Skip to main content
×
Home
    • Aa
    • Aa

Clinical and Laboratory Features of Community-Associated Methicillin-Resistant Staphylococcus aureus: Is It Really New?

  • Leonard B. Johnson (a1), Sajjad Saeed (a1), Joan Pawlak (a1), Odette Manzor (a1) and Louis D. Saravolatz (a1)...
Abstract
Objective.

To review the epidemiologic and molecular characteristics of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Detroit, Michigan, to assess the risk factors for infection and the response to therapy.

Design.

Prospective clinical and laboratory study of 2003-2004 CA-MRSA isolates. Molecular features were compared with CA-MRSA isolates from 1980.

Setting.

A 600-bed urban academic medical center.

Patients.

Twenty-three patients with CA-MRSA infections from 2003-2004 were evaluated. In addition, laboratory analysis was performed on 13 CA-MRSA isolates from 1980.

Main Outcome Measures.

Laboratory analysis of isolates included antimicrobial susceptibility testing, pulsed-field genotyping, testing for Panton-Valentine leukocidin (PVL) genes, and staphylococcal cassette chromosome mec typing.

Results.

Patients were predominantly young African American males and presented with skin and soft-tissue infections. All isolates were resistant to erythromycin and highly susceptible to other agents. Patients were generally treated successfully with combination incision and drainage and systemic antibiotics. Among the 23 isolates, 20 (87%) were the same strain. This strain carried the staphylococcal cassette chromosome mec type IV and PVL genes and is genetically identical to USA 300. Thirteen isolates of patients from our community who presented with CA-MRSA infections in 1980 represented a single clone that is unique compared with the 2003-2004 isolates. This strain carried staphylococcal cassette chromosome mec type IVA but did not carry the PVL genes.

Conclusions.

In our community, CA-MRSA is largely due to a single clone with a type IV mec gene and PVL gene. The type IV staphylococcal cassette chromosome mec type can be demonstrated in CA-MRSA isolates from a remote period, suggesting that earlier outbreaks were not related to healthcare exposure.

Copyright
Corresponding author
St. John Hospital and Medical Center, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236 (leonard.johnson@stjohn.org)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3. LD Saravolatz , N Markowitz , L Arking , D Pohlod , E Fisher . Methicillin-resistant Staphylococcus aureus: epidemiologic observations during a community-acquired outbreak. Ann Intern Med 1982; 96:1116.

4. LD Saravolatz , DJ Pohlod , LM Arking . Community-acquired methicillin-resistant Staphylococcus aureus infections: a new source for nosocomial outbreaks. Ann Intern Med 1982; 97:325329.

5. BC Herold , LC Immergluck , MC Maranan , et al. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 1998; 279:593598.

7. P Collignon , I Gosbell , A Vickery , G Nimmo , T Stylianopoulos , T Gottlieb . Community-acquired methicillin-resistant Staphylococcus aureus in Australia. Lancet 1998; 352:145146.

8. S Salmenlinna , O Lyytikainen , J Vuopio-Varkila . Community-acquired methicillin-resistant Staphylococcus aureus, Finland. Emerg Infect Dis 2002; 8:602607.

9. HF Chambers . The changing epidemiology of Staphylococcus aureus? Emerg Infect Dis 2001; 7:178182.

10. K Mongkolrattanothai , S Boyle , MD Kahana , RS Daum . Severe Staphylococcus aureus infections caused by clonally related community-acquired methicillin-susceptible and methicillin-resistant isolates. Clin Infect Dis 2003; 37:10501058.

12. AV Groom , DH Wolsey , TS Naimi , et al. Community-acquired methicillin-resistant Staphylococcus aureus in a rural American Indian community. JAMA 2001; 286:12011205.

13. TS Naimi , KH LeDell , DJ Boxrud , et al. Epidemiology and clonality of community-acquired methicillin-resistant Staphylococcus aureus in Minnesota, 1996-1998. Clin Infect Dis 2001; 33:990996.

14. TS Naimi , KH LeDell , K Como-Sabetti , et al. Comparison of community-and health-care associated methicillin-resistant Staphylococcus aureus infection. JAMA 2003; 290:29762984.

15. RS Daum , T Ito , K Hiramatsu , et al. A novel methicillin-resistance cassette in community-acquired methicillin-resistant staphylococcus aureus isolates of diverse genetic backgrounds. J Infect Dis 2002; 186:13441347.

16. P Dufour , Y Gillet , M Bes , et al. Community-acquired methicillin-resistant Staphylococcus aureus infections in France: emergence of a single clone that produces Panton-Valentine Leukocidin. Clin Infect Dis 2002; 35:819824.

17. CC Wang , WT Lo , ML Chu , LK Siu . Epidemiological typing of community-acquired methicillin-resistant Staphylococcus aureus isolates from children in Taiwan. Clin Infect Dis 2004; 39:481487.

21. LK McDougal , CD Steward , GE Killgore , JM Chaitram , SK McAllister , FC Tenover . Pulsed-field gel electrophoresis typing of oxacillin-resistant Staphylococcus aureus isolates from the United States: establishing a national database. J Clin Microbiol 2003; 41:51135120.

22. DC Oliveira , H de Lencastre . Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2002; 46: 21552161.

23. K Okuma , K Iwakawa , JD Turnidge , et al. Dissemination of new methicillin-resistant Staphylococcus aureus clones in the community. J Clin Microbiol 2002; 40:42894294.

25. DP Levine , RD Cushing , J Jui , WJ Brown . Community-acquired methicillin-resistant Staphylococcus aureus endocarditis in the Detroit Medical Center. Ann Intern Med 1982; 97:330338.

27. L Saiman , M O'Keefe , PL Graham , et al. Hospital transmission of community-acquired methicillin-resistant Staphylococcus aureus among postpartum women. Clin Infect Dis 2003; 37:13131319.

28. ES Pan , BA Diep , HA Carleton , et al. Increasing prevalence of methicillin-resistant Staphylococcus aureus infection in California jails. Clin Infect Dis 2003; 37:13841388.

29. HC Baggett , TW Hennessy , K Rudolph , et al. Community-onset methicillin-resistant Staphylococcus aureus associated with antibiotic use and the cytotoxin Panton-Valentine Leukocidin during a furunculosis outbreak in rural Alaska. J Infect Dis 2004; 189:15651573.

31. PM Adcock , D Paster , F Medley , JE Patterson , TV Murphy . Methicillin-resistant Staphylococcus aureus in two child care centers. J Infect Dis 1998; 178:577580.

32. HA Carleton , BA Diep , ED Charlebois , GF Sensabaugh , F Perdreau-Remington . Community-adapted methicillin-resistant Staphylococcus aureus (MRSA): population dynamics of an expanding community reservoir of MRSA. J Infect Dis 2004; 190:17301738.

33. K Hiramatsu , K Okuma , XX Ma , et al. New trends in Staphylococcus aureus infections: glycopeptide resistance in hospitals and methicillin resistance in the community. Curr Opin Infect Dis 2002; 15:407413.

34. G Lina , Y Piemont , MB Godail-Gamot , et al. Involvement of Panton-Valentine Leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 1999;29:11281132.

35. N Markowitz , EL Quinn , LD Saravolatz . Trimethoprim-sulfamethoxazole compared with vancomycin for the treatment of Staphylococcus aureus infection. Ann Intern Med 1992; 117:390398.

36. EJ Gorak , SM Yamada , JD Brown . Community-acquired methicillin-resistant Staphylococcus aureus in hospitalized adults and children without known risk factors. Clin Infect Dis 1999; 29:797800.

37. MC Lee , AM Rios , MF Aten , et al. Management and outcome of children with skin and soft tissue abscess caused by community-acquired methicillin-resistant Staphylococcus aureus. Pediatr Infect Dis J 2004; 23:123127.

38. GK Siberry , T Tekle , K Carroll , J Dick . Failure of clindamycin treatment of methicillin-resistant Staphylococcus aureus expressing inducible clindamycin resistance in vitro. Clin Infect Dis 2003; 37:12571260.

39. TE Daum , DR Schaberg , MS Terpenning , et al. Increasing resistance of Staphylococcus aureus to ciprofloxacin. Antimicrob Agents Chemother 1990;34:18621863.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Abstract views

Total abstract views: 33 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 25th September 2017. This data will be updated every 24 hours.