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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Community-Acquired Methicillin-Resistant Staphylococcus aureus in Hospitals: Age-Specificity and Potential
Ahmed Alsolami1, Naif Saad ALGhasab2, Mohammed S M Alharbi1
1Department of Internal Medicine, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia.
Abstract:
Methicillin-resistant Staphylococcus aureus (MRSA) lineages are a devastating clinical and public health issue. Data on local lineage profiles are limited. We report on the frequency of community-acquired and hospital-acquired cases (CA-MRSA, HA-MRSA). We studied 147 isolates from King Khalid tertiary care hospitals (KKH), each from a case in a patient and including 33 patients at the Maternity and Children's Hospital (MCH). Of the 147 isolates, 87 males (59%) and 60 females (41%) were in KKH. The overwhelming majority (80%; n = 119/147) were CA-MRSA in KKH. Intriguingly, despite significant differences between males (70%) and females (53%), lineage-acquisition remained age-specific around 58-60 years in both genders. However, while CA-MRSA dominated early in life (0-20, 70% MCH), it increased with age in KKH adults; 21-50 (28%), >50 (59%) until the overall 80% (n = 144/180). Major specimens included skin-wounds, surgeries (70.3%), blood (13.5%), sputum (8.8%), very rarely urine (4.1%), and nasal (3.4%), albeit most patients showed severe enteritis and necrotizing pneumonia. Antibiograms showed high beta lactam resistances, including amoxicillin-clavulanate (83%), oxacillin (84%), cefoxitin FOX (100%), penicillin and ampicillin (~100%), as well as high resistance (82%) to carbapenem. Fortunately, high susceptibility was seen to non-beta lactams and, to a lesser extent, gentamicin, erythromycin, and fusidic acid; 33%, 34%, and 38%, respectively, in KKH. A similar pattern was seen in MCH except for a low resistance pattern to gentamicin CN, clindamycin CD, erythromycin E, and tobramycin TOB; 34%, 31%, 39%, and 41%, respectively, except for fusidic acid. These findings have significant clinical implications for MRSA patient management strategies. Clinical- and lineage-profiles imply host-selection and zoonotic-zooanthroponotic transmission dynamics. Future molecular typing, sequencing, and characterization of dominant clone(s) is imperative.
Insights
Community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) dominates in tertiary care hospitals, with high resistance to beta-lactams and carbapenems. Findings impact patient management and suggest host-selection and transmission dynamics.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant clinical and public health challenge.
- Limited data exists on local MRSA lineage profiles, hindering effective management.
Purpose of the Study:
- To investigate the frequency of community-acquired (CA-MRSA) and hospital-acquired (HA-MRSA) cases.
- To analyze MRSA lineage characteristics and antimicrobial resistance patterns in a tertiary care setting.
Main Methods:
- Studied 147 MRSA isolates from King Khalid tertiary care hospitals (KKH), including the Maternity and Children's Hospital (MCH).
- Collected data on patient demographics, specimen types, and performed antibiograms.
- Analyzed lineage acquisition based on age and gender.
Main Results:
- The majority (80%) of MRSA isolates were CA-MRSA.
- Lineage acquisition showed age-specific patterns, peaking around 58-60 years, with CA-MRSA dominating early in life.
- High resistance rates were observed for beta-lactams (~100%) and carbapenems (82%).
- Susceptibility was noted for non-beta-lactams like gentamicin, erythromycin, and fusidic acid.
Conclusions:
- MRSA clinical and lineage profiles suggest host-selection and potential zoonotic/zooanthroponotic transmission.
- Findings have significant implications for MRSA patient management strategies.
- Further molecular typing and characterization of dominant MRSA clones are imperative.
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