Infect Chemother.  2017 Jun;49(2):109-116. 10.3947/ic.2017.49.2.109.

Emergence of Community-Genotype Methicillin-Resistant Staphylococcus aureus in Korean Hospitals: Clinical Characteristics of Nosocomial Infections by Community-Genotype Strain

Affiliations
  • 1Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. iddrchung@gmail.com
  • 3Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Korea.
  • 4Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND
As community-genotype methicillin-resistant Staphylococcus aureus (MRSA) strains spread into hospitals, the genotypes of the MRSA strains causing hospital-acquired (HA) infections have become more diverse. We describe clinical characteristics of nosocomial MRSA infections by a community-genotype of sequence type (ST) 72.
MATERIALS AND METHODS
A case-control study was designed among patients with HA-MRSA infections. Forty patients with infections caused by ST72-MRSA SCCmec type IV were selected as cases. Cases were matched to the controls with 106 patients infected with ST5/ST239 MRSA, which are representative hospital genotypes in Korea.
RESULTS
Patients infected with ST72 isolates were younger than those with ST5/ST239 isolates. Female gender predominated among ST72 MRSA group compared to ST5/ST239 MRSA group. Solid tumor was a more frequent underlying disease in MRSA infections by ST72 isolates, whereas underlying renal, lung, heart, and neurologic diseases were more frequently found in those by ST5/ST239 isolates. The most common type of infection was pneumonia in both ST72 and ST5/ST239 groups (45.0% vs. 51.9%), followed by skin and soft tissue infection (SSTI). Female gender and underlying solid tumor were identified to be independent predictors for MRSA infections by ST72 isolates. All-cause mortality rates (20.0% vs. 30.2%) were not different between the groups.
CONCLUSION
A community-genotype MRSA, ST72 isolate has emerged as a nosocomial pathogen presenting as hospital-acquired pneumonia and SSTI. Although differences in underlying disorders were found, the distribution of infection type and mortality rate did not differ between the groups.

Keyword

Methicillin-resistant Staphylococcus aureus; Nosocomial infections; Genotyping

MeSH Terms

Case-Control Studies
Cross Infection*
Female
Genotype
Heart
Humans
Korea
Lung
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Mortality
Pneumonia
Skin
Soft Tissue Infections

Figure

  • Figure 1 Antibiotic resistance in MRSA isolates by ST72 and ST5/ ST239 MRSA, methicillin-resistant Staphylococcus aureus; ST, sequence type; CIP, ciprofloxacin; CLI, clindamycin; ERY, erythromycin; RIF, rifampicin; FUS, fusidic acid; TMP/SMX, trimethoprim/sulfamethoxazole; GEN, gentamicin.


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