Replacement of healthcare-associated MRSA by community-associated MRSA in Queensland : confirmation by genotyping
Nimmo, Graeme R., Bergh, Haakon, Nakos, Jennifer, Whiley, David, Marquess, John , Huygens, Flavia, & Paterson, David (2013) Replacement of healthcare-associated MRSA by community-associated MRSA in Queensland : confirmation by genotyping. Journal of Infection, 67(5), pp. 439-447.
To describe the changing prevalence of healthcare- and community-associated MRSA.
Susceptibility phenotypes of MRSA were observed from 2000 to 2012 using routine susceptibility data. Phenotypic definitions of major clones were validated by genotyping isolates from a nested period prevalence survey in 2011.
The predominant healthcare-associated (AUS-2/3 like) MRSA phenotype decreased from 42 to 14 isolates per million occasions of service in outpatients (P < 0.0001) and from 650 to 75 isolates per million accrued patient days in inpatients (P 0.0005), while the respective rates of the healthcare-related EMRSA-15 like phenotype increased from 1 to 19 in outpatients (P < 0.0001) and from 11 to 83 in inpatients (P < 0.0001) and those of the community-associated MRSA phenotype increased from 17 to 296 in outpatients (P < 0.0001) and from 71 to 486 in inpatients (P < 0.0001). When compared with single nucleotide polymorphism genotyping the AUS-2/3 like phenotype had a sensitivity and positive predictive value (PPV) for CC239 of 1 and 0.791 respectively, while the EMRSA-15 like phenotype had a sensitivity and PPV for CC22 of 0.903 and 0.774. PVL-positive CA-MRSA, predominantly ST93 and CC30, accounted for 60.8% of MRSA, while PVL-negative CA-MRSA, mainly CC5 and CC1, accounted for 21.4%.
The initially dominant healthcare-associated MRSA clone has been progressively replaced, mainly by four community-associated lineages.
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|Item Type:||Journal Article|
|Keywords:||MRSA, healthcare-associated, community-associated, Queensland, genotyping|
|Subjects:||Australian and New Zealand Standard Research Classification > BIOLOGICAL SCIENCES (060000) > MICROBIOLOGY (060500) > Infectious Agents (060502)
Australian and New Zealand Standard Research Classification > BIOLOGICAL SCIENCES (060000) > MICROBIOLOGY (060500) > Microbial Genetics (060503)
|Divisions:||Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
|Copyright Owner:||Copyright 2013 Elsevier|
|Copyright Statement:||This is the author’s version of a work that was accepted for publication in Journal of Infection. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Infection, [VOL 67, ISSUE 5, (2013)] DOI: 10.1016/j.jinf.2013.07.020|
|Deposited On:||13 Feb 2014 00:44|
|Last Modified:||14 Feb 2014 02:43|
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