Prevalence of Major Methicillin-Resistant <i>Staphylococcus aureus</i> Clones in Korea Between 2001 and 2008

Kang, Gi Su; Jung, Yung Hee; Kim, Hwa Su; Lee, Yeong Seon; Park, Chan; Lee, Kwang Jun; Ok, Jeong

doi:10.3343/alm.2016.36.6.536

“…According to several studies, CC5 is the main CC detected in the Americas and Asia. 55 , 63–65 We observed the same trend, since of the 14 clones, 50% were grouped into CC5 (69%), followed by CC8 (8.4%). CC5 is more common in MRSA with SCC mec -II, and CC8 has been associated with MRSA-SCC mec -IV isolates with PVL, which leads to more serious clinical conditions, in particular fulminant pneumonia or deep vein thrombosis.…”

Section: Discussionsupporting

confidence: 70%

Molecular Characterization of Staphylococcus aureus Obtained from Blood Cultures of Paediatric Patients Treated in a Tertiary Care Hospital in Mexico

Vazquez-Rosas¹,

Mérida-Vieyra²,

Aparicio-Ozores³

et al. 2021

IDR

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Purpose Staphylococcus aureus is one of the main causative agents of hospital-acquired (HA) infections. In Mexico, information about the characteristics of clinical S. aureus isolates is limited. Our aim was to characterize S. aureus strains obtained from blood cultures of paediatric patients treated in a tertiary care hospital. Materials and Methods We analysed 249 S. aureus isolates over the period from 2006 to 2019, and their resistance profiles were determined. The isolates were classified into methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA). Staphylococcal cassettes chromosome mec (SCC mec ) were detected. Virulence genes ( cna, clfA, clfB, eta, etb, fnbA, fnbB, hla, pvl, sec, and tsst ) were amplified, and their clonal relationships were established by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and clonal complex (CC) typing. We reviewed one hundred medical files to collect clinical information. Results Thirty-eight percent of the isolates were MRSA and showed an expanded profile of resistance to other non-beta-lactam antibiotics, while MSSA strains presented a reduced resistance profile. SCC mec- II was the most frequent element (86.3%). Eight virulence factors were detected in MSSA and six in MRSA. The pvl gene was detected in four MRSA-SCC mec- IV isolates ( P ≤0.0001). MRSA isolates were distributed among 14 clones and were classified into 15 sequence types (ST); the most frequent was ST1011 (17%). The most common CC in MRSA was CC5 (69%, P ≤0.0001), and in MSSA, it was CC30 (30%, P ≤0.0001). Eighty-seven percent of MRSA isolates were HA-MRSA, and 13% were community-acquired MRSA (CA-MRSA). Of 21 HA-MRSA isolates, 17 had SCC mec -II, while two CA-MRSA isolates had SCC mec -IV. Of MSSA isolates, 77% were derived from HA infections and 23% from CA infections. Conclusion MSSA isolates had more virulence factors. MRSA isolates were resistant to more non-beta-lactam antibiotics, and those with SCC mec -IV expressed a greater variety of virulence factors. Most S. aureus isolates belonged to CC5.

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“…ST72 MRSA seemed to play a major role in the spread of CA-MRSA to the hospital via COHA transfer. The prevalence of ST239 has recently decreased in Korea [6830], and ST72 MRSA has been found to be the most common clone in both CA- and HA-MRSA infections in Korean pediatric patients [1331]. The absence of ST239 and the presence of only a few major MRSA strains in this hospital provide evidence of the clonal spread of MRSA, indicating that a rapid change in MRSA clones is possible in a hospital.…”

Section: Discussionmentioning

confidence: 99%

“…In Korea, MRSA is highly endemic, constituting 60–81% of clinical S. aureus isolates [56] and 58–64% of bacteremic isolates; ST5-SCC mec type II is the most prevalent HA-MRSA [78910]. HA-MRSA strains have spread to the community [12].…”

Section: Introductionmentioning

confidence: 99%

Impact of Community-Onset Methicillin-ResistantStaphylococcus aureusonStaphylococcus aureusBacteremia in a Central Korea Veterans Health Service Hospital

Bae

¹

,

Kim

²

,

Jang

³

et al. 2019

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Background No study has examined the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in Korean veterans' hospitals. We investigated the microbiological and clinical epidemiology of S. aureus bacteremia at the central Veterans Health Services (VHS) hospital in Korea. Methods Patients with S. aureus bacteremia were consecutively enrolled from February to August 2015. Bacteremia was classified as hospital-acquired (HA), community-onset healthcare-associated (COHA), or community-acquired (CA). MRSA bacteremia risk factors were analyzed. Species identification, antimicrobial susceptibility, and presence of luk and tst were tested. Staphylococcal cassette chromosome mec (SCC mec ) typing, spa sequence typing agr polymorphism typing, and multilocus sequence typing were performed. Biofilm production and δ-hemolysin activity were measured to determine agr function. Results In total, 60 patients were enrolled (30 HA, 23 COHA, and seven CA bacteremia); 44 (73.3%) had MRSA bacteremia (26 HA, 16 COHA, and two CA). MRSA bacteremia occurred more frequently in non-CA patients and those who had received antibiotic treatment within the past month ( P <0.05). The major MRSA strains comprised 24 ST5- agr 2-SCC mec II, 11 ST72- agr 1-SCC mec IV, and five ST8- agr 1-SCC mec IV strains. Of 26 agr 2-SCC mec II strains, including two MSSA strains, 25 were multidrug-resistant, 18 were tst -positive, and 13 were agr -defective, whereas only five of the 18 agr 1-SCC mec IV strains were multidrug-resistant, and all were tst -negative and agr -intact. agr 1-SCC mec IV and ST8- agr 1-SCC mec IV strains were more likely than agr 2-SCC mec II strains to be COHA. Conclusions MRSA was highly prevalent in both COHA and HA bacteremia. The introduction of virulent CA-MRSA strains may be an important cause of increased HA-MRSA bacteremia in VHS hospitals.

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“…These differences can be attributed to variations in microbiological methods (sampling technique, culture sites, and method of MRSA identification), local infection control standards, and the local prevalence of MRSA. Gi et al [32] reported that the methicillin resistance rate of staphylococcal isolates in Korea is slightly higher than that in other countries. Another study showed that the prevalence of MRSA is 73% among the nosocomial S. aureus isolates in Korea, which is higher than that in other Asian countries [21].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors for Positive Nasal Methicillin-Resistant Staphylococcus aureus Carriage among Orthopedic Patients in Korea

Choi

¹

,

Lee

²

,

Kim

³

et al. 2019

JCM

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Methicillin-resistant Staphylococcus aureus (MRSA) causes purulent skin and soft tissue infections as well as other life-threatening diseases. Recent guidelines recommend screening for MRSA at the time of admission. However, few studies have been conducted to determine the prevalence and risk factors for MRSA colonization. A prospective data collection and retrospective analysis was performed. MRSA screening tests were performed using nasal swabs in patients enrolled between January 2017 and July 2018. Demographic data, socio-economic data, medical comorbidities, and other risk factors for MRSA carriage were evaluated among 1577 patients enrolled in the study. The prevalence of MRSA nasal carriage was 7.2%. Univariate regression analysis showed that colonization with MRSA at the time of hospital admission was significantly related to patient age, body mass index, smoking, alcohol, trauma, recent antibiotic use, and route of hospital admission. Multiple logistic regression analysis for the risk factors for positive MRSA nasal carriage showed that being under- or overweight, trauma diagnosis, antibiotic use one month prior to admission, and admission through an emergency department were related to MRSA colonization. This study highlights the importance of a preoperative screening test for patients scheduled to undergo surgery involving implant insertion, particularly those at risk for MRSA.

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Prevalence of Major Methicillin-Resistant Staphylococcus aureus Clones in Korea Between 2001 and 2008

Cited by 16 publications

References 14 publications

Molecular Characterization of Staphylococcus aureus Obtained from Blood Cultures of Paediatric Patients Treated in a Tertiary Care Hospital in Mexico

Molecular Characterization of Staphylococcus aureus Obtained from Blood Cultures of Paediatric Patients Treated in a Tertiary Care Hospital in Mexico

Impact of Community-Onset Methicillin-ResistantStaphylococcus aureusonStaphylococcus aureusBacteremia in a Central Korea Veterans Health Service Hospital

Prevalence and Risk Factors for Positive Nasal Methicillin-Resistant Staphylococcus aureus Carriage among Orthopedic Patients in Korea

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