Comparison of microbiological and clinical characteristics based on SCCmec typing in patients with community-onset meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia

2012 ◽  
Vol 39 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Shu-Chen Kuo ◽  
Mei-Chun Chiang ◽  
Wen-Sen Lee ◽  
Liang-Yu Chen ◽  
Hau-Shin Wu ◽  
...  
2018 ◽  
Vol 146 (10) ◽  
pp. 1326-1336 ◽  
Author(s):  
Y. M. Wi ◽  
J. Y. Rhee ◽  
C. I. Kang ◽  
D. R. Chung ◽  
J. H. Song ◽  
...  

AbstractWe investigated the clinical predictors of methicillin-resistance and their impact on mortality in 371 patients with Staphylococcus aureus bacteraemia identified from two prospective multi-centre studies. Methicillin resistant S. aureus (MRSA) accounted for 42.2% of community-onset and 74.5% of hospital-onset cases. No significant clinical difference was found between patients infected with MRSA vs. methicillin-sensitive S. aureus (MSSA), except that the former were more likely to have had hospital-onset bacteraemia and received antibiotics in the preceding 90 days. After stratifying according to the acquisition site, prior antibiotic use was the only independent predictor of having MRSA in both community-onset and hospital-onset cases. The frequency of inappropriate empirical antibiotic therapy was higher in patients with MRSA than in those with MSSA bacteraemia. However, methicillin resistance was not a predictor of mortality in patients and the clinical characteristics and outcomes of both MRSA and MSSA bacteraemia were similar. This study indicates that there are no definitive clinical or epidemiological risk factors which could distinguish MRSA from MSSA cases with the exception of the previous use of antibiotics for having MRSA bacteraemia, which emphasises the prudent use of glycopeptide treatment of patients at risk for invasive MRSA infections.


2021 ◽  
Vol 33 (3) ◽  
pp. 6-15
Author(s):  
Safaa Al Khawaja ◽  
Nermin Kamal Saeed ◽  
Mahmood Al Awainati

Background and Objectives: Staphylococcus aureus bacteremia (SAB) is a significant health problem with high morbidity & mortality. The aim of this study was to evaluate the epidemiology of SAB in Bahrain along with withs clinical characteristics and outcomes. Methods: This study was conducted at Salmaniya medical complex (SMC) microbiology laboratory including all patients with SAB for one year period (2019). Demographic, lab data & outcomes were obtained from the electronic record system of patients. Results: A total of 164 episodes of SAB were identified during the study period. About 137 were encountered among inpatients, while 27 cases among outpatients attending hemodialysis unit. Bahraini nationality & male gender were predominant (141, 85.98% & 108, 65.85% respectively). Nosocomial SAB accounts for only 29.37%, while the majority of SAB cases were of community-onset (116, 70.37%), but among such community-onset cases; 83 (50.61% of total) were of health care-associated category (56 had prior hospitalization and 27 were on regular dialysis). Among all patients with SAB, diabetes was the commonest risk factor encountered, followed by dialysis dependence and sickle cell diseases (SCD). Mortality rate was 25.6% (42 patients). Among the 122 survivors of the initial SAB episode, recurrence of bacteremia was documented among 26 cases (21.3%). Conclusion: SAB was a significant health problem among the Bahraini. Diabetes Mellitus, SCD and dialysis dependence were found to be important risk factors. Recurrence of bacteremia was a common complication among the patient’s dependant on hemodialysis Keywords: Staphylococcus aureus, Bacteremia, Nosocomial, Community onset, Hemodialysis


2016 ◽  
Vol 144 (14) ◽  
pp. 3037-3045 ◽  
Author(s):  
L. HU ◽  
Y. LI ◽  
Y. LU ◽  
J. D. KLENA ◽  
Y. QIU ◽  
...  

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.


2021 ◽  
Vol 10 (4) ◽  
pp. 758
Author(s):  
Jason W. Lee ◽  
Tobi Somerville ◽  
Stephen B. Kaye ◽  
Vito Romano

Bacterial keratitis is a devastating condition that can rapidly progress to serious complications if not treated promptly. Certain causative microorganisms such as Staphylococcus aureus and Pseudomonas aeruginosa are notorious for their resistance to antibiotics. Resistant bacterial keratitis results in poorer outcomes such as scarring and the need for surgical intervention. Thorough understanding of the causative pathogen and its virulence factors is vital for the discovery of novel treatments to avoid further antibiotic resistance. While much has been previously reported on P. aeruginosa, S. aureus has been less extensively studied. This review aims to give a brief overview of S. aureus epidemiology, pathophysiology and clinical characteristics as well as summarise the current evidence for potential novel therapies.


Author(s):  
Anna Bläckberg ◽  
Christian Morenius ◽  
Lars Olaison ◽  
Andreas Berge ◽  
Magnus Rasmussen

AbstractInfective endocarditis (IE) caused by bacteria within Haemophilus (excluding Haemophilus influenzae), Aggregatibacter, Cardiobacterium, Eikenella and Kingella (HACEK) is rare. This study aimed to describe clinical features of IE caused by HACEK genera in comparison with IE due to other pathogens. Cases of IE due to HACEK were identified through the Swedish Registry of Infective Endocarditis (SRIE). Clinical characteristics of IE cases caused by HACEK were compared with cases of IE due to other pathogens reported to the same registry. Ninety-six patients with IE caused by HACEK were identified, and this corresponds to 1.8% of all IE cases. Eighty-three cases were definite endocarditis, and the mortality rate was 2%. The median age was 63 years, which was lower compared to patients with IE caused by other pathogens (66, 70 and 73 years respectively, p ≤ 0.01). Patients with IE caused by Haemophilus were younger compared to patients with IE due to Aggregatibacter (47 vs 67 years, p ≤ 0.001). Patients with IE due to HACEK exhibited longer duration from onset of symptoms to hospitalization and had more prosthetic valve endocarditis compared to patients with IE due to Staphylococcus aureus (10 vs 2 days, p ≤ 0.001, and 35 vs 14%, p ≤ 0.001). This is, to date, the largest study on IE due to HACEK. Aggregatibacter was the most common cause of IE within the group. The condition has a subacute onset and often strikes in patients with prosthetic valves, and the mortality rate is relatively low.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S468-S468
Author(s):  
Mariawy Riollano ◽  
Deena Altman ◽  
shanna kowalsky ◽  
Stephanie Pan

Abstract Background Staphylococcus aureus is a well-known cause of hospital acquired infections. Methicillin resistant staphylococcus aureus (MRSA) colonization is a recognized risk factor for invasive infections. The neonatal population in the intensive care unit (NICU) is particularly vulnerable to these types of infections, resulting in high mortality and morbidity. However, only scant data is available to establish the risk for invasive disease in patients with Methicillin sensitive staphylococcus aureus (MSSA). As a result, surveillance and prevention strategies are only address for MRSA colonization. Here, we describe the clinical characteristics of S. aureus colonized patients identified in late 2018 during transmission events in a single center NICU. As a result of the targeted surveillance investigation for MRSA infection control measures, S. aureus colonization was stratified, and we were able to compare the differences in invasive disease between MRSA and MSSA. Methods This is a retrospective chart review of the 47 colonized patients identified during October 2018- January 2019 SA transmission events in single center NICU. Risk factors, clinical characteristics, and the hospital course of these cases, including the proportion of invasive illness were reviewed. Results We found that most clinical characteristic, risk factors, and hospital course were the same between MRSA and MSSA colonized infants (p values > 0.05). Additionally, there was no difference in the proportion of invasive infection between MRSA and MSSA colonized patients (p value > 0.05). The type of invasive infections identified were SSTI, bacteremia, and osteomyelitis. Conclusion The proportion of invasive infection was the same in MSSA and MRSA colonized patients. This data provides us with supportive material for future recommendations of infection control measures for MSSA colonized patients. Disclosures All Authors: No reported disclosures


2017 ◽  
Vol 145 (13) ◽  
pp. 2817-2826 ◽  
Author(s):  
E. MACMORRAN ◽  
S. HARCH ◽  
E ATHAN ◽  
S LANE ◽  
S TONG ◽  
...  

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.


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