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Diagnostic Microbiology and Infectious Disease
Volume 61, Issue 3, July 2008, Pages 245-250
Bacteriology
Community-associated methicillin-resistant and methicillin-sensitive Staphylococcus aureus: skin and soft tissue infections in Hong Kong
社区获得性甲氧西林耐药和敏感的金黄色葡萄球菌：皮肤和软组织感染（香港）
Pak-Leung Hoa, , , Shuk-Kwan Chuangb, Yu-Fai Choic, Rodney A. Leed, Albert C.H. Lite, Tak-Keung Ngf, Tak-Lun Queg, Kam-Chuen Shekh, Hon-Kuan Tongi, Cindy W.S. Tsej, Wai-Kit Tungk, Raymond W.H. Yungb and for the Hong Kong CA-MRSA surveillance network
aDivision of Infectious Diseases, Department of Microbiology and Centre of Infection, The University of Hong Kong, Hong Kong SAR, China
bCentre for Health Protection, Department of Health, Hong Kong SAR, China
cDepartment of Accidents and Emergency, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
dDepartment of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
eDepartment of Accidents and Emergency, Princess Margaret and Yan Chai Hospitals, Hong Kong SAR, China
fDepartment of Clinical Pathology, Princess Margaret and Yan Chai Hospitals, Hong Kong SAR, China
gDepartment of Clinical Pathology, Tuen Mun Hospital, Hong Kong SAR, China
hDepartment of Accidents and Emergency, Tuen Mun Hospital, Hong Kong SAR, China
iDepartment of Accidents and Emergency, Queen Mary Hospital, Hong Kong SAR, China
jDepartment of Clinical Pathology, Kwong Wah Hospital, Hong Kong SAR, China
kDepartment of Accidents and Emergency, Kwong Wah Hospital, Hong Kong SAR, China
Received 19 November 2007; accepted 25 December 2007. Available online 12 February 2008.
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–β-lactam antibiotics. In contrast, HKU200 isolates are characterized by having SCCmec type IV or V, agr4, spa t437, and variable non–β-lactam susceptibility profiles. The major CA-MRSA spa types were shared by a minority of the MSSA.
Keywords: MRSA; Antimicrobial resistance; PFGE; Skin and soft tissue infections
CA-MRSA in Hong Kong.pdf
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