Methicillin-Resistant Staphylococcus aureus as a Community Organism

Moreno, Francisco; Crisp, Cindy; Jorgensen, James H.; Patterson, Jan E.

doi:10.1093/clinids/21.5.1308

Cited by 211 publications

(119 citation statements)

References 6 publications

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“…[12][13][14][15][16] More-recent reports have suggested that other risk factors also may exist, such as household contacts with risk factors for MRSA and child-care attendance. [17][18][19] Notably, the CA-MRSA isolates described in the past decade differ significantly from previous strains of MRSA in that they have distinct DNA-fingerprinting patterns 20 and lack multidrug resistance.…”

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confidence: 99%

Community-Acquired Methicillin-Resistant Staphylococcus aureus in Southern New England Children

Dietrich¹,

2004

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ABSTRACT. Objective. This study was performed to understand the epidemiology of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in southern New England children.Methods. A retrospective review was conducted of the medical records of children 0 to 18 years old with MRSA isolated by the Rhode Island Hospital microbiology laboratory (Providence, RI) between 1997 and 2001. A case was classified as either health care-associated MRSA (HCA-MRSA) or CA-MRSA based on time of culture and other strict criteria. The spectrum of illness of the HCA-MRSA and CA-MRSA cases was compared, as were the antibiotic-susceptibility patterns of their isolates. Risk factors for CA-MRSA acquisition were identified, and molecular subtyping of selected isolates was performed.Results. 6,7 In the early 1980s, the first reports of communityacquired (CA)-MRSA in adults emerged. 8 -10 These isolates were found initially in intravenous drug users or members of other high-risk groups with frequent contact with the health care system. In the late 1980s, the first cases of CA-MRSA in children were reported. 11 Most of these children also had a history of frequent health care contact. Thus, although the infections occurred in a community setting, these MRSA strains are better described as health careassociated (HCA) rather than truly CA.From the 1990s to the present, CA-MRSA has emerged as a pathogen in adults and children without traditional risk factors for MRSA acquisition. [12][13][14][15][16] More-recent reports have suggested that other risk factors also may exist, such as household contacts with risk factors for MRSA and child-care attendance. [17][18][19] Notably, the CA-MRSA isolates described in the past decade differ significantly from previous strains of MRSA in that they have distinct DNA-fingerprinting patterns 20 and lack multidrug resistance. 21 Recent research has demonstrated that these strains have novel resistance and virulence genes. Resistance to ␤-lactam antibiotics is conveyed by acquisition of a chromosomal mecA gene that encodes for a penicillin-binding protein with a low affinity for this antibiotic class. The mecA genes are found on mobile genetic elements called staphylococcal chromosomal cassettes (SCCmec). CA-MRSA strains have been found to have a novel allelic form of SCCmec type IV, thus differing from HCA-MRSA strains that carry types I, II, or III SCCmec cassettes. The mecA gene of HCA-MRSA strains is flanked by insertion sequencelike elements, acquired through horizontal gene transfer, which act as a trap for additional unrelated antibiotic-resistance genetic determinants leading to by guest on May 9, 2018 http://pediatrics.aappublications.org/ Downloaded from the multidrug resistance seen in these strains. The smaller type IV SCCmec cassette found in CA-MRSA does not carry any such multiresistance genes 22,23 ; however, these strains can still cause fatal disease. 24 Additionally, CA-MRSA strains, unlike HCA-MRSA strains, have been found to carry virulence genes encoding a leu...

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confidence: 99%

Community-Acquired Methicillin-Resistant Staphylococcus aureus in Southern New England Children

Dietrich¹,

2004

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“…12 Over the last decade, MRSA has become increasingly common in hospitals and in community settings. [22][23][24] Combination antimicrobial is an important treatment approach for infections. Synergy is one of the most common reasons for using combination antimicrobial therapy.…”

Section: Discussionmentioning

confidence: 99%

In vitro activity of two old antibiotics against clinical isolates of methicillin-resistant Staphylococcus aureus

Song

Cai

et al. 2010

J Antibiot

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The objective of this paper was to investigate the in vitro effects of fusidic acid combined with fosfomycin against methicillin-resistant Staphylococcus aureus (MRSA). In all, 196 MRSA strains isolated from three clinical specimens of human infections from hospitals in China were used in this study. The checkerboard method was used to determine whether combinations act synergistically against these strains. The susceptibility results for fusidic acid and fosfomycin were interpreted according to the guidelines of the Clinical and Laboratory Standards Institute. The combination of fusidic acid and fosfomycin demonstrated the following interactions: 87.76% (172/196) synergism, 12.24% (24/196) indifference and no antagonism was seen (minimum and maximum fractional inhibitory concentration index 0.14 and 0.75, respectively). Thus, combinations of fusidic acid and fosfomycin show synergism for most of the MRSA isolates tested in this study, and may be a future therapeutic alternative for infections caused by MRSA.

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“…Further information should be collected to develop a hypothesis on risk factors specific for community acquisition. Intravenous drug use, previous antibiotic use, and underlying diseases have previously been associated with community acquisition of MRSA (147,176). A recent study covering 30 months identified a similar proportion (22%, 20/92) of community-acquired MRSA in a university hospital.…”

Section: Mrsa In Communitymentioning

confidence: 93%

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Finland

Salmenlinna¹,

Lyytikäinen

Kotilainen

et al. 2000

European Journal of Clinical Microbiology & Infectious Dise

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Methicillin-Resistant Staphylococcus aureus as a Community Organism

Cited by 211 publications

References 6 publications

Community-Acquired Methicillin-Resistant Staphylococcus aureus in Southern New England Children

Community-Acquired Methicillin-Resistant Staphylococcus aureus in Southern New England Children

In vitro activity of two old antibiotics against clinical isolates of methicillin-resistant Staphylococcus aureus

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Finland

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