| Title | Differences in Clinical and Molecular Characteristics of Skin and Soft-Tissue (SSTI) Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates between Two Hospitals in Northern California. | | Author(s) | Bhattacharya D, Carleton H, Tsai CJ, Baron EJ, Perdreau-Remington F | | Institution | Stanford University, Stanford, CA, Univ. of California San Francisco, San Francisco, CA. | | Source | J Clin Microbiol 2007 Apr 4. | | Abstract | Community-onset MRSA (CO-MRSA) skin and soft tissue infections (SSTI) are associated with SCCmec IV and Panton-Valentine Leukocidin (PVL) genes. CO-MRSA epidemiologic studies suggest that genotypic variation exists within one geographic region. We compared MRSA genotypes and demographic and clinical characteristics of patients with CO-MRSA SSTI between 2 regional medical centers. We also examined factors associated with SCCmec IV and PVL carriage. 279 MRSA SSTI isolates from 2000-2002 at San Francisco General Hospital (SFGH) and Stanford University (SUH) were genotyped by Pulsed Field Gel Electrophoresis and PCR for SCCmec and PVL genes. Medical records were reviewed for clinical characteristics. 93% and 69% MRSA SSTI were CO-MRSA at SFGH and SUH, respectively. Patients with CO-MRSA SSTI at SFGH were more likely to be nonwhite, younger, homeless, and have no previous healthcare exposure (p<.01). SFGH CO-MRSA strains were more likely to carry SCCmec type IV and PVL genes (90% and 55%, respectively) compared to SUH (29% and 16%, respectively). In multivariate analyses, nonwhite ethnicity was associated with both SCCmec type IV and PVL carriage; (OR: 2.65, 95% CI: 1.19-5.95 and OR: 1.94, 95% CI: 1.03-3.65), respectively. ST8:USA 300:IV became the dominant clone at SFGH by 2002, but not at SUH. Despite geographic proximity, CO-MRSA SSTI exhibited differing SCCmec types, PVL carriage, and clonal dynamics. CO-MRSA SSTIs at SUH were more likely to represent feral isolates of nosocomial origin. Clinicians should assess for nosocomial and community risk factors realizing that different populations with CO-MRSA SSTI may require separate antimicrobial strategies. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 17409211 |
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