Details

Autor(en) / Beteiligte

• Liu, Catherine
• Graber, Christopher J.
• Karr, Michael
• Diep, Binh An
• Basuino, Li
• Schwartz, Brian S.
• Enright, Mark C.
• O'Hanlon, Simon J.
• Thomas, Jonathon C.
• Perdreau-Remington, Francoise
• Gordon, Shelley
• Gunthorpe, Helen
• Jacobs, Richard
• Jensen, Peter
• Leoung, Gifford
• Rumack, James S.
• Chambers, Henry F.

Titel

A Population-Based Study of the Incidence and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Disease in San Francisco, 2004–2005

Ist Teil von

• Clinical infectious diseases, 2008-06, Vol.46 (11), p.1637-1646

Ort / Verlag

Chicago, IL: The University of Chicago Press

Erscheinungsjahr

2008

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background. Methicillin-resistant Staphylococcus aureus (MRSA) infections have become a major public health problem in both the community and hospitals. Few studies have characterized the incidence and clonal composition of disease-causing strains in an entire population. Our objective was to perform a population-based survey of the clinical and molecular epidemiology of MRSA disease in San Francisco, California. Methods. We prospectively collected 3985 MRSA isolates and associated clinical and demographic information over a 12-month period (2004–2005) at 9 San Francisco—area medical centers. A random sample of 801 isolates was selected for molecular analysis. Results. The annual incidence of community-onset MRSA disease among San Francisco residents was 316 cases per 100,000 population, compared with 31 cases per 100,000 population for hospital-onset disease. Persons who were aged 35–44 years, were men, and were black had the highest incidence of community-onset disease. The USA300 MRSA clone accounted for 234 cases of community-onset disease and 15 cases of hospital-onset disease per 100,000 population, constituting an estimated 78.5% and 43.4% of all cases of MRSA disease, respectively. Patients with community-onset USA300 MRSA versus non-USA300 MRSA disease were more likely to be male, be of younger age, and have skin and soft-tissue infections. USA300 strains were generally more susceptible to multiple antibiotics, although decreased susceptibility to tetracycline was observed in both community-onset (P=.008) and hospital-onset (P=.03) USA300 compared to non-USA300 strains. Conclusions. The annual incidence of community-onset MRSA disease in San Francisco is substantial, surpassing that of hospital-onset disease. USA300 is the predominant clone in both the community and hospitals. The dissemination of USA300 from the community into the hospital setting has blurred its distinction as a community-associated pathogen.