Differences between methicillin-resistant Staphylococcus aureus bacteremic isolates harboring type IV and type v staphylococcal cassette chromosome mec genes based on prior patient healthcare exposure

S. Y. Chen, Jiun-Ling Wang, T. H.H. Chen, W. C. Chiang, J. T. Wang, S. C. Chen, S. C. Chang, P. R. Hsueh

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Abstract

This observational study enrolled adult patients with bacteremia due to methicillin-resistant Staphylococcus aureus (MRSA) who were treated at the emergency department of a teaching hospital from 2001 to 2007. MRSA isolates with type IV and type V staphylococcal cassette chromosome mec (SCCmec) genes (SCC IV/V-MRSA) were included in the final analysis. Healthcare-associated SCC IV/V-MRSA (HA-SCC IV/V-MRSA) and community-acquired SCC IV/V-MRSA (CA-SCC IV/V-MRSA) were defined as the identification of an SCC IV/V-MRSA isolate from a patient with and without healthcare-associated risk factors, respectively. Thirty-four cases of CA-SCC IV/V-MRSA (20 SCCmec type IV, 14 SCCmec type V) and 81 cases of HA-SCC IV/V-MRSA (59 SCCmec type IV, 22 SCCmec type V) bacteremia were identified. Vascular device-associated infections were a significant infection source in HA-SCC IV/V-MRSA bacteremia cases. SCCmec type IV HA-SCC IV/V-MRSA isolates (3.4%) were significantly less likely to carry the Panton-Valentine leukocidin (PVL) gene than SCCmec type IV CA-SCC IV/V-MRSA isolates (35.0%, p = 0.001). The 90-day cumulative probability of survival was 76% for patients with CA-SCC IV/V-MRSA bacteremia and 66% for patients with HA-SCC IV/V-MRSA bacteremia (p = 0.247, by the Wilcoxon rank-sum test). Significant differences in antimicrobial susceptibility were observed between bacterial isolates from patients with CA-SCC IV/V-MRSA bacteremia and HA-SCC IV/V-MRSA bacteremia.

Original languageEnglish
Pages (from-to)1539-1546
Number of pages8
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume29
Issue number12
DOIs
Publication statusPublished - 2010 Dec 1

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Methicillin-Resistant Staphylococcus aureus
Chromosomes
Delivery of Health Care
Genes
Bacteremia
Nonparametric Statistics
Infection
Teaching Hospitals
Observational Studies

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

@article{9cd8fbbcc91d45db93ab66dfc410efa6,
title = "Differences between methicillin-resistant Staphylococcus aureus bacteremic isolates harboring type IV and type v staphylococcal cassette chromosome mec genes based on prior patient healthcare exposure",
abstract = "This observational study enrolled adult patients with bacteremia due to methicillin-resistant Staphylococcus aureus (MRSA) who were treated at the emergency department of a teaching hospital from 2001 to 2007. MRSA isolates with type IV and type V staphylococcal cassette chromosome mec (SCCmec) genes (SCC IV/V-MRSA) were included in the final analysis. Healthcare-associated SCC IV/V-MRSA (HA-SCC IV/V-MRSA) and community-acquired SCC IV/V-MRSA (CA-SCC IV/V-MRSA) were defined as the identification of an SCC IV/V-MRSA isolate from a patient with and without healthcare-associated risk factors, respectively. Thirty-four cases of CA-SCC IV/V-MRSA (20 SCCmec type IV, 14 SCCmec type V) and 81 cases of HA-SCC IV/V-MRSA (59 SCCmec type IV, 22 SCCmec type V) bacteremia were identified. Vascular device-associated infections were a significant infection source in HA-SCC IV/V-MRSA bacteremia cases. SCCmec type IV HA-SCC IV/V-MRSA isolates (3.4{\%}) were significantly less likely to carry the Panton-Valentine leukocidin (PVL) gene than SCCmec type IV CA-SCC IV/V-MRSA isolates (35.0{\%}, p = 0.001). The 90-day cumulative probability of survival was 76{\%} for patients with CA-SCC IV/V-MRSA bacteremia and 66{\%} for patients with HA-SCC IV/V-MRSA bacteremia (p = 0.247, by the Wilcoxon rank-sum test). Significant differences in antimicrobial susceptibility were observed between bacterial isolates from patients with CA-SCC IV/V-MRSA bacteremia and HA-SCC IV/V-MRSA bacteremia.",
author = "Chen, {S. Y.} and Jiun-Ling Wang and Chen, {T. H.H.} and Chiang, {W. C.} and Wang, {J. T.} and Chen, {S. C.} and Chang, {S. C.} and Hsueh, {P. R.}",
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Differences between methicillin-resistant Staphylococcus aureus bacteremic isolates harboring type IV and type v staphylococcal cassette chromosome mec genes based on prior patient healthcare exposure. / Chen, S. Y.; Wang, Jiun-Ling; Chen, T. H.H.; Chiang, W. C.; Wang, J. T.; Chen, S. C.; Chang, S. C.; Hsueh, P. R.

In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 29, No. 12, 01.12.2010, p. 1539-1546.

Research output: Contribution to journalArticle

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T1 - Differences between methicillin-resistant Staphylococcus aureus bacteremic isolates harboring type IV and type v staphylococcal cassette chromosome mec genes based on prior patient healthcare exposure

AU - Chen, S. Y.

AU - Wang, Jiun-Ling

AU - Chen, T. H.H.

AU - Chiang, W. C.

AU - Wang, J. T.

AU - Chen, S. C.

AU - Chang, S. C.

AU - Hsueh, P. R.

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AB - This observational study enrolled adult patients with bacteremia due to methicillin-resistant Staphylococcus aureus (MRSA) who were treated at the emergency department of a teaching hospital from 2001 to 2007. MRSA isolates with type IV and type V staphylococcal cassette chromosome mec (SCCmec) genes (SCC IV/V-MRSA) were included in the final analysis. Healthcare-associated SCC IV/V-MRSA (HA-SCC IV/V-MRSA) and community-acquired SCC IV/V-MRSA (CA-SCC IV/V-MRSA) were defined as the identification of an SCC IV/V-MRSA isolate from a patient with and without healthcare-associated risk factors, respectively. Thirty-four cases of CA-SCC IV/V-MRSA (20 SCCmec type IV, 14 SCCmec type V) and 81 cases of HA-SCC IV/V-MRSA (59 SCCmec type IV, 22 SCCmec type V) bacteremia were identified. Vascular device-associated infections were a significant infection source in HA-SCC IV/V-MRSA bacteremia cases. SCCmec type IV HA-SCC IV/V-MRSA isolates (3.4%) were significantly less likely to carry the Panton-Valentine leukocidin (PVL) gene than SCCmec type IV CA-SCC IV/V-MRSA isolates (35.0%, p = 0.001). The 90-day cumulative probability of survival was 76% for patients with CA-SCC IV/V-MRSA bacteremia and 66% for patients with HA-SCC IV/V-MRSA bacteremia (p = 0.247, by the Wilcoxon rank-sum test). Significant differences in antimicrobial susceptibility were observed between bacterial isolates from patients with CA-SCC IV/V-MRSA bacteremia and HA-SCC IV/V-MRSA bacteremia.

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