Continued Emergence of USA300 Methicillin-ResistantStaphylococcus aureusin the United States: Results from a Nationwide Surveillance Study

Autor: Kristopher P. Heilmann, Fathollah Riahi, Gary V. Doern, Sandra S. Richter, S. Tendolkar, Daniel J. Diekema, Jennifer S. McDanel, Cassie L. Dohrn
Rok vydání: 2014
Předmět:
Adult
Male
Methicillin-Resistant Staphylococcus aureus
0301 basic medicine
Microbiology (medical)
Pediatrics
medicine.medical_specialty
Adolescent
Epidemiology
030106 microbiology
Microbial Sensitivity Tests
medicine.disease_cause
Microbiology
Young Adult
03 medical and health sciences
Pneumonia
Staphylococcal
medicine
Pulsed-field gel electrophoresis
Humans
Typing
Child
Abscess
Aged
Cross Infection
Molecular Epidemiology
Molecular epidemiology
business.industry
Infant
Newborn
Infant
Middle Aged
Staphylococcal Infections
biochemical phenomena
metabolism
and nutrition
bacterial infections and mycoses
medicine.disease
Methicillin-resistant Staphylococcus aureus
United States
Pneumonia
030104 developmental biology
Infectious Diseases
Staphylococcus aureus
Child
Preschool
Population Surveillance
Wound Infection
Female
business
Zdroj: Infection Control & Hospital Epidemiology. 35:285-292
ISSN: 1559-6834
0899-823X
DOI: 10.1086/675283
Popis: Background.The epidemiology of methicillin-resistantStaphylococcus aureus(MRSA) is changing, with USA300 emerging first in community and then in healthcare settings. We performed nationwide surveillance to assess recent trends in the molecular epidemiology of MRSA.Methods.One hundred consecutive unique clinically significantS. aureusisolates were recovered from patients at each of 43 US centers between July 1, 2011, and December 31, 2011. Susceptibility testing, pulsed-field gel electrophoresis (PFGE), staphylococcal protein A gene (spa) and staphylococcal cassette chromosome mec typing, and Panton-Valentine leukocidin detection were performed on all MRSA isolates.Results.Of 4,131 isolates collected, 2,093 (51%) were MRSA. Specimen sources of MRSA isolates included wound or abscess (54%), blood (24%), lower respiratory tract (11%), and other sterile site (10%). Thirty percent were isolated more than 48 hours after hospital admission (ie, were associated with nosocomial acquisition of infection). USA300 was the most common PFGE type (1,269 isolates; 61%), overall and in all regions, followed by USA100 (368 isolates; 18%). Among 173spatypes found, the most common were t008 (51%) and t002 (18%); no otherspatype accounted for more than 2% of isolates. One strain type (USA300/t008/IV) constituted almost half of all MRSA isolates (1,005 isolates; 48%) and was the most common at all body sites, causing 37% of MRSA bloodstream infections (BSIs) and 38% of nosocomial MRSA infections. Multidrug-resistant phenotypes were found among 34 USA300 isolates (3%) from 18 states.Conclusions.The USA300 PFGE type continues to advance nationwide. A single strain type (USA300/t008/IV) predominates in all regions and infection sites and is now more common than USA 100 as a cause of MRSA BSI and nosocomial infections. Although most USA300 retain typical susceptibility profiles, multidrug-resistant phenotypes are emerging.
Databáze: OpenAIRE
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