| Changing epidemiology of community-onset methicillin-resistant Staphylococcus aureus bacteremia. | |
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MedLine Citation:
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PMID: 12828320 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To review cases of community-onset Staphylococcus aureus bacteremia and to evaluate whether the risk factors and epidemiology of methicillin-resistant S. aureus (MRSA) bacteremia have changed from early reports. DESIGN: Retrospective case-comparison study of community-onset MRSA (n = 26) and methicillin-susceptible S. aureus (MSSA) (n = 26) bacteremias at our institution. SETTING: A 600-bed urban academic medical center. PATIENTS: Twenty-six patients with community-onset MRSA bacteremia were compared with 26 patients with community-onset MSSA bacteremia. Molecular analysis was performed on S. aureus isolates from the 26 MRSA cases as well as from 13 cases of community-onset S. aureus bacteremia from 1980 and 9 cases of nosocomial S. aureus bacteremia from 2001. RESULTS: The two groups were similar except that patients with MRSA bacteremia were more likely to have presented from a long-term-care facility (26.9% vs 4%; P = .05) and to have had multiple admissions within the preceding year (46% vs 15%; P = .03). Clamped homogeneous electric fields analysis of MRSA isolates from 1982 revealed predominantly that one clone was the epidemic strain, whereas there were 14 unique strains among current community-onset isolates. Among current nosocomial isolates, 3 patterns were identified, all of which were present in the community-onset cases. CONCLUSIONS: Previously described risk factors for MRSA acquisition may not be helpful in predicting disease due to the polyclonal spread of MRSA in the community. Unlike early outbreaks of MRSA in patients presenting from the community, current acquisition appears to be polyclonal and is usually related to contact with the healthcare system. |
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Authors:
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Leonard B Johnson; Arti Bhan; Joan Pawlak; Odette Manzor; Louis D Saravolatz |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America Volume: 24 ISSN: 0899-823X ISO Abbreviation: Infect Control Hosp Epidemiol Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-06-27 Completed Date: 2004-03-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8804099 Medline TA: Infect Control Hosp Epidemiol Country: United States |
Other Details:
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Languages: eng Pagination: 431-5 Citation Subset: IM; N |
Affiliation:
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St. John Hospital and Medical Center, Wayne State University, Detroit, Michigan 48236, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Academic Medical Centers Aged Bacteremia / epidemiology*, etiology, microbiology Catheters, Indwelling / adverse effects, microbiology Community-Acquired Infections / epidemiology, microbiology Endocarditis / complications, microbiology Female Humans Male Methicillin Resistance* Michigan Middle Aged Retrospective Studies Risk Factors Staphylococcal Infections / epidemiology*, microbiology Staphylococcus aureus / isolation & purification* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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