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Title: Characterisation of hospital- and community-acquired methicillin-resistant Staphylococcus aureus in Hong Kong
Authors: Siu, G
Boost, M
O'Donoghue, M 
Issue Date: 2007
Publisher: Elsevier
Source: Clinical microbiology and infection, 2007, v. 13, suppl. 1, P1580, p. s443 (Poster) (Abstracts) How to cite?
Journal: Clinical microbiology and infection 
Abstract: Objectives: In the past, methicillin-resistant Staphylococcus aureus (MRSA) was mainly a pathogen associated with hospital acquired infections (HA-MRSA), but in recent years community-acquired strains (CA-MRSA) causing infections with high morbidity and mortality have emerged. In Hong Kong, although almost 50% of hospital isolates of S. aureus are HA-MRSA community isolation of HA-MRSA remains low. However, in the last year, there have been several reports of infections with CA-MRSA. This study aimed to characterise both hospital and community isolates of MRSA.
Methods: The presence of the mecA resistance gene was confirmed in 139 hospital isolates (clinical isolates) and 13 community isolates (nasal carriage) of MRSA. The mecA gene was further characterized by multiplex PCR. Those found to harbour the SCCmec IV element were investigated for the presence of genes coding for Panton-Valentine leucocidin and for agr to determine their prototypic or archaic type.
Results: 95% of HA-MRSA strains were found to be multi-drug resistant, displaying resistance to an average of 6 non-b-lactam drugs. 91 strains (65%) harboured SCCmec variant IIIA and 22 (16%) SCCmec III. One strain was PVL positive. CA-MRSA remains uncommon in hospital isolates with only 3 (2%) of isolates harbouring the SCCmec IV element. These belonged to the less virulent archaic type only one being a PVL producer. In contrast, over 50% of community isolates were CA-MRSA, 3 strains with the SCCmec IV element and 4 with new SCCmec patterns. Fusidic acid and erythromycin resistance was present in 80% of community isolates. Characterisation revealed the presence of both archaic strains and a highly resistant PVL-producing prototypic strain.
Conclusions: CA-MRSA remains rare in hospital infections in Hong Kong, with most HA-MRSA strains harbouring type III subtypes of the SCCmec element. One healthy community dwelling person was found to be colonised by a highly virulent agr type 3 positive strain, which has not previously been reported from nasal carriage. As colonisation typically precedes infection, the potential of increased incidence of severe CA- MRSA-associated infections is likely.
Description: 17th European Congress of Clinical Microbiology and Infectious Diseases, and 25th International Congress of Chemotherapy, Munich, Germany, 31 Mar - 3 Apr 2007
ISSN: 1198-743X
EISSN: 1469-0691
DOI: 10.1111/j.1469-0691.2007.01733.x
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