Community-associated Methicillin-resistant<i>Staphylococcus aureus</i>in Pediatric Patients

Ochoa, Theresa J.; Mohr, John; Wanger, Audrey; Murphy, James R.; Heresi, Gloria P.

doi:10.3201/eid1106.050142

Cited by 97 publications

(79 citation statements)

References 14 publications

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“…In fact, the incidence of isolates that are resistant to erythromycin but susceptible to clindamycin varies worldwide (256). In the United States, the incidence of the inducible MLS B phenotype also varies widely by hospital, by geographical area, and temporally, ranging from 2.6% to 27.9% (7,40,47,182).…”

Section: Clinical Implications Of Inducible Mls B Resistancementioning

confidence: 99%

Modes and Modulations of Antibiotic Resistance Gene Expression

et al. 2007

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SUMMARY Since antibiotic resistance usually affords a gain of function, there is an associated biological cost resulting in a loss of fitness of the bacterial host. Considering that antibiotic resistance is most often only transiently advantageous to bacteria, an efficient and elegant way for them to escape the lethal action of drugs is the alteration of resistance gene expression. It appears that expression of bacterial resistance to antibiotics is frequently regulated, which indicates that modulation of gene expression probably reflects a good compromise between energy saving and adjustment to a rapidly evolving environment. Modulation of gene expression can occur at the transcriptional or translational level following mutations or the movement of mobile genetic elements and may involve induction by the antibiotic. In the latter case, the antibiotic can have a triple activity: as an antibacterial agent, as an inducer of resistance to itself, and as an inducer of the dissemination of resistance determinants. We will review certain mechanisms, all reversible, that bacteria have elaborated to achieve antibiotic resistance by the fine-tuning of the expression of genetic information.

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Section: Clinical Implications Of Inducible Mls B Resistancementioning

confidence: 99%

Modes and Modulations of Antibiotic Resistance Gene Expression

et al. 2007

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“…Previously limited to hospitals, MRSA infections have been increasingly reported in the community. 8,[9][10][11][12][13][14] A recent meta-analysis of 27 studies of the prevalence of community-acquired-MRSA among hospital patients that used clinical specimens, as opposed to surveillance cultures conducted at the time of admission, yielded a prevalence of MRSA of 30.2%. unique microbiologic and genetic properties that may allow them to spread more easily or cause more skin disease than traditional hospital-based strains.…”

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confidence: 99%

“…16 Because many clinical infections arise from spread from a healthy carrier, an understanding of the risk factors for carriage of S aureus is crucial to understanding the potential for invasive infections and transmission of MRSA; however, most surveillance of S aureus and MRSA has focused on individuals with invasive infections rather than on an entire population. [10][11][12]17,18 Focusing on individuals with invasive infections provides a good indication of severe disease but does not provide an accurate assessment of the reservoir of S aureus and potential for transmission.…”

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confidence: 99%

Nasal Carriage of Staphylococcus aureus and Methicillin-Resistant S aureus in the United States, 2001-2002

Mainous

Hueston²,

Everett³

et al. 2006

The Annals of Family Medicine

172

113

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PURPOSE Staphylococcus aureus is a common cause of invasive infections, yet most assessments of prevalence are based on health care-based samples. We computed population-based estimates of nasal carriage of S aureus and risk factors for carriage, as well as population-based estimates of nasal carriage of methicillin-resistant S aureus (MRSA). RESULTS An estimated 86.9 million persons (32.40% of the population) were colonized with S aureus. The prevalence of MRSA among S aureus isolates was 2.58%, for an estimated population carriage of MRSA of 0.84% or 2.2 million persons. Among individuals with S aureus isolates, individuals aged 65 years or older had the highest MRSA prevalence (8.28%). Among all the racial/ethnic groups studied, Hispanics had the highest prevalence of colonization with S aureus but, when colonized, were less likely to have MRSA. METHODSCONCLUSIONS This fi rst nationally representative assessment of carriage of S aureus indicates that nearly one third of the population is currently colonized by this organism. Although the prevalence of MRSA remains low, more than 2.2 million people carry this resistant organism; thus, vigilance in promoting appropriate microbial transmission protocols should remain a priority.

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“…Another report documented rapidly fatal infections in four children in North Dakota and Minnesota from 1997 to 1999 (2). A further rapid increase in the incidence of MRSA disease among previously healthy people was documented at the UCMC in 1998 to 1999 (3) and 2004 to 2005 (4), and in other geographic areas in the United States (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). These infections were caused by newly emergent strains of MRSA.…”

mentioning

confidence: 98%

Pediatric Staphylococcus aureus Isolate Genotypes and Infections from the Dawn of the Community-Associated Methicillin-Resistant S. aureus Epidemic Era in Chicago, 1994 to 1997

et al. 2015

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dWidespread infections with community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) have occurred in the United States with the dissemination of the USA300 strain beginning in 2000. We examined 105 isolates obtained from children treated at the University of Chicago from 1994 to 1997 (75 methicillin-susceptible S. aureus [MSSA] and 30 MRSA isolates) in order to investigate for possible evidence of USA300 during this period. Infections were defined epidemiologically based on medical record review. The isolates underwent multilocus sequence typing (MLST), as well as assays for the Panton-Valentine leukocidin (PVL) genes, the protein A gene (spa), and arcA and opp3, proxy markers for the arginine catabolic mobile element (ACME), characteristic of USA300 MRSA. MRSA isolates also underwent staphylococcal cassette chromosome mec (SCCmec) typing and pulsed-field gel electrophoresis (PFGE) subtyping. MSSA isolates belonged to 17 sequence type (ST) groups. The 12 epidemiologically defined CA-MRSA infection isolates were either ST1 (n ‫؍‬ 4) or ST8 (n ‫؍‬ 8). They belonged to 3 different PFGE types: USA100 (n ‫؍‬ 1), USA400 (n ‫؍‬ 5), and USA500 (n ‫؍‬ 6). Among the CA-MRSA infection isolates, 8 (67%) were PVL ؉ . None of the MRSA or MSSA isolates contained arcA or opp3. Only one MRSA isolate was USA300 by PFGE. This was a health care-associated (HA) MRSA isolate, negative for PVL, that carried SCCmec type II. USA300 with its characteristic features was not identified in the collection from the years 1994 to 1997. In the mid-1990s, there was a major shift in the clinical and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) infections in the United States. One of the first reports of a different epidemiology for MRSA infections was from the children's hospital at the University of Chicago Medical Center (UCMC), in which previously healthy children were found to have MRSA infections (1). Notably, the incidence of MRSA infections among children having no previous exposure to the health care system increased significantly from 1988 -1990 to 1993-1995 at the UCMC. Another report documented rapidly fatal infections in four children in North Dakota and Minnesota from 1997 to 1999 (2). A further rapid increase in the incidence of MRSA disease among previously healthy people was documented at the UCMC in 1998UCMC in to 1999UCMC in (3) and 2004UCMC in to 2005, and in other geographic areas in the United States (5-16). These infections were caused by newly emergent strains of MRSA. Because these infections occurred in community settings, the new strains of MRSA causing these infections were called community-associated (CA) MRSA strains, and the infections, as defined by epidemiologic criteria (4, 6), have been called CA-MRSA infections.CA-MRSA strains have been studied extensively. Pulsed-field gel electrophoresis (PFGE) revealed that the initial strains found in the Midwest, Alaska, and New York belonged to a single clonal group classified as USA400 (17). Since 2000, however...

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Community-associated Methicillin-resistantStaphylococcus aureusin Pediatric Patients

Cited by 97 publications

References 14 publications

Modes and Modulations of Antibiotic Resistance Gene Expression

Modes and Modulations of Antibiotic Resistance Gene Expression

Nasal Carriage of Staphylococcus aureus and Methicillin-Resistant S aureus in the United States, 2001-2002

Pediatric Staphylococcus aureus Isolate Genotypes and Infections from the Dawn of the Community-Associated Methicillin-Resistant S. aureus Epidemic Era in Chicago, 1994 to 1997

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