Community-associated methicillin-resistant and methicillin-sensitive Staphylococcus aureus: skin and soft tissue infections in Hong Kong

Diagn Microbiol Infect Dis. 2008 Jul;61(3):245-50. doi: 10.1016/j.diagmicrobio.2007.12.015. Epub 2008 Feb 12.

Abstract

This prospective study assessed the epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among patients with purulent skin and soft tissue infections (SSTIs) in Hong Kong. Among 298 patients with SSTIs, 10.4% (13/125) of all S. aureus isolates and 5% (12/241) of all abscesses were attributed to pvl-positive CA-MRSA. Overall, 77% and 69.9% of CA-MRSA and methicillin-sensitive S. aureus (MSSA) were susceptible to erythromycin, 77% and 74.8% to clindamycin, 100% and 97.1% to minocycline, and 100% and 98.1% to rifampin, respectively. Filipino ethnicity was the only clinical and epidemiologic factor significantly associated with CA-MRSA infection (odds ratio, 14.8; 95% confidence interval, 3.3-70.0; P < 0.001). Pulsed-field gel electrophoresis analysis showed that 6 CA-MRSA isolates belonged to the ST30-HKU100 clone, 5 belonged to the ST59-HKU200 clone, and 1 was singleton. Features of HKU100 isolates include SCCmec type IV, agr3, spa t019, and pan-susceptibility to non-beta-lactam antibiotics. In contrast, HKU200 isolates are characterized by having SCCmec type IV or V, agr4, spa t437, and variable non-beta-lactam susceptibility profiles. The major CA-MRSA spa types were shared by a minority of the MSSA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Toxins / biosynthesis
  • Bacterial Typing Techniques
  • Child
  • Child, Preschool
  • Community-Acquired Infections / epidemiology*
  • Community-Acquired Infections / microbiology
  • DNA, Bacterial / genetics
  • Electrophoresis, Gel, Pulsed-Field
  • Ethnic Groups
  • Exotoxins / biosynthesis
  • Female
  • Genotype
  • Hong Kong / epidemiology
  • Humans
  • Leukocidins / biosynthesis
  • Male
  • Methicillin Resistance*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Prospective Studies
  • Soft Tissue Infections / epidemiology*
  • Soft Tissue Infections / microbiology
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcal Skin Infections / epidemiology*
  • Staphylococcal Skin Infections / microbiology
  • Staphylococcus aureus / classification
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / genetics
  • Staphylococcus aureus / isolation & purification

Substances

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