Molecular epidemiology and household transmission of community-associated methicillin-resistant Staphylococcus aureus in Hong Kong

Ho, Pak-Leung; Cheung, Clara; Mak, Gannon C.K.; Tse, Cindy Wing-Sze; Ng, Tak‐Keung; Cheung, Chris H. Y.; Que, Tak-Lun; Lam, Robert F.; Lai, Robin Kit-Ho; Yung, R; Yuen, Kwok‐Yung

doi:10.1016/j.diagmicrobio.2006.08.003

Cited by 75 publications

(62 citation statements)

References 32 publications

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“…This is in accordance with other reports (Tristan et al, 2007;Boyle-Vavra & Daum, 2007) that pvl carriage is much more frequently associated with SCCmec types IV and V than other types (I, II or III) in S. aureus. In Hong Kong, pvl-positive SCCmec type V isolates have been reported in five MRSA strains (Ho et al, 2007). Our results confirmed the previous findings at an extended scale.…”

Section: Jmm Correspondencesupporting

confidence: 82%

“…The most prevalent MLST types were ST30 and ST59, shared by 22 (52.4 %) and 15 (35.7 %) isolates, respectively. Further expanding on a published report by Ho et al (2007), our study showed that the predominant CA-MRSA clones in Hong Kong possessed the genetic background ST30-IV. Our pvl-positive MRSA isolates were segregated by PFGE into 5 clusters, with 2 predominant clusters, A and E, comprising 21 and 17 strains, respectively (Fig.…”

Section: Jmm Correspondencesupporting

confidence: 75%

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Panton–Valentine leukocidin-positive meticillin-resistant Staphylococcus aureus in the community in Hong Kong

Cheung

Chu

et al. 2008

Journal of Medical Microbiology

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Panton-Valentine leukocidin-positive meticillin-resistant Staphylococcus aureus in the community in Hong Kong Meticillin-resistant Staphylococcus aureus (MRSA) strains producing the potent tissue necrotizing toxin Panton-Valentine leukocidin (PVL) encoded by the pvl gene, and harbouring SCCmec type IV or V elements, have been implicated as being associated with MRSA infection acquired in the community setting (Vandenesch et al., 2003; Boyle-Vavra & Daum, 2007). Since the 1990s, community-associated (CA)-MRSA infections have shown a steady increase, and are becoming a significant public-health concern. PVLpositive MRSA isolates have been shown to have distinct genetic backgrounds in different areas, for instance, multilocus sequence typing (MLST) types ST80, ST8 and ST59 were found in the major clones

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Section: Jmm Correspondencesupporting

confidence: 82%

Section: Jmm Correspondencesupporting

confidence: 75%

Panton–Valentine leukocidin-positive meticillin-resistant Staphylococcus aureus in the community in Hong Kong

Cheung

Chu

et al. 2008

Journal of Medical Microbiology

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“…These isolates belong to the dominant Taiwan C-MRSA clones (CC59:SCCmec V:pvl-positive and spa CC t437). Since CC59:SCCmec V isolates have now been reported in other countries (7,10,13,15,19) and since other C-MRSA lineages have also been found to have low-level ␤-lactam resistance (23,28,30), the findings and implications of our study may be relevant to predominant C-MRSA lineages on other continents. Our results indicate that as more clinical laboratories switch to using automated susceptibility testing instruments for determining antimicrobial susceptibility, there is a need for careful evaluation of the performance of these methods for the detection of mecA-positive S. aureus with a low-level oxacillin resistance to prevent their further spread in health care and community settings.…”

Section: Discussionmentioning

confidence: 62%

mecA -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan

et al. 2012

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Although the presence of mecA is the genotypic determinant of methicillin-resistant Staphylococcus aureus (MRSA), certain MRSA strains, especially community-associated MRSA (C-MRSA), can display an oxacillin MIC in the Clinical and Laboratory Standards Institute susceptible breakpoint range (<2 g/ml). Among 91 and 180 isolates thought to be methicillin-susceptible S. aureus (MSSA) with oxacillin MICs of 2 and 1 g/ml as determined by the Sensititre broth microdilution test initially, 52 (57.1%) and 6 (3.3%), respectively, were mecA positive. These mecA-positive low-oxacillin-MIC isolates belong to the dominant Taiwan C-MRSA clone (clonal complex [CC] 59), 56 of which carried SCCmec type V and were pvl positive, and 43 of which belonged to spa CC t437. All 271 isolates were retested by Sensititre, as well as by Vitek II and disk diffusion (DD). Based on the oxacillin results, the sensitivities of the Sensititre, Vitek II, and DD methods were 48.3% (28/58), 46.6% (27/58), and 89.6% (52/ 58), respectively. Although cefoxitin was better at detecting these isolates, 12.1, 10.4, and 5.2% of these isolates were still misidentified as MSSA by Sensititre, Vitek II, and DD, respectively. These results highlight the difficulty in the accurate identification of MRSA with borderline oxacillin MICs in the CC59:SCCmec V clone, which likely has contributed to its spread in the health care and community settings. Since this clone has now been detected in other countries, and since other C-MRSA lineages have also been found to have low-level ␤-lactam resistance, the findings of the present study may be relevant to other regions. Further studies are warranted to determine the extent and clinical impact of such misidentification.

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“…The spread of MRSA among household contacts has been reported previously, but the observed MRSA transmission rates to household contacts are variable (5,14,16,18,22,23,36). Johansson et al (18) observed that in 22 of 51 index persons (43%), MRSA was transmitted to one or more household contacts.…”

Section: Discussionmentioning

confidence: 96%

Transmission of Methicillin-Resistant Staphylococcus aureus to Household Contacts

et al. 2010

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The frequency of and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) transmission from a MRSA index person to household contacts were assessed in this prospective study. Between January 2005 and December 2007, 62 newly diagnosed MRSA index persons (46 patients and 16 health care workers) and their 160 household contacts were included in the study analysis. Transmission of MRSA from an index person to household contacts occurred in nearly half of the cases (47%; n ‫؍‬ 29). These 29 index persons together had 84 household contacts, of which two-thirds (67%; n ‫؍‬ 56) became MRSA positive. Prolonged exposure time to MRSA at home was a significant risk factor for MRSA transmission to household contacts. In addition, MRSA colonization at least in the throat, younger age, and eczema in index persons were significantly associated with MRSA transmission; the presence of wounds was negatively associated with MRSA transmission. Furthermore, an increased number of household contacts and being the partner of a MRSA index person were householdrelated risk factors for MRSA acquisition from the index person. No predominant pulsed-field gel electrophoresis (PFGE) type was observed to be transmitted more frequently than other PFGE types. To date, screening household contacts and providing MRSA eradication therapy to those found positive simultaneously with the index person is not included in the "search-and-destroy" policy. We suggest including both in MRSA prevention guidelines, as this may reduce further spread of MRSA.

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Molecular epidemiology and household transmission of community-associated methicillin-resistant Staphylococcus aureus in Hong Kong

Cited by 75 publications

References 32 publications

Panton–Valentine leukocidin-positive meticillin-resistant Staphylococcus aureus in the community in Hong Kong

Panton–Valentine leukocidin-positive meticillin-resistant Staphylococcus aureus in the community in Hong Kong

mecA -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan

Transmission of Methicillin-Resistant Staphylococcus aureus to Household Contacts

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