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Comparisons of community-associated methicillin-resistant Staphylococcus aureus (MRSA) and hospital-associated MSRA infections in Sacramento, California.
J Clin Microbiol 2006; 44(7):2423-7JC

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) has long been a common pathogen in healthcare facilities, but in the past decade, it has emerged as a problematic pathogen in the community setting as well. A retrospective case series study of patients from whom MRSA was isolated from December 1, 2003, through May 31, 2004, was conducted at the University of California, Davis, Medical Center. Patient data were collected from electronic medical records and traditional chart reviews to determine whether MRSA acquisition was likely to have been in the community or in the hospital. Antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE) were performed for all confirmed isolates. Skin and soft tissue were the most common infection sites for all MRSA patients. Among the 283 MRSA infections, 127 (44.9%) were defined as community-associated (CA)-MRSA. Ninety-six percent of the CA-MRSA isolates were susceptible to clindamycin. Double-disk diffusion tests were performed to examine inducible clindamycin resistance by erythromycin induction on both CA and hospital-associated (HA) clindamycin-susceptible and erythromycin-resistant isolates. Ten percent (17 of 183) were positive. Most CA-MRSA isolates were identified by PFGE as a unique strain, genotype USA300, which was not genetically related to the predominant genotype, USA100, in the HA-MRSA isolates. Injecting drug users accounted for 49% of CA-MRSA infections but only 19% of the HA-MRSA infections (odds ratio, 4.2; 95% confidence interval, 2.4 to 7.4). Our study shows that a single clone of CA-MRSA accounts for the majority of infections. This strain originated in the community and is not related to MRSA strains from healthcare settings. Injecting drug users could be a major reservoir for CA-MRSA transmission.

Authors+Show Affiliations

Department of Infectious Disease, University of California, Davis, Medical Center, 4150 V Street, PSSB, G500, Sacramento, CA 95817, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16825359

Citation

Huang, Hsin, et al. "Comparisons of Community-associated Methicillin-resistant Staphylococcus Aureus (MRSA) and Hospital-associated MSRA Infections in Sacramento, California." Journal of Clinical Microbiology, vol. 44, no. 7, 2006, pp. 2423-7.
Huang H, Flynn NM, King JH, et al. Comparisons of community-associated methicillin-resistant Staphylococcus aureus (MRSA) and hospital-associated MSRA infections in Sacramento, California. J Clin Microbiol. 2006;44(7):2423-7.
Huang, H., Flynn, N. M., King, J. H., Monchaud, C., Morita, M., & Cohen, S. H. (2006). Comparisons of community-associated methicillin-resistant Staphylococcus aureus (MRSA) and hospital-associated MSRA infections in Sacramento, California. Journal of Clinical Microbiology, 44(7), pp. 2423-7.
Huang H, et al. Comparisons of Community-associated Methicillin-resistant Staphylococcus Aureus (MRSA) and Hospital-associated MSRA Infections in Sacramento, California. J Clin Microbiol. 2006;44(7):2423-7. PubMed PMID: 16825359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparisons of community-associated methicillin-resistant Staphylococcus aureus (MRSA) and hospital-associated MSRA infections in Sacramento, California. AU - Huang,Hsin, AU - Flynn,Neil M, AU - King,Jeff H, AU - Monchaud,Caroline, AU - Morita,Margaret, AU - Cohen,Stuart H, PY - 2006/7/11/pubmed PY - 2006/10/25/medline PY - 2006/7/11/entrez SP - 2423 EP - 7 JF - Journal of clinical microbiology JO - J. Clin. Microbiol. VL - 44 IS - 7 N2 - Methicillin-resistant Staphylococcus aureus (MRSA) has long been a common pathogen in healthcare facilities, but in the past decade, it has emerged as a problematic pathogen in the community setting as well. A retrospective case series study of patients from whom MRSA was isolated from December 1, 2003, through May 31, 2004, was conducted at the University of California, Davis, Medical Center. Patient data were collected from electronic medical records and traditional chart reviews to determine whether MRSA acquisition was likely to have been in the community or in the hospital. Antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE) were performed for all confirmed isolates. Skin and soft tissue were the most common infection sites for all MRSA patients. Among the 283 MRSA infections, 127 (44.9%) were defined as community-associated (CA)-MRSA. Ninety-six percent of the CA-MRSA isolates were susceptible to clindamycin. Double-disk diffusion tests were performed to examine inducible clindamycin resistance by erythromycin induction on both CA and hospital-associated (HA) clindamycin-susceptible and erythromycin-resistant isolates. Ten percent (17 of 183) were positive. Most CA-MRSA isolates were identified by PFGE as a unique strain, genotype USA300, which was not genetically related to the predominant genotype, USA100, in the HA-MRSA isolates. Injecting drug users accounted for 49% of CA-MRSA infections but only 19% of the HA-MRSA infections (odds ratio, 4.2; 95% confidence interval, 2.4 to 7.4). Our study shows that a single clone of CA-MRSA accounts for the majority of infections. This strain originated in the community and is not related to MRSA strains from healthcare settings. Injecting drug users could be a major reservoir for CA-MRSA transmission. SN - 0095-1137 UR - https://www.unboundmedicine.com/medline/citation/16825359/Comparisons_of_community_associated_methicillin_resistant_Staphylococcus_aureus__MRSA__and_hospital_associated_MSRA_infections_in_Sacramento_California_ L2 - http://jcm.asm.org/cgi/pmidlookup?view=long&pmid=16825359 DB - PRIME DP - Unbound Medicine ER -