scholarly journals Community-Associated Methicillin-Resistant Staphylococcus aureus: Epidemiology and Clinical Consequences of an Emerging Epidemic

2010 ◽  
Vol 23 (3) ◽  
pp. 616-687 ◽  
Author(s):  
Michael Z. David ◽  
Robert S. Daum
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Soft Tissue Infections ◽  
Methicillin Resistant ◽  
Clinical Syndromes ◽  
Clinical Consequences ◽  
Mrsa Infection ◽  
Mrsa Strains ◽  
Susceptibility Patterns

SUMMARY Staphylococcus aureus is an important cause of skin and soft-tissue infections (SSTIs), endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, foreign-body infections, and sepsis. Methicillin-resistant S. aureus (MRSA) isolates were once confined largely to hospitals, other health care environments, and patients frequenting these facilities. Since the mid-1990s, however, there has been an explosion in the number of MRSA infections reported in populations lacking risk factors for exposure to the health care system. This increase in the incidence of MRSA infection has been associated with the recognition of new MRSA clones known as community-associated MRSA (CA-MRSA). CA-MRSA strains differ from the older, health care-associated MRSA strains; they infect a different group of patients, they cause different clinical syndromes, they differ in antimicrobial susceptibility patterns, they spread rapidly among healthy people in the community, and they frequently cause infections in health care environments as well. This review details what is known about the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection. It also addresses the therapy of these infections and strategies for their prevention.

Multiclonal outbreak of methicillin-resistant Staphylococcus aureus infections on a collegiate football team

2008 ◽  
Vol 137 (1) ◽  
pp. 85-93 ◽  
Author(s):  
A. J. HALL ◽  
D. BIXLER ◽  
L. E. HADDY
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Infection Risk ◽  
Physical Contact ◽  
Soft Tissue Infections ◽  
Risk Of Infection ◽  
Methicillin Resistant ◽  
Football Team ◽  
Mrsa Strains ◽  
Collegiate Football

SUMMARYAn outbreak of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) occurred in a college football team in August 2006. Of 109 players on the team roster, 88 (81%) were interviewed during a cohort investigation. Twenty-five cases were identified, six of which were culture-confirmed. Available culture isolates were typed by pulsed-field gel electrophoresis (PFGE), which identified two different MRSA strains associated with the outbreak. Playing positions with the most physical contact (offensive linemen, defensive linemen, and tight ends) had the greatest risk of infection [risk ratio (RR) 5·1, 95% confidence interval (CI) 2·3–11·5. Other risk factors included recent skin trauma (RR 1·9, 95% CI 0·95–3·7), use of therapeutic hydrocollator packs (RR 2·5, 95% CI 1·1–5·7), and miscellaneous training equipment use (RR 2·1, 95% CI 1·1–4·1). The outbreak was successfully controlled through team education and implementation of improved infection-control practices and hygiene policies.

scholarly journals Panton-Valentine Leukocidin (PVL)-Positive Health Care-Associated Methicillin-Resistant Staphylococcus aureus Isolates Are Associated with Skin and Soft Tissue Infections and Colonized Mainly by Infective PVL-Encoding Bacteriophages

2014 ◽  
Vol 53 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Qiwen Hu ◽  
Hang Cheng ◽  
Wenchang Yuan ◽  
Fangyin Zeng ◽  
Weilong Shang ◽  
...  
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Health Concern ◽  
Soft Tissue Infections ◽  
Positive Health ◽  
Methicillin Resistant ◽  
Mrsa Strains ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

The emergence of Panton-Valentine leukocidin (PVL)-positive methicillin-resistantStaphylococcus aureus(MRSA) is a public health concern worldwide. PVL is associated with community-associated MRSA and is linked to skin and soft tissue infections (SSTIs). However, PVL genes have also been detected in health care-associated (HA) MRSA isolates. The diseases associated with PVL-positive HA-MRSA isolates and the distributions of PVL-encoding bacteriophages in HA-MRSA have not been determined. In this study, a total of 259 HA-MRSA strains isolated between 2009 and 2012 in China from inpatients with SSTIs, pneumonia, and bacteremia were selected for molecular typing, including staphylococcal cassette chromosomemectyping, multilocus sequence typing, and staphylococcal protein A gene typing. The PVL genes and PVL bacteriophages in the MRSA isolates were characterized by PCR. Among the tested MRSA isolates, 28.6% (74/259) were PVL positive. The high prevalence of PVL-carrying HA-MRSA was observed to be associated with SSTIs but not with pneumonia or bacteremia. The PVL-positive HA-MRSA isolates were colonized mainly by infective PVL phages, namely, Φ7247PVL, ΦSLT, and ΦSa2958. The distribution of PVL-carrying bacteriophages differed geographically. Our study highlights the potential risk of the emergence of multidrug-resistant HA-MRSA strains with increased virulence.

scholarly journals Inducible Clindamycin Resistance and Molecular Epidemiologic Trends of Pediatric Community-Acquired Methicillin-Resistant Staphylococcus aureus in Dallas, Texas

2005 ◽  
Vol 49 (6) ◽  
pp. 2283-2288 ◽  
Author(s):  
Susana Chavez-Bueno ◽  
Bülent Bozdogan ◽  
Kathy Katz ◽  
Karen L. Bowlware ◽  
Nancy Cushion ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Resistance Mechanisms ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Inducible Resistance ◽  
Mrsa Infection ◽  
Resistant Strains ◽  
Mrsa Strains ◽  
Disk Test

ABSTRACT Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection occurs commonly in children. Clindamycin resistance may be inducible or constitutive, and the rates of inducible resistance in CA-MRSA that could produce clindamycin treatment failures vary worldwide. The double-disk test was performed in 197 erythromycin-resistant and clindamycin-susceptible CA-MRSA strains from children in Dallas, Texas, from 1999 to 2002 to determine inducible clindamycin resistance. Resistance mechanisms were studied by PCR; epidemiologic trends were studied by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Inducible resistance was demonstrated in 28 (93% ±6%) of 30 tested isolates in 1999, 21 (64%, ±11%) of 33 in 2000, 12 (23% ±7%) of 52 in 2001, and 6 (7% ±3%) of 82 in 2002. All noninducible strains had the msr(A) gene. Among inducible resistant strains, 31 had erm(B), 24 had erm(C), and 12 had erm(A) genes. Two distinct pulsed types were the most prevalent; one of them was the most common pulsed type in 1999, whereas in 2002 a different pulsed type was prevalent. MLST analyses determined that ST-8 was the most common type, with 76% ±5% found in 2002. All but one of these clindamycin-susceptible, erythromycin-resistant ST-8 strains showed no induction of clindamycin resistance. We conclude that, among erythromycin-resistant, clindamycin-susceptible CA-MRSA strains isolated from children in Dallas, inducible methylase resistance became less common from 1999 to 2002 (P < 0.001). The phenotype of strains was associated with their sequence type. Our results demonstrate a clonal shift in CA-MRSA in Dallas children from 1999 to 2002.

scholarly journals Methicillin resistant Staphylococcus aureus (MRSA) carriage among health care workers in a tertiary care hospital in Bhubaneswar

2018 ◽  
Vol 5 (8) ◽  
pp. 3276
Author(s):  
Nipa Singh ◽  
Sourav Mohanty ◽  
Subhra Snigdha Panda ◽  
Smrutilata Sahoo ◽  
Dipti Pattnaik ◽  
...  
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Health Care Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Care Hospital ◽  
Mannitol Salt Agar ◽  
Methicillin Resistant ◽  
Care Workers ◽  
Hospital Infection Control ◽  
Mrsa Strains

Background: Methicillin resistant Staphylococcus aureus (MRSA) is a multidrug resistant organism emerging as a major cause of hospital acquired infection. In a healthcare setup a patient may acquire MRSA through the hands, clothes and equipments of health care workers. Screening of health care workers colonised with MRSA will be helpful in preventing the spread of this organism in a hospital. With this background the present study was undertaken to estimate the carriage rate of MRSA among healthcare workers in our hospital.Methods: Nasal swabs were collected from 120 health care workers working in Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar during the study period of July- September 2017. The swabs were inoculated onto mannitol salt agar plates for isolation of Staphylococcus aureus. MRSA strains were identified by cefoxitin disc method. Antibiogram of MRSA strains was determined.Results: The prevalence of MRSA carriage among health care workers was 7.5% with the carrier rate being highest among nurses (10%). All the MRSA isolates were 100% resistant to penicillin. MRSA isolates were 90% resistant to amoxyclav, 60% to cotrimoxazole and erythromycin and 50% to clindamycin.Conclusions: Although the prevalence of MRSA among health care workers in our hospital is not alarming, it is important to emphasize the need for stringent hospital infection control policies to reduce the spread of MRSA to susceptible individuals.

scholarly journals The prevalence and source of methicillin-resistant Staphylococcus aureus (MRSA) in the community in Hong Kong

2004 ◽  
Vol 132 (6) ◽  
pp. 1091-1097 ◽  
Author(s):  
M. M. O'DONOGHUE ◽  
M. V. BOOST
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Hong Kong ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Care Community ◽  
Nasal Swabs ◽  
Working Together ◽  
Mrsa Strains ◽  
Mrsa Colonization

Although reports of isolation of methicillin-resistant Staphylococcus aureus (MRSA) from patients admitted from the community have increased, few studies have investigated colonization of healthy subjects. This study aimed to determine community levels of MRSA in Hong Kong. Nasal swabs from a cross section of young adults and family units were cultured for MRSA. Antibiotic sensitivities and risk factors for carriage were determined and clonal relationships were investigated by pulsed-field gel electrophoresis (PFGE). Overall carriage was low (1·4%), and associated with health-care exposures (OR 13·56, 95% CI 1·11–165·21). Subjects working in health care yielded multi-resistant MRSA strains, but isolates from non-hospital-exposed subjects were methicillin-resistant only. Strains indistinguishable by PFGE were carried by subjects working together, and some spread to other contacts was observed. MRSA colonization in the community is rare in Hong Kong and is largely associated with working in health care. Community-acquired staphylococcal infections may be treated with agents effective against methicillin-sensitive strains.

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