and ST97-IV [2B]. Community-associated MRSA, in particular the ST45-VT [5C2&5] clone, has acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. The ST45-VT [5C2&5] clone accounted for 11.7% of CA-MRSA. As CA-MRSA is well established in the Australian community, it is important that antimicrobial resistance patterns in community- and healthcare-associated SAB are monitored, as this information will guide therapeutic practices in treating S. aureus sepsis.

scholarly journals Australian Group on Antimicrobial Resistance (AGAR) Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP) Annual Report 2017

2019 ◽  
Vol 43 ◽  
Author(s):  
Geoffrey W Coombs ◽  
Denise A Daley ◽  
Yung Thin Lee ◽  
Stanley Pang ◽  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Beta Lactam ◽  
Methicillin Resistant ◽  
Linezolid Resistance ◽  
Resistance Patterns ◽  
Australian Community ◽  
Healthcare Associated ◽  
Community Onset ◽  
Outcome Programme

From 1 January to 31 December 2017, 36 institutions around Australia participated in the Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2017 was to determine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to methicillin and to characterise the molecular epidemiology of the methicillin-resistant isolates. A total of 2,515 S. aureus bacteraemia episodes were reported, of which 77% were community-onset. Approximately one in five S. aureus (19.0%) were methicillin resistant. The 30-day all-cause mortality associated with methicillin-resistant SAB was 18.7% which was significantly higher than the 14.0% mortality associated with methicillin-susceptible SAB. With the exception of the β-lactams and erythromycin, antimicrobial resistance in methicillin-susceptible S. aureus was rare. However in addition to the β-lactams approximately 42% of methicillin-resistant S. aureus (MRSA) were resistant to erythromycin and ciprofloxacin and approximately 14% resistant to co-trimoxazole, tetracycline and gentamicin. When applying the EUCAST breakpoints teicoplanin resistance was detected in five S. aureus isolates. Resistance was not detected for vancomycin and linezolid. Resistance to non-beta-lactam antimicrobials was largely attributable to two healthcare-associated MRSA clones: ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). ST22-IV [2B] (EMRSA-15) is the predominant healthcare-associated clone in Australia. Seventy-five percent of methicillin-resistant SAB were due to community-associated clones. Although polyclonal approximately 74% of community-associated clones were characterised as ST93-IV [2B] (Queensland CA-MRSA), ST5-IV [2B], ST45-VT [5C2&5] and ST1-IV [2B]. CA-MRSA, in particular the ST45-VT [5C2&5] clone has acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. ST45-VT [5C2&5] accounted for 12.8% of CA-MRSA. As CA-MRSA is well established in the Australian community it is important antimicrobial resistance patterns in community- and healthcare-associated SAB is monitored as this information will guide therapeutic practices in treating S. aureus sepsis.

scholarly journals The rise of methicillin resistant Staphylococcus aureus: now the dominant cause of skin and soft tissue infection in Central Australia

2017 ◽  
Vol 145 (13) ◽  
pp. 2817-2826 ◽  
Author(s):  
E. MACMORRAN ◽  
S. HARCH ◽  
E ATHAN ◽  
S LANE ◽  
S TONG ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Treatment Outcomes ◽  
Univariate Analysis ◽  
Methicillin Resistant ◽  
Dominant Phenotype ◽  
Mrsa Infection ◽  
Central Australia ◽  
Healthcare Associated ◽  
Community Onset

SUMMARYThis study aimed to examine the epidemiology and treatment outcomes of community-onset purulent staphylococcal skin and soft tissue infections (SSTI) in Central Australia. We performed a prospective observational study of patients hospitalised with community-onset purulent staphylococcal SSTI (n = 160). Indigenous patients accounted for 78% of cases. Patients were predominantly young adults; however, there were high rates of co-morbid disease. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was the dominant phenotype, accounting for 60% of cases. Hospitalisation during the preceding 6 months, and haemodialysis dependence were significant predictors of CA-MRSA infection on univariate analysis. Clinical presentation and treatment outcomes were found to be comparable for methicillin-susceptible S. aureus (MSSA) and methicillin-resistant cases. All MRSA isolates were characterised as non-multi-resistant, with this term used interchangeably with CA-MRSA in this analysis. We did not find an association between receipt of an active antimicrobial agent within the first 48 h, and progression of infection; need for further surgical debridement; unplanned General Practitioner or hospital re-presentation; or need for further antibiotics. At least one adverse outcome was experienced by 39% of patients. Clindamycin resistance was common, while rates of trimethoprim–sulfamethoxazole resistance were low. This study suggested the possibility of healthcare-associated transmission of CA-MRSA. This is the first Australian report of CA-MRSA superseding MSSA as the cause of community onset staphylococcal SSTI.

scholarly journals Trends in antibiotic resistance patterns of methicillin resistant and methicillin sensitive Staphylococcus aureus in Khwaja Yunus Ali Medical College Hospital

KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Abdullah Akhtar Ahmed ◽  
Md Abdus Salam ◽  
Md Shakhaowat Hossain ◽  
Md Babul Aktar ◽  
Nusrat Akhtar Juyee ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Pathogenic Bacteria ◽  
Current Status ◽  
Clinical Samples ◽  
Sensitivity Testing ◽  
Methicillin Resistant ◽  
Resistance Patterns ◽  
Antibiotic Resistance Patterns

Background: Antimicrobial resistance in pathogens is a growing concern for health. It is a great concern around the globe about the threat of increasing antimicrobial resistance. In response to this concerns, medical experts have proposed initiatives to curtail the spread of antimicrobial resistance in pathogenic bacteria. We have taken this surveillance study in KYAMCH to contain the spread of antimicrobial resistance.Objectives: To determine the prevalence of MRSA from different clinical samples and to record its current status to commonly used anti Staphylococcus antibiotics.Methods: The clinical samples were taken to the laboratory and within four hours cultured for isolates and identification pathogens. Finally, antibiotic sensitivity testing of the isolated Staphylococcus aureus was performed. Results: More than 80% of MRSA isolates were resistant to ampicillin (98%) followed by amoxicillin, cefixime and azithromycin with 94%, 93.5% and 85% respectively and maximum sensitivity toward tobramycin with 86% followed by 85% gentamicin and 79% meropenem.Conclusion: The detected trend in antibiotic resistance patterns of methicillin-resistant and methicillin-sensitive Staphylococcus aureus in this study is alarming. This has created a huge clinical burden in the hospital settings as well as in the community.KYAMC Journal Vol. 9, No.-1, April 2018, Page 6-10

scholarly journals 469. Contributions of Infections among Persons Who Inject Drugs to the Changing Incidence of Healthcare-Associated, Community-Onset Methicillin-Resistant Staphylococcus aureus Infections, 2009–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S229-S230
Author(s):  
Kelly A Jackson ◽  
Runa Hatti Gokhale ◽  
Joelle Nadle ◽  
Susan Petit ◽  
Susan Ray ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Care Facility ◽  
Term Care ◽  
Persons Who Inject Drugs ◽  
Methicillin Resistant ◽  
Long Term Care Facility ◽  
Active Population ◽  
Healthcare Associated ◽  
Community Onset

Abstract Background Recently, overall reductions for invasive MRSA infections (isolation from a normally sterile site) have slowed. Healthcare-associated community-onset (HACO) invasive methicillin-resistant Staphylococcus aureus (MRSA) infections are those with recent healthcare exposures who develop MRSA infection outside acute care hospitals, and account for most invasive MRSA infections. HACO incidence decreased 6.6% per year during 2005–2008; the contribution of persons who inject drugs (PWID) to HACO incidence has not been reported. Methods We identified invasive MRSA infections using active, population- and laboratory-based surveillance data during 2009–2017 from 25 counties in 7 sites (CA, CT, GA, MD, MN, NY, TN). Cases were HACO if culture was obtained from an outpatient, or ≤3 days after hospitalization in a patient with ≥1 of the following healthcare exposures (HEs): hospitalization, surgery, dialysis, or residence in a long-term care facility (LTCF) in the past year; or central vascular catheter ≤2 days before culture. We calculated incidence (per census population) overall, for PWID cases and others, and for cases associated with each HE. For each HE, we calculated the proportion of overall incidence increase for PWID and others. Results HACO MRSA incidence declined overall from 2009 to 2016 but increased from 2016 to 2017 overall (8%), for both PWID (63%) and others (5%) (figure). For both PWID and non-PWID, incidence from 2016 to 2017 increased by 0.5 cases/100,000 population; 91% of the increase in PWID occurred in cases with a past year hospitalization while 78% of the increase in cases not associated with injection drug use (IDU) occurred in cases with past year LTCF residence. Past year LTCF residence was less common among PWID (16%) then among other cases (38%, P < 0.01). Conclusion After years of declines, HACO MRSA incidence increased equally in 2017 for cases associated with IDU and in cases unrelated to IDU. Increases in PWID-associated cases account for half the overall increase, indicating that efforts to reduce HACO MRSA should address PWID risk factors as these infections may be due to self-injection. In addition, increases not related to PWID, if sustained, would be a reversal of historic trends and require further investigation into causes. Disclosures All authors: No reported disclosures.

scholarly journals Antimicrobial Resistance Patterns and Plasmid Profiles of Methicillin Resistant Staphylococcus aureus Isolated from Clinical Samples

2019 ◽  
Vol 7 (1) ◽  
pp. 8-14
Author(s):  
Gaurav Agrahari ◽  
Amrit Koirala ◽  
Roshan Thapa ◽  
Mahesh Kumar Chaudhary ◽  
Reshma Tuladhar
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Antibiotic Susceptibility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Plasmid Profile ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Plasmid Profiles ◽  
Resistance Patterns

Methicillin-resistant Staphylococcus aureus (MRSA), showing resistance to several antibiotics is a global health problem associated with considerable mortality and morbidity. Antibiotic susceptibility test is a commonly used method to characterize MRSA in epidemiologic studies. Additionally, plasmid profile has been reported to be useful in tracing the epidemiology of antibiotic resistance. This research was conducted to determine the antimicrobial resistance patterns and plasmid profiles of MRSA isolated from clinical samples at KIST Medical College, Imadol, Kathmandu, Nepal. All the clinical specimens sent to the laboratory were processed by standard microbiological techniques and antibiotic susceptibility testing was done by the modified Kirby Bauer disc diffusion method. Further, plasmid profiling was done by Alkaline-lysis method. A total of 27 (38.02%) MRSA were isolated from 71 S. aureus positive samples. MRSA showed the highest resistance towards penicillin (92.60%) and ampicillin (92.60%). In contrast, high levels of sensitivity were shown towards vancomycin (85.19%) and tetracycline (85.19%). Out of 27 MRSA positive samples, single plasmids were isolated from only 6 (22.22%) MRSA isolates. Antibiograms alone are inadequate to accomplish the characterization of MRSA during epidemiological studies. However, plasmid profile analysis in conjunction with the antibiotic susceptibility pattern is valuable in the epidemiological investigation of MRSA, and for reducing MRSA prevalence and treatment cost.

scholarly journals STAPHYLOCOCCUS AUREUS INFECTIONS AND THEIR ANTIBIOTIC SUSCEPTIBILITY PROFILE AT A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 10 (12) ◽  
pp. 396
Author(s):  
Anthony N Ofulah ◽  
Shashidhar Vishwanath ◽  
Shashidhar Vishwanath ◽  
Barnini Banerjee ◽  
Shashidhar Vishwanath ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
Age Groups ◽  
Bacterial Pathogen ◽  
Care Hospital ◽  
Beta Lactam ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Beta Lactam Antibiotics

  Objective: Staphylococcus aureus remains an important bacterial pathogen causing diverse infections which are both nosocomial and community acquired. Increasing resistance among S. aureus to various antibiotics is a cause of concern.Methods: A prospective observational study of 4 months duration was conducted to analyze the spectrum of infections caused by S. aureus and to study its antimicrobial resistance to commonly used antibiotics. Specimens from various clinical sites received in the laboratory for culture and sensitivity were processed as per standard techniques. Identification and susceptibility testing of S. aureus isolates were done using automated systems.Results: A total of 234 S. aureus isolates were obtained during the study period. Males accounted for 70.1% (n=164) of patients with S. aureus infections. These patients were uniformly distributed across all age groups. S. aureus was most commonly isolated from pus and exudates (64.5%) followed by respiratory specimens (20.5%) and mainly cultured from the skin and soft tissue infections (56%). Methicillin-resistant S. aureus (MRSA) accounted for 47% (n=110) of isolates. Higher rates of susceptibility were noted for tetracycline (95.3%), gentamicin (85.4%), and trimethoprim/ sulfamethoxazole (88%). Low susceptibility rate was seen for ciprofloxacin (11.2%). Inducible clindamycin resistance was seen in 22.4% (n=50) isolates. Methicillin-sensitive S. aureus isolates were found to be more susceptible to non-beta lactam antibiotics than the methicillin-resistant isolates.Conclusion: A high frequency of MRSA was found in our study. Regular surveillance of antimicrobial resistance profile of this most frequent pathogen is necessary to aid in providing appropriate empirical antibiotic therapy.

scholarly journals Antimicrobial Resistance Patterns in Methicillin-Resistant Staphylococcus aureus from Patients Hospitalized during 2015–2017 in Hospitals in Poland

2019 ◽  
Vol 29 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Barbara Kot ◽  
Kamila Wierzchowska ◽  
Małgorzata Piechota ◽  
Agata Grużewska
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Polymorphism Analysis ◽  
Methicillin Resistant ◽  
Resistance Patterns ◽  
Spa Gene

Objective: The aim of this study was to determine antimicrobial resistance profiles of methicillin-resistant Staphylococcus aureus (MRSA) isolates from clinical samples from patients hospitalized during 2015–2017 in hospitals of ­Masovian district in Poland. Materials and Methods: Antimicrobial resistance of 112 MRSA isolates was tested with a disc diffusion method. Isolates were examined for methicillin resistance using a 30 µg cefoxitin disk. Resistance was confirmed by PCR detection of the mecA gene. PCR was also used to determine spa gene polymorphism in X-region. Results: A large number of MRSA isolates showed resistance to levofloxacin (83.9%), ciprofloxacin (83%), erythromycin (77.7%) and clindamycin (72.3%). A lower number of MRSA isolates showed resistance to tetracycline (10.7%), amikacin (14.2%), gentamicin and trimethoprim with sulfamethoxazole (8.0%). None of the MRSA isolates were resistant to linezolid and teicoplanin. Among MRSA isolates, 92.9% were multidrug-resistant (MDR). Resistance to erythromycin, clindamycin, ciprofloxacin and levofloxacin was the most common resistance pattern among MDR MRSA isolates. The highest number of isolates was resistant to 4 groups of antimicrobials (53.8%). The number of drugs to which MRSA isolates were resistant in 2017 was significantly higher than that in 2016 (p = 0.002). The size polymorphism analysis of X fragment of the spa gene revealed high genetic diversity of the investigated group MRSA isolates. Conclusion: This study demonstrates that in the hospital environment, MRSA isolates can quickly acquire new antimicrobial resistance determinants and that knowledge of current resistance patterns is important for the effective treatment of infections caused by MDR MRSA.

Genetic diversity of healthcare-associated methicillin-resistant Staphylococcus aureus isolates from Southern Iran

2021 ◽  
Author(s):  
Sorour Farzi ◽  
Mohsen Rezazadeh ◽  
Ahmadreza Mirhosseini ◽  
Mohammad Amin Rezazadeh ◽  
Farhan Houshyar ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Molecular Epidemiology ◽  
Resistance Pattern ◽  
Spa Typing ◽  
Methicillin Resistant ◽  
Antibiotic Resistance Pattern ◽  
Southern Iran ◽  
Resistance Patterns ◽  
Healthcare Associated

AbstractStaphylococcus aureus is a common pathogen causing hospital infections. The increasing rate of healthcare-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA) in developing countries has led to many public health problems. This study aimed to investigate the molecular epidemiology as well as the antibiotic resistance pattern of clinical isolates of MRSA from Southern Iran. A total of 135 S. aureus isolates were collected from the patients referred to three hospitals in South Iran. The phenotypic and genotypic diagnosis of MRSA isolates was performed by disk diffusion and PCR methods, respectively. The antibiotic resistance pattern for MRSA isolates was performed using Kirby–Bauer method. The molecular epidemiology of isolates was performed by MLST, Spa typing and SCCmec typing. From 135 S. aureus isolates, 50 (37%) MRSA strains were detected from which two different sequence types including ST239 and ST605 were identified. SCCmec type III was the most common profile (50%) and t030 was the predominant spa type (48%) among the strains. The MRSA isolates had the highest resistance to penicillin (100%), tetracycline (88%), levofloxacin (86%), ciprofloxacin (84%), erythromycin (82%), gentamicin (80%), and clindamycin (78%). The results of this study show that the most common genetic type among the MRSA isolates was ST239-SCCmec III/t030. The rapid and timely detection of MRSA and the administration of appropriate antibiotics according to the published antibiotic resistance patterns are essential. Furthermore, the continuous and nationwide MRSA surveillance studies are necessary to investigate clonal distribution and spreading of MRSA from community to hospitals.

scholarly journals Clinical characteristics, virulence factors and molecular typing of methicillin-resistant Staphylococcus aureus infections in Shenzhen City, China

2016 ◽  
Vol 144 (14) ◽  
pp. 3037-3045 ◽  
Author(s):  
L. HU ◽  
Y. LI ◽  
Y. LU ◽  
J. D. KLENA ◽  
Y. QIU ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Characteristics ◽  
Molecular Characteristics ◽  
Methicillin Resistant ◽  
Shenzhen City ◽  
Clinical Presentations ◽  
Similar Genetic Background ◽  
Mrsa Strains ◽  
Healthcare Associated ◽  
Community Onset

SUMMARYMethicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious hospital and community-acquired infection and some strains are associated with greater severity. We investigated the clinical variability and molecular characteristics of MRSA infections in Shenzhen, China through a study at nine sentinel hospitals from January to December 2014. MRSA infections were classified as community-associated (CA-MRSA), healthcare-associated (HA-MRSA), and healthcare-associated community-onset (HACO-MRSA). In total, 812 MRSA isolates were collected and 183 of these were selected for further study. Patients with HA-MRSA infections were generally of greater age compared to other groups. Distinct body site and clinical presentations were evident in infected patients, e.g. CA-MRSA (skin and soft tissue, 53%), HA-MRSA (respiratory tract, 22%; surgical site, 20%; trauma wounds, 20%) and HACO-MRSA (mastitis, 47%). In contrast to HA-MRSA, other categories of strains were significantly more susceptible to gentamicin, sulfamethoxazole/trimethoprim, and tetracycline. No resistance to vancomycin or linezolid was recorded. The predominant clonal lineage within each strain category was CC59-t437-SCCmec IV/V-agr I (CA, 51·4%; HA, 28·9%; HACO, 52·9%) which exhibited characteristics of a traditional CA clone together with agr I which is more often associated with HA clones. In conclusion, for the three categories of MRSA infections, there were significant differences in clinical characteristics of patients, but the predominant clone in each category shared a similar genetic background which suggests that transmission of MRSA strains has occurred between the community and hospitals in Shenzhen.

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