Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection.
Citations
3,803 citations
Cites background from "Comparison of community- and health..."
...Studies of the emergence of community-associated MRSA disease over the past decade determined that isolates causing community-associated and health care–associated MRSA infections were distinct.(10) Isolates from the community were susceptible to most non– -lactam antimicrobial agents,(10) carried staphylococcal cassette chromosome type IV,(14) and frequently encoded the dermonecrotic cytotoxin known as Panton-Valentine leukocidin....
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...17 In contrast, strains most frequently associated with MRSA infections in health care settings were USA100, USA200, and less often, USA50018; these tradit ional ly have been mult idrugresistant and have carried staphylococcal cassette chromosome type II.10 In hospitalized patients, MRSA has been a problem since the 1960s19; approximately 20% of bloodstream infections in the hospital setting have been caused by S aureus.20 The proportion of hospital-onset S aureus infections that were methicillin-resistant reached 64.4% in US intensive care units in 2003.21 In the hospital, MRSA infections are associated with greater lengths of stay, higher mortality,22 and increased costs.23,24 Although more recently there has been increased surveillance activity for invasive MRSA infections in the community, surveillance for MRSA bloodstream infections in the United States traditionally has been limited to hospital-onset (ie, nosocomial) disease.20,21 As the epidemiology of MRSA disease changes, including both community- and health care–associated disease, accurate information on the scope and magnitude of the burden of MRSA disease in the US population is needed to set priorities for prevention and control....
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...In contrast, strains most frequently associated with MRSA infections in health care settings were USA100, USA200, and less often, USA500(18); these tradit ional ly have been mult idrugresistant and have carried staphylococcal cassette chromosome type II.(10) In hospitalized patients, MRSA has been a problem since the 1960s(19); approximately 20% of bloodstream infections in the hospital setting have been caused by S aureus....
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3,370 citations
Cites background from "Comparison of community- and health..."
...However, because 95%–100% of CA-MRSA strains are susceptible in vitro [81, 82], it has become an important option for the outpatient treatment of SSTI [83–85]....
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2,096 citations
1,816 citations
Additional excerpts
...003 Invasive procedure within 60 d 690/2581 (27) 392/1463 (27) 162/508 (32) 64/247 (26) 289/1145 (25) 175/681 (26) ....
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...Staphylococcus aureus 869 (31) 487 (31) 256 (43) 43 (17) 339 (28) 231 (32) ....
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...001 Native valve predisposition 884/2761 (32) 538/1547 (35) 147/596 (25) 93/252 (37) 370/1201 (31) 274/712 (38) ....
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...002 CHF 876/2713 (32) 414/1527 (27) 207/591 (35) 97/249 (39) 383/1162 (33) 189/711 (27) ....
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1,807 citations
Cites background from "Comparison of community- and health..."
...PVL , but only 4% of HA-MRSA isolates were PVL (654)....
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...Thus, MRSA in the community has a complex epidemiology arising from the circulation of “escaped,” or so-called feral, HAMRSA strains in the general population (115, 117, 154, 437, 529, 852) and the newly recognized CA-MRSA strains (654)....
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...This case definition was initially used to demonstrate that MRSA infections were occurring among healthy people in the community without health care exposure (306, 654)....
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...CA-MRSA isolates have typically been susceptible to most non- -lactam antimicrobial drugs (383, 654), including several orally available agents....
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References
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"Comparison of community- and health..." refers background in this paper
...In Europe, Panton Valentine leukocidin genes are associated with community-associated staphylococcal skin infections and necrotizing pneumonia.(26,34,35) Similarly, in our study, most community-associated MRSA isolates that had Panton Valentine leukocidin genes were associated with skin and soft tissue infections....
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1,790 citations