| Autor: |
Pan, Sung-Ching, Wang, Jann-Tay, Lauderdale, Tsai-Ling, Ko, Wen-Chien, Chen, Yao-Shen, Liu, Jien-Wei, Lau, Yeu-Jun, Wang, Li-Hsin, Liu, Ke-Sun, Liao, Chun-Hsing, Lin, San-Yi, Hu, Bor-Shen, Chang, Shan-Chwen |
| Předmět: |
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| Zdroj: |
Journal of the Formosan Medical Association; Jul2014, Vol. 113 Issue 7, p409-416, 8p |
| Abstrakt: |
Background/Purpose: After community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified, new community-onset, healthcare-associated MRSA (HA-MRSA-CO) infections have been noticed as MRSA infection in patients with community-onset infection who have underlying conditions resulting in frequent exposure to the healthcare system. However, previous studies have not thoroughly investigated whether HA-MRSA-CO has characteristics resembling those of CA-MRSA or hospital-onset, healthcare-associated MRSA (HA-MRSA-HO) infection. Methods: A multicenter, retrospective study was conducted to analyze the clinical and microbiological data of patients with clinical isolates of MRSA from nine hospitals in Taiwan. Results: In total, 203 patients with MRSA isolates, including 27 patients with CA-MRSA (13.3%), 59 with HA-MRSA-CO (29.1%), and 117 with HA-MRSA-HO (57.6%), were studied. Compared to HA-MRSA-HO isolates, the CA-MRSA and HA-MRSA-CO isolates were associated with a higher proportion of skin and soft tissue infections (81.8% and 65.3% vs. 40.5%, p =0.001 and p =0.002) as well as lesser rate of resistance to ciprofloxacin (33.3% and 50.9% vs. 74.4%, p <0.001 and p =0.002), gentamicin (44.4% and 64.4% vs. 84.6%, p <0.001 and p =0.002), and trimethoprim/sulfamethoxazole (33.3% and 42.4% vs. 58.1%, p =0.02 and p =0.048), and a lower 30-day all-cause mortality rate (7.4% and 0% vs. 20.9%, p <0.001). Most of the CA-MRSA isolates were classified as staphylococcal cassette chromosome mec (SCCmec) type VT (11/27, 40.7%), whereas most HA-MRSA-HO isolates were classified as SCCmec type III (66/117, 56.4%). Conclusion: The CA-MRSA, HA-MRSA-CO, and HA-MRSA-HO clinical isolates significantly differed in their clinical presentations and molecular characteristics. [Copyright &y& Elsevier] |
| Databáze: |
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