scholarly journals Molecular Types of Methicillin-Resistant Staphylococcus aureus and Methicillin-Sensitive S. aureus Strains Causing Skin and Soft Tissue Infections and Nasal Colonization, Identified in Community Health Centers in New York City

2015 ◽  
Vol 53 (8) ◽  
pp. 2648-2658 ◽  
Author(s):  
Maria Pardos de la Gandara ◽  
Juan Antonio Raygoza Garay ◽  
Michael Mwangi ◽  
Jonathan N. Tobin ◽  
Amanda Tsang ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
New York City ◽  
Soft Tissue ◽  
York City ◽  
Community Health Centers ◽  
Health Centers ◽  
Soft Tissue Infections ◽  
Content Type ◽  
Clonal Type

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.

scholarly journals High Prevalence of Mupirocin Resistance in Staphylococcus aureus Isolates from a Pediatric Population

2015 ◽  
Vol 59 (6) ◽  
pp. 3350-3356 ◽  
Author(s):  
Nina K. Antonov ◽  
Maria C. Garzon ◽  
Kimberly D. Morel ◽  
Susan Whittier ◽  
Paul J. Planet ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
Staphylococcus Aureus ◽  
New York City ◽  
York City ◽  
Methicillin Resistance ◽  
Strong Association ◽  
Resistant Isolate ◽  
Content Type ◽  
Mupirocin Resistance

ABSTRACTTopical mupirocin is used widely to treat skin and soft tissue infections and to eradicate nasal carriage of methicillin-resistantStaphylococcus aureus(MRSA). Few studies to date have characterized the rates ofS. aureusmupirocin resistance in pediatric populations. We retrospectively studied 358 uniqueS. aureusisolates obtained from 249 children seen in a predominantly outpatient setting by the Division of Pediatric Dermatology at a major academic center in New York City between 1 May 2012 and 17 September 2013. Mupirocin resistance rates and the associated risk factors were determined using a logistic regression analysis. In our patient population, 19.3% of patients had mupirocin-resistantS. aureusisolates at the time of their first culture, and 22.1% of patients withS. aureusinfection had a mupirocin-resistant isolate at some time during the study period. Overall, 31.3% of allS. aureusisolates collected during the study period were resistant to mupirocin. Prior mupirocin use was strongly correlated (odds ratio [OR] = 26.5;P= <0.001) with mupirocin resistance. Additional risk factors for mupirocin resistance included methicillin resistance, atopic dermatitis (AD), epidermolysis bullosa (EB), immunosuppression, and residence in northern Manhattan and the Bronx. Resistance to mupirocin is widespread in children with dermatologic complaints in the New York City area, and given the strong association with mupirocin exposure, it is likely that mupirocin use contributes to the increased resistance. Routine mupirocin testing may be important for MRSA decolonization strategies or the treatment of minor skin infections in children.

scholarly journals Drug Use Is Associated With Purulent Skin and Soft Tissue Infections in a Large Urban Jail: 2011–2015

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Betsy Szeto ◽  
Fatos Kaba ◽  
Carolyn T A Herzig ◽  
Montina Befus ◽  
Franklin D Lowy ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Soft Tissue ◽  
Drug Use ◽  
York City ◽  
The United States ◽  
Urgent Care ◽  
Preventive Strategy ◽  
Soft Tissue Infections ◽  
Multivariable Analyses

Abstract Background Skin and soft tissue infections (SSTIs) are a common problem in jails in the United States. This study aimed to identify factors associated with purulent SSTIs in the New York City jail system. Methods We conducted a case-control study of purulent SSTIs at the New York City jail. Cases were matched to controls by visit date to the jail’s urgent care clinic. Bivariate and multivariable analyses were conducted using conditional logistic regression. Results From April 2011 to April 2015, 1010 cases of SSTIs were identified and matched to 1010 controls. In multivariable analyses, report upon entry to jail of current injection drug use (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.77–4.31), current snorting of drugs (OR, 1.50; 95% CI, 1.12–2.00), current heroin use (OR, 1.53; 95% CI, 1.08–2.17), current cocaine use (OR, 1.76; 95% CI, 1.18–2.65), and antibiotic use within the previous 6 months (OR, 4.05; 95% CI, 2.98–5.49) were significantly associated with SSTI diagnosis. Conclusions Skin and soft tissue infections were strongly associated with a history of drug use at jail entry. Targeting intravenous drug use may be a preventive strategy for SSTIs in this population. Strategies such as harm reduction programs may be investigated.

scholarly journals Identification and Characterization of Linezolid-Resistantcfr-Positive Staphylococcus aureus USA300 Isolates from a New York City Medical Center

2014 ◽  
Vol 58 (11) ◽  
pp. 6949-6952 ◽  
Author(s):  
Jeffrey B. Locke ◽  
Douglas E. Zuill ◽  
Caitlyn R. Scharn ◽  
Jennifer Deane ◽  
Daniel F. Sahm ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
New York City ◽  
York City ◽  
Medical Center ◽  
Surveillance Program ◽  
Content Type ◽  
Gene Environment ◽  
Routine Surveillance

ABSTRACTThecfrgene was identified in three linezolid-resistant USA300 methicillin-resistantStaphylococcus aureus(MRSA) isolates collected over a 3-day period at a New York City medical center in 2011 as part of a routine surveillance program. Each isolate possessed a plasmid containing a pSCFS3-likecfrgene environment. Transformation of thecfr-bearing plasmids into theS. aureusATCC 29213 background recapitulated the expected Cfr antibiogram, including resistance to linezolid, tiamulin, clindamycin, and florfenicol and susceptibility to tedizolid.

scholarly journals Outbreak of non-tuberculous mycobacteria skin or soft tissue infections associated with handling fish – New York City, 2013–2014

2017 ◽  
Vol 145 (11) ◽  
pp. 2269-2279 ◽  
Author(s):  
K. YACISIN ◽  
J. L. HSIEH ◽  
D. WEISS ◽  
J. ACKELSBERG ◽  
E. LEE ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Soft Tissue ◽  
York City ◽  
Soft Tissue Infections ◽  
Skin Injury ◽  
Department Of Health ◽  
Sex Risk ◽  
Direct Exposure ◽  
Chinese Markets

SUMMARYMycobacterium marinum, a bacterium found in freshwater and saltwater, can infect persons with direct exposure to fish or aquariums. During December 2013, the New York City Department of Health and Mental Hygiene learned of four suspected or confirmed M. marinum skin or soft tissue infections (SSTIs) among persons who purchased whole fish from Chinese markets. Ninety-eight case-patients with non-tuberculous mycobacteria (NTM) SSTIs were identified with onset June 2013–March 2014. Of these, 77 (79%) were female. The median age was 62 years (range 30–91). Whole genome sequencing of clinical isolates revealed two main clusters and marked genetic diversity. Environmental samples from distributors yielded NTM though not M. marinum. We compared 56 case-patients with 185 control subjects who shopped in Chinese markets, frequency-matched by age group and sex. Risk factors for infection included skin injury to the finger or hand (odds ratio [OR]: 15·5; 95% confidence interval [CI]: 6·9–37·3), hand injury while preparing fish or seafood (OR 8·3; 95% CI 3·8–19·1), and purchasing tilapia (OR 3·6; 95% CI 1·1–13·9) or whiting (OR 2·7; 95% CI 1·1–6·6). A definitive environmental outbreak source was not identified.

scholarly journals Health Care Access and Utilization by Homeless Adolescents in New York City

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Michael S. Irwig
Keyword(s):  
Health Care ◽  
New York ◽  
New York City ◽  
Community Health ◽  
York City ◽  
Community Health Centers ◽  
Homeless Youth ◽  
Health Centers ◽  
Medical Services ◽  
Homeless Adolescents

To date, little data has been collected from homeless adolescents regarding their access to, and utilization of, health care. In this study, 68 adolescents aged 16-25 were interviewed after being randomly selected from among those who came to a drop-in center for homeless youth in New York City in July 1996. The interviews followed a standardized questionnaire designed to collect demographic information as well as to assess past and current use of medical services. Prior to homelessness, 68% of subjects had been utilizing medical services on a regular basis, and the principal sources of care were as follows: hospital clinics, 51%; community health centers, 33%; and private physician offices, 22% (with more than one facility utilized in some cases). By contrast, 90% of participants reported having received care during homelessness, 68% of whom obtained regular health care at shelters, 32% at drop-in centers, and 25% at hospital clinics. Despite the fact that 42.4% of the sample was covered by health insurance at the time of interview, only 10% of subjects reported having ever been denied health care at any facility visited. Taken together, these findings suggest that, in the population studied, an increase in the percentage of adolescents regularly utilizing medical services occurs upon homelessness, coincident with a shift in utilization from hospital clinics and community health centers to shelters and drop-in centers. These results clearly warrant further study on the access and utilization of health care by homeless adolescents. If substantiated, the present findings call fo renewed efforts toward optimizing health care delivery to homeless adolescents at shelters, drop-in-centers, and other such facilities where these individuals utilize medical resources most frequently.

scholarly journals Role of Antibodies in Protection Elicited by Active Vaccination with Genetically Inactivated Alpha Hemolysin in a Mouse Model of Staphylococcus aureus Skin and Soft Tissue Infections

2014 ◽  
Vol 21 (5) ◽  
pp. 622-627 ◽  
Author(s):  
Christopher P. Mocca ◽  
Rebecca A. Brady ◽  
Drusilla L. Burns
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Murine Model ◽  
Bacterial Colonization ◽  
Passive Immunization ◽  
The United States ◽  
Soft Tissue Infections ◽  
Content Type ◽  
Alpha Hemolysin ◽  
Active Vaccination

ABSTRACTDue to the emergence of highly virulent community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) infections,S. aureushas become a major threat to public health. A majority of CA-MRSA skin and soft tissue infections in the United States are caused byS. aureusUSA300 strains that are known to produce high levels of alpha hemolysin (Hla). Therefore, vaccines that contain inactivated forms of this toxin are currently being developed. In this study, we sought to determine the immune mechanisms of protection for this antigen using a vaccine composed of a genetically inactivated form of Hla (HlaH35L). Using a murine model of skin and soft tissue infections (SSTI), we found that BALB/c mice were protected by vaccination with HlaH35L; however, Jh mice, which are deficient in mature B lymphocytes and lack IgM and IgG in their serum, were not protected. Passive immunization with anti-HlaH35L antibodies conferred protection against bacterial colonization. Moreover, we found a positive correlation between the total antibody concentration induced by active vaccination and reduced bacterial levels. Animals that developed detectable neutralizing antibody titers after active vaccination were significantly protected from infection. These data demonstrate that antibodies to Hla represent the major mechanism of protection afforded by active vaccination with inactivated Hla in this murine model of SSTI, and in this disease model, antibody levels correlate with protection. These results provide important information for the future development and evaluation ofS. aureusvaccines.

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