The progressive intercontinental spread of methicillin-resistant Staphylococcus aureus.
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On the basis of evidence from countries where MRSA is not a problem, it has been suggested that early detection, effective infection control measures, and rational antibiotic use will limit the transmission of these organisms; however, spread is still increasing in many countries.Abstract:
Methicillin-resistant Staphylococcus aureus was initially detected in Europe in the 1960s, soon after the introduction of methicillin. Naturally-resistant strains were isolated in some countries before the use of methicillin or related agents. These strains probably spread initially from one or more ancestral genetic clones in natural populations of S. aureus by horizontal transfer and recombination. These original strains, possibly emerging in many countries, then increased in numbers and diversity in hospitals as a result of selection by exposure to antibiotics and by cross-infection. After a decline in the 1970s, new epidemic strains that differed from the original MRSAs emerged in Australia, the United States, and the Irish Republic and have now reached global proportions. Most strains are highly resistant to antibiotics and some are only sensitive to vancomycin or teicoplanin. Intercountry and intercontinental spread has also occurred by transfer of infected or colonized patients or staff. However, the main mode of spread is person-to-person within a unit or hospital and subsequently to other hospitals in the same country. New epidemic strains have continued to emerge and decline for unknown reasons. On the basis of evidence from countries where MRSA is not a problem, it has been suggested that early detection, effective infection control measures, and rational antibiotic use will limit the transmission of these organisms; however, spread is still increasing in many countries.read more
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Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic.
Michael Z. David,Robert S. Daum +1 more
TL;DR: This review details the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection and addresses the therapy of these infections and strategies for their prevention.
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Survey of Infections Due to Staphylococcus Species: Frequency of Occurrence and Antimicrobial Susceptibility of Isolates Collected in the United States, Canada, Latin America, Europe, and the Western Pacific Region for the SENTRY Antimicrobial Surveillance Program, 1997–1999
Daniel J. Diekema,M. A. Pfaller,F. J. Schmitz,J. Smayevsky,Jan M. Bell,R N Jones,Mondell L. Beach +6 more
TL;DR: Given the increasing multidrug resistance among staphylococci and the possible emergence of vancomycin-resistant strains, global strategies are needed to control emergence and spread of multiply resistant staphlyococci.
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A New Class of Genetic Element, Staphylococcus Cassette Chromosome mec, Encodes Methicillin Resistance in Staphylococcus aureus
TL;DR: It is proposed that SCCmec driven by a novel set of recombinases represents a new family of staphylococcal genomic elements.
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Novel Multiplex PCR Assay for Characterization and Concomitant Subtyping of Staphylococcal Cassette Chromosome mec Types I to V in Methicillin-Resistant Staphylococcus aureus
TL;DR: A novel multiplex PCR assay allowing for concomitant detection of the methicillin resistance (mecA gene) to facilitate detection and classification of all currently described SCCmec types and subtypes I, II, III, IVa, b, c, d, and V is demonstrated.
Journal ArticleDOI
Methicillin-Resistant Staphylococcus aureus: Molecular Characterization, Evolution, and Epidemiology
Sahreena Lakhundi,Kunyan Zhang +1 more
TL;DR: The origin of MRSA is described, with emphasis on the diverse nature of staphylococcal cassette chromosome mec (SCCmec).
References
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Methicillin-Resistant Staphylococcus aureus in Europe
TL;DR: In order to obtain pan-European data on methicillin-resistantStaphylococcus aureus (MRSA), 43 laboratories from 10 European countries each screened 200 consecutive Staphyloccus Aureus isolates for MRSA resistance only one isolate per patient was permitted All participants used a uniform oxacillin-supplemented screening plate and sent to Munich for reconfirmation and further susceptibility testing as mentioned in this paper.
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TL;DR: This study suggests that hospitals of all sizes are facing the problem of MRSA, the problem appears to be increasing regardless of hospital size, and control measures advocated for MRSA appear to require re-evaluation.
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Journal ArticleDOI
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