Epidemiologic Similarities in Pediatric Community-Associated Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus in the San Francisco Bay Area

Hsiang, Michelle S.; Shiau, Rita; Nadle, Joelle; Chan, Liana C.; Lee, Brian; Chambers, Henry F.; Pan, Erica

doi:10.1093/jpids/pis061

Cited by 16 publications

(14 citation statements)

References 34 publications

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“…43,44 Molecular analysis of S aureus strains from both pediatric and adult populations seeking care for infections demonstrates substantial overlap between the genetic backgrounds of MSSA and MRSA isolates. 45,46 One could speculate that differences in antibiotic prescribing patterns and inferiority of vancomycin for treatment of MRSA infections compared with the antistaphylococcal penicillins for the treatment of MSSA infections could also be contributing factors to differences in mortality noted in some studies. 31 Although it was not evaluated in our study, PVL positivity has also been found to correlate with worse outcomes in children.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Adverse Outcomes in Children With Staphylococcus aureus Bacteremia

Kumarachandran¹,

Johnson²,

Shirley³

et al. 2017

The Journal of Pediatric Pharmacology and Therapeutics

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Staphylococcus aureus bacteremia is a common infection, associated with significant morbidity and mortality in children. Factors associated with adverse treatment outcomes are poorly understood in the pediatric population. METHODS Our study compared clinical and microbiologic characteristics of children admitted during a 5-year period (2007-2012) to a large university-based hospital and found to have S aureus bacteremia with outcome measures, in order to identify risk factors associated with treatment failure (defined as 30day mortality, delayed microbiologic resolution, or recurrence of S aureus bacteremia within 60 days of completing effective antibiotic therapy). RESULTS In all, 71 patients were found to have S aureus bacteremia, and of these, 17 patients (24%) experienced treatment failure. Based on the logistic regression model, only high vancomycin minimum inhibitory concentration in combination with a high-risk source of infection (i.e., infected graft or device, intra-abdominal infection, or respiratory tract infection) was significantly associated with risk of treatment failure. CONCLUSIONS Infection associated with a high-risk source may increase the chance of treatment failure in pediatric patients with S aureus bacteremia. Vancomycin minimum inhibitory concentration alone was not found to be a predictor of treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

Predictors of Adverse Outcomes in Children With Staphylococcus aureus Bacteremia

Kumarachandran¹,

Johnson²,

Shirley³

et al. 2017

The Journal of Pediatric Pharmacology and Therapeutics

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“…MRSA transmission has become increasingly common in community populations as well (9, 11, 17, 18). Risk factors for community-acquired MRSA include homelessness, IV drug use, incarceration (2, 15, 19, 20) and skin or soft-tissue infection, particularly if associated with immunodeficiency (19, 21).…”

Section: Introductionmentioning

confidence: 99%

Preoperative Prevalence of Staphylococcus aureus in Cardiothoracic and Neurological Surgical Patients

Kapoor

Barnett

Gutmann

et al. 2014

Front. Public Health

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Methicillin-resistant Staphylococcus aureus (MRSA) is a global cause of both hospital and community-acquired infection. This retrospective, observational study determined the prevalence of MRSA carriers in cardiothoracic and neurological surgical patients presenting to an outpatient preoperative assessment center in Columbus, OH. Aggressive skin and soft-tissue infection may be caused by MRSA with potentially fatal complications. Cardiothoracic and neurological surgical patients are at high risk for surgical-site infection. Results indicated that 4.25% of the sample carried MRSA and 25.25% carried methicillin-sensitive S. aureus.

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“…6 In the face of the debate concerning the role pathogenesis plays in MRSA infections, the isolation of MSSA from patients with moderate to severe S. aureus infections has added complexity and a new paradigm. It is therefore worthwhile examining the virulence and antimicrobial resistance potential of MRSA and MSSA populations since establishment of any difference between MRSA and MSSA will aid patient treatment outcome.…”

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confidence: 99%

Comparison of antibiotic resistance, virulence gene profiles, and pathogenicity of methicillin-resistant and methicillin-susceptibleStaphylococcus aureususing aCaenorhabditis elegansinfection model

Thompson

Brown

2014

Pathogens and Global Health

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Objectives: This study compared the presence of 35 virulence genes, resistance phenotypes to 11 antistaphylococcal antibiotics, and pathogenicity in methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA). Methods: Multiplex PCR analysis was used to differentiate Staphylococcus aureus isolates (n5102) based on characterization of the Staphylococcal Cassette Chromosome mec (SCCmec). Singleplex and multiplex PCR assays targeting 35 virulence determinants were used to analyze the virulence repertoire of S. aureus. In vitro activities of the antibiotics were determined by the disk-diffusion method. The pathogenicity of representative isolates was assessed using Caenorhabditis elegans survival assays. Significance in virulence distribution and antibiotic resistance phenotypes was assessed using the Chi-squared tests. Kaplan-Meier survival estimates were used to analyze nematode survival and significance of survival rates evaluated using the log-rank test. Results: Except for sei (staphylococcal enterotoxin I) (P 5 0.027), all other virulence genes were not significantly associated with MRSA. Resistance to clindamycin (P 5 0.03), tetracycline (P 5 0.048), trimethoprim/sulfamethoxazole (P 5 0.038), and oxacillin (P 5 0.004) was significantly associated with MRSA. Survival assay showed MSSA having a lower median lifespan of 3 days than MRSA that had a median lifespan of 6 days. The difference in the killing time of MRSA and MSSA was significant (P , 0.001). Conclusion: While antibiotic resistance was significantly associated with MRSA, there was no preferential distribution of the virulence genes. The quicker killing potential of MSSA compared to MRSA suggests that carriage of virulence determinants per se does not determine pathogenicity in S. aureus. Pathogenicity is impacted by other factors, possibly antibiotic resistance.

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Epidemiologic Similarities in Pediatric Community-Associated Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus in the San Francisco Bay Area

Cited by 16 publications

References 34 publications

Predictors of Adverse Outcomes in Children With Staphylococcus aureus Bacteremia

Predictors of Adverse Outcomes in Children With Staphylococcus aureus Bacteremia

Preoperative Prevalence of Staphylococcus aureus in Cardiothoracic and Neurological Surgical Patients

Comparison of antibiotic resistance, virulence gene profiles, and pathogenicity of methicillin-resistant and methicillin-susceptibleStaphylococcus aureususing aCaenorhabditis elegansinfection model

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