Recurrent Furunculosis Caused by a Community-Acquired<i>Staphylococcus aureus</i>Strain Belonging to the USA300 Clone

Balachandra, Shirish; Gándara, María Pardos de la; Salvato, Scott; Urban, Tracie; Parola, Claude; Khalida, Chamanara; Kost, Rhonda G.; Evering, Teresa H.; Pastagia, Mina; D’Orazio, Brianna; Tomasz, Alexander; Lencastre, Herminia Garcez

doi:10.1089/mdr.2014.0283

Cited by 12 publications

(10 citation statements)

References 38 publications

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“…In the present study, we performed an extensive screening on some patients presenting with recurrent skin and soft tissue infections with MRSA in which carriage was checked both in the nares and at nine additional body sites (pharynx, axillae, cubital folds, inguinal folds, and patellar folds). In some patients, the nasal carriage was negative (data not shown), and in one USA300-infected patient, the infecting MRSA strain was found only in the inguinal and patellar folds (38). A recent study described an outbreak and extensive spread of MRSA belonging to the clonal type USA300 in northern Manhattan (30) during the same time period in which our CAMP study was performed.…”

Section: Figmentioning

confidence: 76%

Molecular Types of Methicillin-Resistant Staphylococcus aureus and Methicillin-Sensitive S. aureus Strains Causing Skin and Soft Tissue Infections and Nasal Colonization, Identified in Community Health Centers in New York City

et al. 2015

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Network (CDN) launched a research and learning collaborative project with six community health centers in the New York City metropolitan area to determine the nature (clonal type) of community-acquired Staphylococcus aureus strains causing skin and soft tissue infections (SSTIs). Between November 2011 and March 2013, wound and nasal samples from 129 patients with active SSTIs suspicious for S. aureus were collected and characterized by molecular typing techniques. In 63 of 129 patients, the skin wounds were infected by S. aureus: methicillinresistant S. aureus (MRSA) was recovered from 39 wounds and methicillin-sensitive S. aureus (MSSA) was recovered from 24. Most-46 of the 63-wound isolates belonged to the CC8/Panton-Valentine leukocidin-positive (PVL ؉ ) group of S. aureus clone USA300: 34 of these strains were MRSA and 12 were MSSA. Of the 63 patients with S. aureus infections, 30 were also colonized by S. aureus in the nares: 16 of the colonizing isolates were MRSA, and 14 were MSSA, and the majority of the colonizing isolates belonged to the USA300 clonal group. In most cases (70%), the colonizing isolate belonged to the same clonal type as the strain involved with the infection. In three of the patients, the identity of invasive and colonizing MRSA isolates was further documented by whole-genome sequencing. Staphylococcus aureus is the most common cause of bacterial infections in humans worldwide (1), and methicillin-resistant Staphylococcus aureus (MRSA) is the main cause of skin and soft tissue infections (SSTIs) in North America, with a single clone, USA300, accounting for 98% of these infections (2, 3).The first human case of MRSA infection in the United States was reported in Boston, MA, in 1968 (4). MRSA was first detected in hospitals, and over the following decades, it became the main nosocomial pathogen around the world (5). In 1998, the prevalence of MRSA in 12 hospitals throughout the city of New York was assessed (6), and a single MRSA clone was found to be responsible for an overwhelming majority of MRSA infections. The same MRSA clone was subsequently identified as dominant in MRSA infections in 29 hospitals in the tristate area (7), and it was also identified in MRSA infections in Japan (8). This MRSA clone (multilocus sequence typing [MLST] clonal complex CC5, sequence type ST5, SCCmecII, and unique pulsed-field gel electrophoresis [PFGE] profile)-also known as the "New York/Japan clone" or "MRSA clone USA100"-became the most prevalent MRSA clone involved in MRSA infections in hospitals in the United States in the 1990s (9).In 1993, a new MRSA clone emerged in Kimberley, Western Australia (10), in a community of patients without previous health care contact (community-acquired MRSA [CA-MRSA]). In the late 1990s, CA-MRSA also appeared in the United States and was responsible for the death of four otherwise healthy pediatric patients in Minnesota and North Dakota (11). These new CA-MRSA strains belonged to a clone (USA400/CC1/SCCmecIV)

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Section: Figmentioning

confidence: 76%

Molecular Types of Methicillin-Resistant Staphylococcus aureus and Methicillin-Sensitive S. aureus Strains Causing Skin and Soft Tissue Infections and Nasal Colonization, Identified in Community Health Centers in New York City

et al. 2015

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“…The Arginine Catabolic Mobile Element (ACME) and the Panton-Valentine Leukocidin (PVL), screens for two virulence genetic determinants strongly associated to CA-MRSA. All molecular techniques were performed as previously described [17–28]. …”

Section: Methodsmentioning

confidence: 99%

Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York Community Health Centers

Jenks

Gándara

D’Orazio

et al. 2016

Travel Medicine and Infectious Disease

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Background Staphylococcus aureus is the most common cause of Skin and Soft Tissue Infections (SSTIs) in the community in the United States of America. Community Health Centers (CHC) serve as primary care providers for thousands of immigrants in New York. Methods As part of a research collaborative, 6 New York City-area CHCs recruited patients with SSTIs. Characterization was performed in all S. aureus isolates from wounds and nasal swabs collected from patients. Statistical analysis examined the differences in wound and nasal cultures among immigrant compared to native-born patients. Results Wound and nasal specimens were recovered from 129 patients and tested for antibiotic susceptibility. 40 patients were immigrants from 15 different countries. Although not statistically significant, immigrants had lower rates of MRSA infections (n=15) than did native-born participants, and immigrants showed significantly higher rates of MSSA wound cultures (n=11) (OR=3.5, 95% CI: 1.3, 9.7). Conclusions In our study, immigrants were more likely to present with SSTIs caused by MSSA than US-born patients. This suggests that antibiotic resistance may vary regionally and that immigrants presenting with SSTIs may benefit from a broader range of antibiotics. Immigrants also reported lower frequencies of antibiotic prescription or consumption in the months prior to SSTI infection.

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“…This RCT included practicing clinicians, patients, clinical and laboratory researchers, NYbased Federally Qualified Health Centers (FQHCs) and community hospital Emergency Departments (EDs). The stakeholder research collaborative expands an earlier partnership, the Community-Acquired MRSA Project (CAMP1) which developed research to address CA-MRSA (25)(26)(27)(28)(29). The study was approved by Institutional Review Boards at Clinical Directors Network and Rockefeller University.…”

Section: Methodsmentioning

confidence: 99%

Comparative Effectiveness Study of Home-Based Interventions to Prevent CA-MRSA Infection Recurrence

Hower

D’Orazio

Gándara

et al. 2020

Preprint

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BACKGROUND: Recurrent skin and soft tissue infections (SSTI) caused by Community-Associated Methicillin-Resistant (CA-MRSA) or Methicillin-Sensitive Staphylococcus aureus (CA-MSSA) present treatment challenges. OBJECTIVES: Can an evidence-based intervention (CDC Guidelines, topical decolonization, surface decontamination) reduce SSTI recurrence, mitigate household contamination and transmission, and improve patient-reported outcomes? DESIGN: Randomized trial SETTING: Community settings PARTICIPANTS: Participants (n=186) with confirmed MRSA(+)/MSSA(+) SSTIs and household members. INTERVENTION Community Health Workers/Promotoras conducted home visits and provided participants with instructions, a five-day supply of mupirocin for nasal application, chlorhexidine for body cleansing, and disinfecting wipes for household cleaning (EXP) versus Usual Care (UC). MEASUREMENTS: Primary outcome was six-month SSTI recurrence recorded in electronic health records (EHR). Home visits (months 0/3) and telephone assessments (months 0/1/6) collected self-report data. Surveillance culture swabs (nares, axilla, groin) were obtained from index patients and participating household members. Secondary outcomes included household surface contamination, household member colonization and transmission, quality of life and satisfaction with care. RESULTS: Among patients with SSTIs (n=421), 44.2% were MRSA(+)/MSSA(+); an intent-to-treat analyses (n=186) demonstrated no significant differences in SSTI recurrence (OR: 1.4, 95% CI: 0.51-3.5). Among the enrolled cohort (n=119), there were no significant SSTI recurrence effects (OR=1.14, 95% CI=0.35-3.6). EXP participants showed reduced but non-significant colonization rates. There were no differential reductions in household member transmission or in reductions in proportions of households with >1 contaminated surface. Mupirocin resistance did not increase. No significant improvements for patient-reported outcomes were seen. LIMITATIONS: A lower-than-predicted six-month recurrence rate may have limited the ability to detect effects. CONCLUSION: This intervention did not reduce clinician-reported MRSA/MSSA SSTI recurrence. No differences were observed for household members decolonization or household surfaces decontamination.

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Recurrent Furunculosis Caused by a Community-AcquiredStaphylococcus aureusStrain Belonging to the USA300 Clone

Cited by 12 publications

References 38 publications

Molecular Types of Methicillin-Resistant Staphylococcus aureus and Methicillin-Sensitive S. aureus Strains Causing Skin and Soft Tissue Infections and Nasal Colonization, Identified in Community Health Centers in New York City

Molecular Types of Methicillin-Resistant Staphylococcus aureus and Methicillin-Sensitive S. aureus Strains Causing Skin and Soft Tissue Infections and Nasal Colonization, Identified in Community Health Centers in New York City

Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York Community Health Centers

Comparative Effectiveness Study of Home-Based Interventions to Prevent CA-MRSA Infection Recurrence

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