1. Staphylococcus aureus bacteremia at 5 US academic medical centers, 2008-2011: significant geographic variation in community-onset infections
- Author
-
Sylvia Garcia-Houchins, Susan Boyle-Vavra, Alison Baesa, Philip Gialanella, Loren G. Miller, Arnold S. Bayer, Joann Volinski, Brad Spellberg, Julia Sieth, Samantha J. Eells, Felicia Ruffin, Belinda Ostrowsky, Henry F. Chambers, Raul Macias-Gil, Vance G. Fowler, Thomas H. Rude, Michael Z. David, and Robert S. Daum
- Subjects
History ,Databases, Factual ,Bacteremia ,MRSA ,medicine.disease_cause ,Medical and Health Sciences ,Child ,Articles and Commentaries ,Geographic difference ,Cross Infection ,Academic Medical Centers ,Incidence (epidemiology) ,Incidence ,Bacterial ,Hematology ,Staphylococcal Infections ,Biological Sciences ,21st Century ,Community-Acquired Infections ,Infectious Diseases ,Staphylococcus aureus ,Child, Preschool ,epidemiology ,Patient Safety ,Infection ,Microbiology (medical) ,Adult ,Methicillin-Resistant Staphylococcus aureus ,medicine.medical_specialty ,Genotype ,Adolescent ,Staphylococcal infections ,History, 21st Century ,Microbiology ,Vaccine Related ,Databases ,Young Adult ,Clinical Research ,Internal medicine ,Sepsis ,Biodefense ,medicine ,Genetics ,Humans ,Preschool ,Factual ,business.industry ,SCCmec ,Prevention ,Infant, Newborn ,Infant ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,bacterial infections and mycoses ,Newborn ,Methicillin-resistant Staphylococcus aureus ,United States ,Emerging Infectious Diseases ,Genes ,genotyping ,Genes, Bacterial ,Antimicrobial Resistance ,Methicillin Susceptible Staphylococcus Aureus ,business ,Multilocus Sequence Typing - Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) first appeared clinically in the early 1960s [1]. MRSA isolates became endemic in most US hospitals by the late 1980s [2–4]. In the 1990s, a new wave of MRSA infections occurred in community settings [3–8]. In many centers, MRSA isolates predominate as a cause of S. aureus community-onset (CO) infections, including bacteremia [3–5, 9]. Rather than being “escaped” hospital-based MRSA clones, the community MRSA strains were derived from methicillin-susceptible S. aureus (MSSA) strains that acquired a novel resistance element, SCCmec type IV [2, 4, 10–12]. These strain types, especially the USA300 genetic background, were highly virulent, often susceptible to multiple non–β-lactam antibiotics, and carried signature toxin genes (most commonly Panton-Valentine leukocidin [PVL]) rarely found in the older, hospital-acquired strain types [13]. USA300 also had a constitutive upregulation of several key virulence genes [14]. Driven by emergence of USA300, the incidence of MRSA infections rose dramatically in the early 2000s. In 2000, the Centers for Disease Control and Prevention (CDC) estimated that there were >30 000 hospitalizations for MRSA bacteremia [15]; however, more recent published reports have described declines in invasive MRSA infection rates, particularly in healthcare settings [16–20]. In the United States and the United Kingdom, the decline in MRSA bacteremia rates appears to have preceded enhanced infection prevention efforts in hospitals [21]. In a study of US military personnel and their dependents, rates of MRSA bacteremia declined between 2008 and 2011 [22]. However, to date, few reports have documented the incidence of MSSA bacteremia in this time period, or assessed potential geographic variations in CO infection rates, as opposed to hospital-onset (HO) rates. The current study was conducted to define trends in the annual incidence of MRSA and MSSA bacteremia at 5 large, geographically dispersed US academic medical centers to assess the incidence of HO and CO MSSA and MRSA bacteremia during a 4-year period.
- Published
- 2014