Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection.
Timothy S. Naimi,Kathleen H. LeDell,Kathryn Como-Sabetti,Stephanie M. Borchardt,David Boxrud,Jerome Etienne,Susan K. Johnson,François Vandenesch,Scott K. Fridkin,Carol O'Boyle,Richard Danila,Ruth Lynfield +11 more
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TLDR
It is suggested that most community-associated MRSA strains did not originate in health care settings, and that their microbiological features may have contributed to their emergence in the community.Abstract:
Context Methicillin-resistant Staphylococcus aureus (MRSA) has traditionally been considered a health care–associated pathogen in patients with established risk factors. However, MRSA has emerged in patients without established risk factors (community-associated MRSA). Objective To characterize epidemiological and microbiological characteristics of community-associated MRSA cases compared with health care–associated MRSA cases. Design, Setting, and Patients Prospective cohort study of patients with MRSA infection identified at 12 Minnesota laboratory facilities from January 1 through December 31, 2000, comparing community-associated (median age, 23 years) with health care–associated (median age, 68 years) MRSA cases. Main Outcome Measures Clinical infections associated with either communityassociated or health care–associated MRSA, microbiological characteristics of the MRSA isolates including susceptibility testing, pulsed-field gel electrophoresis, and staphylococcal exotoxin gene testing. Results Of 1100 MRSA infections, 131 (12%) were community-associated and 937 (85%) were health care–associated; 32 (3%) could not be classified due to lack of information. Skin and soft tissue infections were more common among communityassociated cases (75%) than among health care–associated cases (37%) (odds ratio [OR], 4.25; 95% confidence interval [CI], 2.97-5.90). Although communityassociated MRSA isolates were more likely to be susceptible to 4 antimicrobial classes (adjusted OR, 2.44; 95% CI, 1.35-3.86), most community-associated infections were initially treated with antimicrobials to which the isolate was nonsusceptible. Communityassociated isolates were also more likely to belong to 1 of 2 pulsed-field gel electrophoresis clonal groups in both univariate and multivariate analysis. Communityassociated isolates typically possessed different exotoxin gene profiles (eg, Panton Valentine leukocidin genes) compared with health care–associated isolates. Conclusions Community-associated and health care–associated MRSA cases differ demographically and clinically, and their respective isolates are microbiologically distinct. This suggests that most community-associated MRSA strains did not originate in health care settings, and that their microbiological features may have contributed to their emergence in the community. Clinicians should be aware that therapy with -lactam antimicrobials can no longer be relied on as the sole empiric therapy for severely ill outpatients whose infections may be staphylococcal in origin.read more
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Methicillin-resistant Staphylococcus aureus necrotizing pneumonia arising from an infected episiotomy site.
TL;DR: Community-acquired MRSA is an emerging problem, which may present as skin and soft tissue infections or sepsis in a postpartum patient and the use of empirical treatment with &bgr;-lactam agents may fail.
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Serious infections due to methicillin-resistant Staphylococcus aureus: An evolving challenge for physicians
TL;DR: The aims of this article are to review the current state of knowledge regarding MRSA infections, to identify those factors which may help physicians to recognize the patients at high risk, and to manage these infections appropriately.
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Human metapneumovirus-associated lower respiratory tract infections in Korean infants and young children
Yun Kyung Kim,Hoan Jong Lee +1 more
TL;DR: To define the role of human metapneumovirus (hMPV) in previously healthy Korean children, a retrospective study was done on 166 children with lower respiratory tract infections and on their stored nasal aspirates.
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Necrotizing pneumonia and septic shock: suspecting CA-MRSA in patients presenting to Canadian emergency departments.
Joseph Vayalumkal,Heather A Whittingham,Otto G. Vanderkooi,Thomas E. Stewart,Donald E. Low,Michael R. Mulvey,Allison McGeer +6 more
TL;DR: As rates of CA-MRSA increase worldwide, physicians should be aware of the potential for MRSA to cause life-threatening infections in patients presenting to Canadian emergency departments (EDs).
Journal ArticleDOI
Molecular Characteristics and In Vitro Susceptibility to Antimicrobial Agents, Including the Des-Fluoro(6) Quinolone DX-619, of Panton-Valentine Leucocidin-Positive Methicillin-Resistant Staphylococcus aureus Isolates from the Community and Hospitals
Tatsuo Yamamoto,Soshi Dohmae,Kohei Saito,Taketo Otsuka,Tomomi Takano,Megumi Chiba,Katsuko Fujikawa,Mayumi Tanaka +7 more
TL;DR: The data suggest that DX-619 exhibits a superior activity against PVL+ MRSA strains with various virulence genetic traits from the community as well as from hospitals.
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