Methicillin-susceptible, non-multiresistant methicillin-resistant and multiresistant methicillin-resistant Staphylococcus aureus infections: a clinical, epidemiological and microbiological comparative study

Eur J Clin Microbiol Infect Dis. 2008 May;27(5):355-64. doi: 10.1007/s10096-007-0449-3. Epub 2008 Feb 16.

Abstract

Non-multiresistant methicillin-resistant Staphylococcus aureus (nmMRSA) infections are emerging worldwide and are often community-associated. This prospective case-cohort study compares features of 96 nmMRSA clinical isolates with 96 matched multiresistant MRSA (mMRSA) and 192 matched methicillin-susceptible S. aureus (MSSA) clinical isolates. Seventy-four percent of nmMRSA infections were healthcare-associated. nmMRSA infections were much more likely to involve skin and soft tissue (skin and soft tissue infections; SSTIs) and were much less likely to be treated appropriately with antibiotics than MSSA or mMRSA infections. Panton-Valentine leukocidin (PVL) genes were detected in 55% of nmMRSA, 16% of MSSA and 2% of mMRSA isolates. Independent of the methicillin-resistance phenotype, 59% of PVL-positive SSTIs presented as furunculosis compared to only 10% of PVL-negative SSTIs. Patients with PVL-positive infections were much younger than patients with PVL-negative infections. The proportion of PVL-positive infections peaked in the 10-29 years old age group, followed by a linear decline.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology*
  • Australia / epidemiology
  • Bacterial Proteins / genetics
  • Bacterial Toxins / genetics
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cohort Studies
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • DNA, Bacterial / genetics
  • Drug Resistance, Bacterial*
  • Drug Resistance, Multiple, Bacterial*
  • Exotoxins / genetics
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Leukocidins / genetics
  • Male
  • Methicillin / pharmacology*
  • Middle Aged
  • Prospective Studies
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / classification
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Bacterial Toxins
  • DNA, Bacterial
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin
  • Methicillin