Molecular and clinical characteristics of hospital and community onset methicillin-resistant Staphylococcus aureus strains associated with bloodstream infections
Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) are classified epidemiologically as health care-associated hospital onset (HAHO)-, health care-associated community onset (HACO)-, or community-associated (CA)-MRSA. Clinical and molecular differences between HAHO- and HACO-MRSA BSI are not well known. Thus, we evaluated clinical and molecular characteristics of MRSA BSI to determine if distinct features are associated with HAHO- or HACO-MRSA strains. Molecular genotyping and medical record reviews were conducted on 282 MRSA BSI isolates from January 2007 to December 2009. MRSA classifications were 38% HAHO-, 54% HACO-, and 8% CA-MRSA. Comparing patients with HAHO-MRSA to those with HACO-MRSA, HAHO-MRSA patients had significantly higher rates of malignancy, surgery, recent invasive devices, and mortality and longer hospital stays. Patients with HACO-MRSA were more likely to have a history of renal failure, hemodialysis, residence in a long-term-care facility, long-term invasive devices, and higher rate of MRSA relapse. Distinct MRSA molecular strain differences also were seen between HAHO-MRSA (60% staphylococcal cassette chromosome mec type II [SCCmec II], 30% SCCmec III, and 9% SCCmec IV) and HACO-MRSA (47% SCCmec II, 35% SCCmec III, and 16% SCCmec IV) (P < 0.001). In summary, our study reveals significant clinical and molecular differences between patients with HAHO- and HACO-MRSA BSI. In order to decrease rates of MRSA infection, preventive efforts need to be directed toward patients in the community with health care-associated risk factors in addition to inpatient infection control..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:53 |
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| Enthalten in: |
Journal of clinical microbiology - 53(2015), 5, Seite 1599-1608 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wang, Shu-Hua [VerfasserIn] |
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| Links: |
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| RVK: |
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| doi: |
10.1128/JCM.03147-14 |
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| funding: |
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OLC1965742521 |
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| 520 | |a Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) are classified epidemiologically as health care-associated hospital onset (HAHO)-, health care-associated community onset (HACO)-, or community-associated (CA)-MRSA. Clinical and molecular differences between HAHO- and HACO-MRSA BSI are not well known. Thus, we evaluated clinical and molecular characteristics of MRSA BSI to determine if distinct features are associated with HAHO- or HACO-MRSA strains. Molecular genotyping and medical record reviews were conducted on 282 MRSA BSI isolates from January 2007 to December 2009. MRSA classifications were 38% HAHO-, 54% HACO-, and 8% CA-MRSA. Comparing patients with HAHO-MRSA to those with HACO-MRSA, HAHO-MRSA patients had significantly higher rates of malignancy, surgery, recent invasive devices, and mortality and longer hospital stays. Patients with HACO-MRSA were more likely to have a history of renal failure, hemodialysis, residence in a long-term-care facility, long-term invasive devices, and higher rate of MRSA relapse. Distinct MRSA molecular strain differences also were seen between HAHO-MRSA (60% staphylococcal cassette chromosome mec type II [SCCmec II], 30% SCCmec III, and 9% SCCmec IV) and HACO-MRSA (47% SCCmec II, 35% SCCmec III, and 16% SCCmec IV) (P < 0.001). In summary, our study reveals significant clinical and molecular differences between patients with HAHO- and HACO-MRSA BSI. In order to decrease rates of MRSA infection, preventive efforts need to be directed toward patients in the community with health care-associated risk factors in addition to inpatient infection control. | ||
| 540 | |a Nutzungsrecht: Copyright © 2015, American Society for Microbiology. All Rights Reserved. | ||
| 650 | 4 | |a Cross Infection - pathology | |
| 650 | 4 | |a Methicillin-Resistant Staphylococcus aureus - classification | |
| 650 | 4 | |a Sepsis - microbiology | |
| 650 | 4 | |a Methicillin-Resistant Staphylococcus aureus - isolation & purification | |
| 650 | 4 | |a Sepsis - pathology | |
| 650 | 4 | |a Community-Acquired Infections - pathology | |
| 650 | 4 | |a Staphylococcal Infections - pathology | |
| 650 | 4 | |a Cross Infection - microbiology | |
| 650 | 4 | |a Staphylococcal Infections - microbiology | |
| 650 | 4 | |a Community-Acquired Infections - microbiology | |
| 650 | 4 | |a Methicillin-Resistant Staphylococcus aureus - genetics | |
| 700 | 1 | |a Hines, Lisa |4 oth | |
| 700 | 1 | |a van Balen, Joany |4 oth | |
| 700 | 1 | |a Mediavilla, José R |4 oth | |
| 700 | 1 | |a Pan, Xueliang |4 oth | |
| 700 | 1 | |a Hoet, Armando E |4 oth | |
| 700 | 1 | |a Kreiswirth, Barry N |4 oth | |
| 700 | 1 | |a Pancholi, Preeti |4 oth | |
| 700 | 1 | |a Stevenson, Kurt B |4 oth | |
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