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Increase of the USA300 clone among community-acquired methicillin-susceptible Staphylococcus aureus causing invasive infections.
Pediatr Infect Dis J. 2007 Dec; 26(12):1122-7.PI

Abstract

BACKGROUND

Methicillin-resistant Staphylococcus aureus (MRSA) USA300 is a predominant cause of community-acquired (CA) infection in the United States. We compared clinical characteristics of children with USA300 versus non-USA300 CA-methicillin-susceptible S. aureus (CA-MSSA) invasive infections at Texas Children's Hospital (TCH).

METHODS

Medical records were reviewed from children with invasive CA-MSSA infections at TCH between August 1, 2001 and September 30, 2006. Isolates were characterized by pulsed-field gel electrophoresis and polymerase chain reaction for Panton-Valentine leukocidin genes (pvl).

RESULTS

Invasive CA-MSSA infections increased from 14 in year 1 to 36 in year 5 (5-year total = 122 patients). Among the CA-MSSA isolates available for typing in the 5-year period, USA300 MSSA strains increased from 14% (2 of 14) to 35% (11 of 31) (P = 0.03). USA300 MSSA strains were more likely than non-USA300 MSSA strains to be nonsusceptible to erythromycin [66% (19 of 29) versus 28% (25 of 88); P < 0.01]. Osteomyelitis cases increased from 43% (6 of 14) in year 1 to 67% (24 of 36) in year 5. The majority of pvl(+) MSSA isolates were USA300 (71% (25 of 35); only 5% (4 of 82) of pvl(-) MSSA isolates were USA300. Patients with osteomyelitis caused by pvl isolates had significantly higher mean values for erythrocyte sedimentation rate at admission (P = 0.005) and erythrocyte sedimentation rate maximum value (P = 0.002), maximum C-reactive protein (P = 0.04), and absolute neutrophil count at presentation (P = 0.04) compared with patients whose isolates were pvl(-).

CONCLUSIONS

USA300 accounted for a growing proportion of CA-MSSA isolates among children and was associated with increased numbers of invasive CA-MSSA infections at TCH, especially osteomyelitis. Associations were found in CA-MSSA osteomyelitis between pvl and increased concentrations of systemic inflammatory markers in patients.

Authors+Show Affiliations

Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18043449

Citation

McCaskill, Michelle L., et al. "Increase of the USA300 Clone Among Community-acquired Methicillin-susceptible Staphylococcus Aureus Causing Invasive Infections." The Pediatric Infectious Disease Journal, vol. 26, no. 12, 2007, pp. 1122-7.
McCaskill ML, Mason EO, Kaplan SL, et al. Increase of the USA300 clone among community-acquired methicillin-susceptible Staphylococcus aureus causing invasive infections. Pediatr Infect Dis J. 2007;26(12):1122-7.
McCaskill, M. L., Mason, E. O., Kaplan, S. L., Hammerman, W., Lamberth, L. B., & Hultén, K. G. (2007). Increase of the USA300 clone among community-acquired methicillin-susceptible Staphylococcus aureus causing invasive infections. The Pediatric Infectious Disease Journal, 26(12), 1122-7.
McCaskill ML, et al. Increase of the USA300 Clone Among Community-acquired Methicillin-susceptible Staphylococcus Aureus Causing Invasive Infections. Pediatr Infect Dis J. 2007;26(12):1122-7. PubMed PMID: 18043449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increase of the USA300 clone among community-acquired methicillin-susceptible Staphylococcus aureus causing invasive infections. AU - McCaskill,Michelle L, AU - Mason,Edward O,Jr AU - Kaplan,Sheldon L, AU - Hammerman,Wendy, AU - Lamberth,Linda B, AU - Hultén,Kristina G, PY - 2007/11/29/pubmed PY - 2008/1/3/medline PY - 2007/11/29/entrez SP - 1122 EP - 7 JF - The Pediatric infectious disease journal JO - Pediatr Infect Dis J VL - 26 IS - 12 N2 - BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) USA300 is a predominant cause of community-acquired (CA) infection in the United States. We compared clinical characteristics of children with USA300 versus non-USA300 CA-methicillin-susceptible S. aureus (CA-MSSA) invasive infections at Texas Children's Hospital (TCH). METHODS: Medical records were reviewed from children with invasive CA-MSSA infections at TCH between August 1, 2001 and September 30, 2006. Isolates were characterized by pulsed-field gel electrophoresis and polymerase chain reaction for Panton-Valentine leukocidin genes (pvl). RESULTS: Invasive CA-MSSA infections increased from 14 in year 1 to 36 in year 5 (5-year total = 122 patients). Among the CA-MSSA isolates available for typing in the 5-year period, USA300 MSSA strains increased from 14% (2 of 14) to 35% (11 of 31) (P = 0.03). USA300 MSSA strains were more likely than non-USA300 MSSA strains to be nonsusceptible to erythromycin [66% (19 of 29) versus 28% (25 of 88); P < 0.01]. Osteomyelitis cases increased from 43% (6 of 14) in year 1 to 67% (24 of 36) in year 5. The majority of pvl(+) MSSA isolates were USA300 (71% (25 of 35); only 5% (4 of 82) of pvl(-) MSSA isolates were USA300. Patients with osteomyelitis caused by pvl isolates had significantly higher mean values for erythrocyte sedimentation rate at admission (P = 0.005) and erythrocyte sedimentation rate maximum value (P = 0.002), maximum C-reactive protein (P = 0.04), and absolute neutrophil count at presentation (P = 0.04) compared with patients whose isolates were pvl(-). CONCLUSIONS: USA300 accounted for a growing proportion of CA-MSSA isolates among children and was associated with increased numbers of invasive CA-MSSA infections at TCH, especially osteomyelitis. Associations were found in CA-MSSA osteomyelitis between pvl and increased concentrations of systemic inflammatory markers in patients. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/18043449/Increase_of_the_USA300_clone_among_community_acquired_methicillin_susceptible_Staphylococcus_aureus_causing_invasive_infections_ L2 - https://doi.org/10.1097/INF.0b013e31814536e0 DB - PRIME DP - Unbound Medicine ER -