Clinical characteristics, virulence factors and molecular typing of methicillin-resistant Staphylococcus aureus infections in Shenzhen City, China. Issue 14 (22nd July 2016)

• Record Type: Journal Article
• Authors: HU, L.; LI, Y.; LU, Y.; KLENA, J. D.; QIU, Y.; LIN, Y.; JIANG, M.; SHI, X.; CHEN, L.; LIU, X.; MA, H.; CHENG, J.; WU, S.; KAN, B.; HU, Q.
• Is Part Of: Epidemiology and infection. Volume 144:Issue 14(2016)
• Page Start: 3037
• Page End: 3045
• Publication Date: 2016-07-22
• Subjects: CA-MRSA, -- clinical characteristics, -- HA-MRSA, -- HACO-MRSA, -- methicillin-resistant Staphylococcus aureus, -- molecular typing, -- virulence factors; Communicable diseases -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1017/S0950268816001552
• Languages: English
• ISSNs: 0950-2688

Abstract

SUMMARY: Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious hospital and community-acquired infection and some strains are associated with greater severity. We investigated the clinical variability and molecular characteristics of MRSA infections in Shenzhen, China through a study at nine sentinel hospitals from January to December 2014. MRSA infections were classified as community-associated (CA-MRSA), healthcare-associated (HA-MRSA), and healthcare-associated community-onset (HACO-MRSA). In total, 812 MRSA isolates were collected and 183 of these were selected for further study. Patients with HA-MRSA infections were generally of greater age compared to other groups. Distinct body site and clinical presentations were evident in infected patients, e.g. CA-MRSA (skin and soft tissue, 53%), HA-MRSA (respiratory tract, 22%; surgical site, 20%; trauma wounds, 20%) and HACO-MRSA (mastitis, 47%). In contrast to HA-MRSA, other categories of strains were significantly more susceptible to gentamicin, sulfamethoxazole/trimethoprim, and tetracycline. No resistance to vancomycin or linezolid was recorded. The predominant clonal lineage within each strain category was CC59-t437-SCC mec IV/V- agr I (CA, 51·4%; HA, 28·9%; HACO, 52·9%) which exhibited characteristics of a traditional CA clone together with agr I which is more often associated with HA clones. In conclusion, for the three categories of MRSA infections, there were significant differences in clinical characteristics of patients, but the predominant clone in each category shared a similar genetic background which suggests that transmission of MRSA strains has occurred between the community and hospitals in Shenzhen.