In November 2011, The Rockefeller University Center for Clinical and Translational Science (CCTS), the Laboratory of Microbiology and Infectious Diseases, and Clinical Directors Network (CDN) launched a research and learning collaborative project with six community health centers in the New York City metropolitan area to determine the nature (clonal type) of community-acquiredStaphylococcus aureusstrains causing skin and soft tissue infections (SSTIs). Between November 2011 and March 2013, wound and nasal samples from 129 patients with active SSTIs suspicious forS. aureuswere collected and characterized by molecular typing techniques. In 63 of 129 patients, the skin wounds were infected byS. aureus: methicillin-resistantS. aureus(MRSA) was recovered from 39 wounds and methicillin-sensitiveS. aureus(MSSA) was recovered from 24. Most—46 of the 63–wound isolates belonged to the CC8/Panton-Valentine leukocidin-positive (PVL+) group ofS. aureusclone USA300: 34 of these strains were MRSA and 12 were MSSA. Of the 63 patients withS. aureusinfections, 30 were also colonized byS. aureusin the nares: 16 of the colonizing isolates were MRSA, and 14 were MSSA, and the majority of the colonizing isolates belonged to the USA300 clonal group. In most cases (70%), the colonizing isolate belonged to the same clonal type as the strain involved with the infection. In three of the patients, the identity of invasive and colonizing MRSA isolates was further documented by whole-genome sequencing.
New Models for Emergency and Ambulatory Care at Academic Health Centers-Part I: New York City