scholarly journals Methicillin-resistant Staphylococcus aureus strains in New York City hospitals: inter-hospital spread of resistant strains of type 88.

1984 ◽  
Vol 20 (3) ◽  
pp. 536-538 ◽  
Author(s):  
S Schaefler ◽  
D Jones ◽  
W Perry ◽  
T Baradet ◽  
E Mayr ◽  
...  
2015 ◽  
Vol 144 (5) ◽  
pp. 1014-1017 ◽  
Author(s):  
P. BAKER ◽  
B. COHEN ◽  
J. LIU ◽  
E. LARSON

SUMMARYThis study aims to describe changes in incidence and risk factors for community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) infections upon admission to two New York City hospitals from 2006 to 2012. We examined the first hospitalization for adult patients using electronic health record and administrative data and determined the annual incidence/1000 admissions of total S. aureus, total MRSA, and CA-MRSA (within 48 h of admission) in clinical specimens over the study period. Logistic regression was used to identify factors associated with CA-MRSA in 2006 and 2012. In 137 350 admissions, the incidence of S. aureus, MRSA, and CA-MRSA/1000 admissions were 15·6, 7·0, and 3·5, respectively. The total S. aureus and MRSA isolations decreased significantly over the study period (27% and 25%, respectively) while CA-MRSA incidence was unchanged. CA-MRSA increased as a proportion of all MRSA between 2006 (46%) and 2012 (62%), and was most frequently isolated from respiratory (1·5/1000) and blood (0·7/1000) cultures. Logistic regression analysis of factors associated with isolation of CA-MRSA showed that age ⩾65 years [odds ratio (OR) 2·3, 95% confidence interval (CI) 1·2–4·5], male gender (OR 1·8, 95% CI 1·2–2·8) and history of renal failure (OR 2·6, 95% CI 1·6–4·2) were significant predictors of infection in 2006. No predictors were identified in 2012.


2012 ◽  
Vol 33 (7) ◽  
pp. 725-731 ◽  
Author(s):  
Amanda M. Farr ◽  
Brandon Aden ◽  
Don Weiss ◽  
Denis Nash ◽  
Melissa A. Marx

Objective.To describe trends in hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in New York City over 10 years and to explore the demographics and comorbidities of patients hospitalized with CA-MRSA infections.Design.Retrospective analysis of hospital discharges from New York State's Statewide Planning and Research Cooperative System database from 1997 to 2006.Patients.All patients greater than 1 year of age admitted to New York hospitals with diagnosis codes indicating MRSA who met the criteria for CA-MRSA on the basis of admission information and comorbidities.Methods.We determined hospitalization rates and compared demographics and comorbidities of patients hospitalized with CA-MRSA versus those hospitalized with all other non-MRSA diagnoses by multivariable logistic regression.Results.Of 18,226 hospitalizations with an MRSA diagnosis over 10 years, 3,579 (20%) were classified as community-associated. The CA-MRSA hospitalization rate increased from 1.47 to 10.65 per 100,000 people overall from 1997 to 2006. Relative to non-MRSA hospitalizations, men, children, Bronx and Manhattan residents, the homeless, patients with human immunodeficiency virus (HIV) infection, and persons with diabetes had higher adjusted odds of CA-MRSA hospitalization.Conclusions.The CA-MRSA hospitalization rate appeared to increase between 1997 and 2006 in New York City, with residents of the Bronx and Manhattan, men, and persons with HIV infection or diabetes at increased odds of hospitalization with CA-MRSA. Further studies are needed to explore how changes in MRSA incidence, access to care, and other factors may have impacted these rates.


2020 ◽  
Vol 27 (07) ◽  
pp. 1363-1370
Author(s):  
Aneela Khawaja ◽  
Iffat Javed ◽  
Sohaila Mushtaq ◽  
Saeed Anwar ◽  
Faiqa Arshad ◽  
...  

Antimicrobial resistance (AMR) is a devastating question that is threatening the health globally. The extensive and indiscriminative use of antibiotics has evolved a notorious resistance in Staphylococcus aureus.  This resistance developed through possession of mecA gene, which codes for modified penicillin binding protein (PBP2a) and the emergent strain being labeled “methicillin resistant Staphylococcus aureus”. Conventional phenotypic techniques for detection of MRSA rely on standardization of cultural characteristics. The drawbacks of diagnostic error to report MRSA include: poor prognosis, expensive treatment, dissemination of multi-drug resistant strains and even treatment failure. Latex agglutination method can be adopted as a more accurate and quick strategy for rapid detection of methicillin resistance. Objectives: To compare detection of mecA gene in methicillin resistant isolates of Staphylococcus aureus by latex agglutination and PCR; by assessing the sensitivity and specificity of both methods. Study Design: Descriptive Cross-Sectional study. Setting: Pathology Department, Post Graduate Medical Institute, Lahore. Period: From January 2015 to December 2015; according to standard operating procedures at Microbiology laboratory. Material & Methods: A total 713 consecutive, non-duplicate isolates of Staphylococcus aureus were processed. Methicillin resistance was determined using cefoxitin (30mg) by Kirby-Bauer method using CLSI guideline (2016), latex agglutination method; and PCR for mecA gene. Results: The results showed that out of 713 Staphylococcus aureus isolates, 92 (12.90%) isolates were resistant to cefoxitin and were labelled as MRSA. majority MRSA isolates recovered from pus (44.57%) and wound swab (20.65%), followed by blood (13.04%), fluid (8.70%), CSF (4.35%), CVP (3.26%), HVS (3.26%) and tracheal secretion (2.17%). By latex agglutination method, 87 (94.50%) were positive for PBP2a; while on PCR mecA gene was detected only in 82 (89.10%) MRSA isolates. When assessed with PCR (gold standard) the sensitivity and diagnostic accuracy of latex agglutination was 100% and 94.57%, respectively. Conclusion: Latex agglutination test can be employed as rapid and reliable diagnostic technique in MRSA isolates for mecA gene detection, where resources for molecular methods are inadequate. This can effectually lessen the misdiagnosis of resistant strains, and over/ ill-use of antibiotics.


2015 ◽  
Vol 26 (3) ◽  
pp. 233-243
Author(s):  
Kristine Anne Scordo

Methicillin-resistant Staphylococcus aureus (MRSA) continues to cause significant morbidity and mortality. Despite advances in medical care, the prevalence of both community-acquired and hospital-acquired MRSA has progressively increased. Community-acquired MRSA typically occurs in patients without recent illness or hospitalization, presents as acute skin and soft tissue infections, and is usually not multidrug resistant. Hospital-acquired MRSA, however, presents in patients recently hospitalized or treated in long-term care settings and in those who have had medical procedures and is usually associated with multidrug-resistant strains. Both types of infections, if not properly treated, have the potential to become invasive. This article discusses current intravenous antibiotics that are available for the empiric treatment of MRSA infections along with a newer phenomenon known as the “seesaw effect.”


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