Epidemiology and staphylococcal cassette chromosome mec typing of methicillin-resistant Staphylococcus aureus isolates in Taiwan: A multicenter study

Sung Ching Pan, Jann Tay Wang, Tsai Ling Lauderdale, Wen Chien Ko, Yao Shen Chen, Jien Wei Liu, Yeu Jun Lau, Li Hsin Wang, Ke Sun Liu, Chun Hsing Liao, San Yi Lin, Bor Shen Hu, Shan Chwen Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

7 Scopus citations

Abstract

Background/Purpose: After community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified, new community-onset, healthcare-associated MRSA (HA-MRSA-CO) infections have been noticed as MRSA infection in patients with community-onset infection who have underlying conditions resulting in frequent exposure to the healthcare system. However, previous studies have not thoroughly investigated whether HA-MRSA-CO has characteristics resembling those of CA-MRSA or hospital-onset, healthcare-associated MRSA (HA-MRSA-HO) infection. Methods: A multicenter, retrospective study was conducted to analyze the clinical and microbiological data of patients with clinical isolates of MRSA from nine hospitals in Taiwan. Results: In total, 203 patients with MRSA isolates, including 27 patients with CA-MRSA (13.3%), 59 with HA-MRSA-CO (29.1%), and 117 with HA-MRSA-HO (57.6%), were studied. Compared to HA-MRSA-HO isolates, the CA-MRSA and HA-MRSA-CO isolates were associated with a higher proportion of skin and soft tissue infections (81.8% and 65.3% vs. 40.5%, p=. 0.001 and p=. 0.002) as well as lesser rate of resistance to ciprofloxacin (33.3% and 50.9% vs. 74.4%, p<. 0.001 and p=. 0.002), gentamicin (44.4% and 64.4% vs. 84.6%, p<. 0.001 and p=. 0.002), and trimethoprim/sulfamethoxazole (33.3% and 42.4% vs. 58.1%, p=. 0.02 and p=. 0.048), and a lower 30-day all-cause mortality rate (7.4% and 0% vs. 20.9%, p<. 0.001). Most of the CA-MRSA isolates were classified as staphylococcal cassette chromosome mec (SCC. mec) type VT (11/27, 40.7%), whereas most HA-MRSA-HO isolates were classified as SCC. mec type III (66/117, 56.4%). Conclusion: The CA-MRSA, HA-MRSA-CO, and HA-MRSA-HO clinical isolates significantly differed in their clinical presentations and molecular characteristics.

Original languageEnglish
Pages (from-to)409-416
Number of pages8
JournalJournal of the Formosan Medical Association
Volume113
Issue number7
DOIs
StatePublished - 07 2014
Externally publishedYes

Keywords

  • Methicillin resistance
  • Staphylococcal infections

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