Comparison between patients under hemodialysis with community-onset bacteremia caused by community-associated and healthcare-associated methicillin-resistant Staphylococcus aureus strains.

Patients receiving hemodialysis infected with methicillin-resistant Staphylococcus aureus (MRSA) have been considered to have healthcare-associated (HA) infections, but strains with community-associated (CA) characteristics have also been identified in this population. The authors compared infections of the two strains among patients with end-stage renal disease. From January 2004 to December 2008 the authors analyzed the demographic and microbiologic data of 57 patients with community-onset (defined as a positive culture obtained ≤ 48 hours after admission) MRSA bacteremia and end-stage renal disease at a 2900-bed tertiary medical center. MRSA isolate with staphylococcal cassette chromosome mec (SCCmec) type II/III was classified as HA strains, and SCCmec type IV/V as CA strains. Forty-seven patients (82%) had HA-MRSA strains and 10 patients (18%) had CA-MRSA strains. The major clones of HA-MRSA were sequence type (ST) 5 with SCCmec type II and staphylococcal protein A (spa) t002 as well as ST239 carrying SCCmec type III and spa t037. The CA-MRSA strains were predominantly ST59, more susceptible to non-β-lactam antimicrobial agents, and had a higher percentage of carrying the Panton-Valentine leukocidin gene in comparision with the HA-MRSA strains. Patients infected with HA-MRSA isolates had a higher overall mortality (57.4%, p = 0.012). In multivariate analysis, male patients were more likely to be infected with HA-MRSA isolates than CA-MRSA strains (p = 0.037), and a history of receiving urinary catheterization within 1 year prior to bacteremia onset (p = 0.047) is an independent risk factor to acquiring HA-MRSA strains. Patients undergoing dialysis and infected with HA-MRSA strains had higher mortality rates and were more commonly associated with urinary catheterization within 1 year before bacteremia.

Wu HS ，Kuo SC ，Chen LY ，Chiang MC ，Lin YT ，Wang FD ，Fung CP ... -  《-》

Differences between "classical" risk factors for infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and risk factors for nosocomial bloodstream infections caused by multiple clones of the staphylococcal cassette chromosome mec type IV

Vidal PM ，Trindade PA ，Garcia TO ，Pacheco RL ，Costa SF ，Reinert C ，Hiramatsu K ，Mamizuka EM ，Garcia CP ，Levin AS ... -  《-》

Emergence of community-associated methicillin-resistant Staphylococcus aureus strains as a cause of healthcare-associated bloodstream infections in Korea.

Park SH ，Park C ，Yoo JH ，Choi SM ，Choi JH ，Shin HH ，Lee DG ，Lee S ，Kim J ，Choi SE ，Kwon YM ，Shin WS ... -  《-》

Molecular characteristics of community-acquired methicillin-resistant Staphylococcus aureus in Hokkaido, northern main island of Japan: identification of sequence types 6 and 59 Panton-Valentine leucocidin-positive community-acquired methicillin-resistant

Kawaguchiya M ，Urushibara N ，Kuwahara O ，Ito M ，Mise K ，Kobayashi N ... -  《-》

Molecular characterization and susceptibility of methicillin-resistant and methicillin-susceptible Staphylococcus aureus isolates from hospitals and the community in Vladivostok, Russia.

Baranovich T ，Zaraket H ，Shabana II ，Nevzorova V ，Turcutyuicov V ，Suzuki H ... -  《-》