A Population‐Based Study of the Incidence and Molecular Epidemiology of Methicillin‐Resistant<i>Staphylococcus aureus</i>Disease in San Francisco, 2004–2005

Liu, Catherine; Graber, Christopher J.; Karr, Michael; Diep, Binh An; Basuino, Li; Schwartz, Brian S.; Enright, Mark C.; O’Hanlon, Simon J.; Thomas, J.; Perdreau-Remington, Françoise; Gordon, Shelley; Gunthorpe, Helen; Jacobs, Richard A.; Jensen, Peter; Leoung, Gifford S.; Rumack, James S.; Chambers, Henry F.

doi:10.1086/587893

Cited by 192 publications

(159 citation statements)

References 36 publications

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“…Also, despite dramatic increases in noninvasive community-onset MRSA infections, we did not observe a proportionate increase in invasive community-onset MRSA as might be expected if USA300 MRSA had the same propensity as non-USA300 MRSA to invade the bloodstream. rates of community-acquired and hospital-acquired MRSA among residents in San Francisco, California, USA, community-associated of 316 and 31 cases per 100,000 population, respectively, for which most cultures were from skin and soft tissue (8). The results of our study for community-onset MRSA are slightly lower but similar.…”

Section: Discussionsupporting

confidence: 39%

“…We are unable to extrapolate these fi ndings to children, a population for which an increase of community-onset MRSA SSTIs has been reported (24). Previous reports suggest that men are at higher risk than women for S. aureus infections; therefore, our estimates may overestimate true rates for women (8,12,13). Second, although we did not perform molecular typing on the S. aureus-positive isolates, we expect that a signifi cant proportion (>80%) of noninvasive MRSA infections were caused by the USA300 MRSA strain (1).…”

Section: Discussionmentioning

confidence: 71%

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Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Salam¹,

Khan²,

Malnick³

et al. 2011

Emerg. Infect. Dis.

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Trends in Staphylococcus aureus infections are not well described. To calculate incidence in overall S. aureus infection and invasive and noninvasive infections according to methicillin susceptibility and location, we conducted a 10-year population-based retrospective cohort study (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) using patient-level data in the Veterans Affairs Maryland Health Care System. We found 3,674 S. aureus infections: 2,816 (77%) were noninvasive; 2,256 (61%) were methicillin-resistant S. aureus (MRSA); 2,517 (69%) were community onset, and 1,157 (31%) were hospital onset. Sixty-one percent of noninvasive infections were skin and soft tissue infections; 1,112 (65%) of these were MRSA. Ten-year averaged incidence per 100,000 veterans was 749 (± 132 SD,

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Section: Discussionsupporting

confidence: 39%

Section: Discussionmentioning

confidence: 71%

Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Salam¹,

Khan²,

Malnick³

et al. 2011

Emerg. Infect. Dis.

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“…A recent study, using whole-genome sequencing, suggests that this European CA-MRSA developed from a sub-Saharan methicillin-susceptible S. aureus (MSSA) in the 1980s (Stegger et al 2014). The USA300 clone is widely disseminated throughout the USA and accounted for nearly 80 % of the CA-MRSA in a San Francisco-based study (Liu et al 2008).…”

Section: Methicillin Resistancementioning

confidence: 99%

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

Mernelius¹

2015

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Staphylococcus aureus is a commensal of the human flora, primarily colonizing the anterior nares and throat, but it may also cause infections ranging from mild skin and soft tissue infections to severe diseases such as endocarditis and septicemia. S. aureus is also a major nosocomial problem increasing with the worldwide dissemination of methicillin-resistant S. aureus (MRSA).The main vector for bacterial cross-transmission in healthcare settings is the hands of healthcare workers (HCWs). No S. aureus was detected in the air in this thesis demonstrating that transmission through air is not important. Despite the fact that good compliance with hand hygiene is essential to prevent cross-transmission the compliance is generally less than 50 %.Gold standard to track bacterial transmission in healthcare settings has for long been pulsedfield gel electrophoresis (PFGE), a method that is labor-intensive, lacks consensus protocol and relies on semi-subjective analysis. Molecular typing by sequencing of the hypervariable part of the S. aureus protein A gene (spa typing) has overcome these problems and has shown promising results in epidemiological investigations.The aims of this thesis were to study bacterial transmission with S. aureus colonization of newborn infants as a model and to evaluate spa typing as a molecular tool. Additionally, the influence of compliance with hygiene guidelines on S. aureus transmission was assessed.Analysis of 280 MRSA isolates by spa typing revealed excellent typeability and epidemiological concordance and satisfactory discriminatory power. Additionally, spa typing was considered superior to PFGE thanks to its accessibility, ease of use and rapidity. Also, spa typing results are registered in a global database, facilitating inter-laboratory comparison.The prevalence of S. aureus ranged from 41 % to 66 % in the populations studied and males had the highest colonization rate. Throat was the premier colonization site for adults and transmission from individuals colonized in the throat only was documented, suggesting that throat cultures should be included in S. aureus screening programs. The umbilicus was the premier colonization site for newborn infants. Incubating the swabs in enrichment broth prior to plating increased the prevalence of S. aureus positive samples by 46 %, resulting in prevalence viii ranging from 51 % to 70 % in the populations studied. Thus enrichment prior to plating is necessary to determine more truthful S. aureus colonization rates. There were no indications of an institutional flora, as the colonization rates, spa type distribution and antibiotic resistance prevalence were similar among parents and HCWs.Direct observations and self-reporting by HCWs were both validated as tools for monitoring compliance with hygiene guidelines. The compliance with hygiene guidelines was significantly higher following a 10-point hygiene intervention as compared to baseline. The compliance was also higher three years after the intervention in three of four participating departm...

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“…In the USA, about 111,000 persons with diabetes are hospitalised annually with foot infections and these precede and contribute to almost 60% of all lower extremity amputations [13]. Staphylococcus aureus is the most commonly isolated pathogen in SSTIs, both in ambulatory and hospitalised patients [14][15][16]. Antimicrobial-resistant pathogens, especially methicillin-resistant S. aureus (MRSA), are increasingly isolated in nosocomial infections [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost

Tabak²,

et al. 2010

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Aims/hypothesis Skin and soft tissue infections (SSTIs) cause substantial morbidity in persons with diabetes. There are few data on pathogens or risk factors associated with important outcomes in diabetic patients hospitalised with SSTIs. Methods Using a clinical research database from CareFusion, we identified 3,030 hospitalised diabetic patients with positive culture isolates and a diagnosis of SSTI in 97 US hospitals between 2003 and 2007. We classified the culture isolates and analysed their association with the anatomic location of infection, mortality, length of stay and hospital costs. Results The only culture isolate with a significantly increased prevalence was methicillin-resistant Staphylococcus aureus (MRSA); prevalence for infection of the foot was increased from 11.6 to 21.9% (p<0.0001) and for non-foot locations from 14.0% to 24.6% (p=0.006). Patients with non-foot (vs foot) infections were more severely ill at presentation and had higher mortality rates (2.2% vs 1.0%, p<0.05). Significant independent risk factors associated with higher mortality rates included having a polymicrobial culture with Pseudomonas aeruginosa (OR 3

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A Population‐Based Study of the Incidence and Molecular Epidemiology of Methicillin‐ResistantStaphylococcus aureusDisease in San Francisco, 2004–2005

Cited by 192 publications

References 36 publications

Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost

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