Emergence of two populations of methicillin-resistant Staphylococcus aureus with distinct epidemiological, clinical and biological features, isolated from patients with community-acquired skin infections

被引:53
作者
Del Giudice, P
Blanc, V
Durupt, F
Bes, M
Martinez, JP
Counillon, E
Lina, G
Vandenesch, F
Etienne, J
机构
[1] Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
[2] Ctr Hosp Antibes Lab, Juan Les Pins, Antibes, France
[3] Fac Med Laennec, Ctr Natl Reference Staphylocoques, INSERM, E0230,IFR62, Lyon, France
关键词
community-acquired infections; France; methicillin-resistant Staphylococcus aureus; staphylococcal skin infections; Staphylococcus aureus;
D O I
10.1111/j.1365-2133.2005.06910.x
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background Community-acquired skin and soft-tissue infections due to methicillin-resistant Staphylococcus aureus (MRSA) are an emerging clinical and epidemiological problem. Objectives To characterize community-acquired skin infections caused by S. aureus, and especially MRSA. Methods From November 1999 to December 2003, we conducted in a French hospital a prospective epidemiological, clinical and bacteriological study of skin infections acquired in the community, applying strict criteria for true community-acquired MRSA (CA-MRSA) and health-care-associated MRSA (HCA-MRSA). Results One hundred and ninety-seven patients had 207 skin infections (154 primary and 53 secondary infections). Twenty-two (11%) patients had skin infections caused by MRSA. The incidence of MRSA skin infections acquired in the community rose from 4% in 2000 to 17% in 2003, but the increase was not statistically significant. Six patients (3%) were infected by CA-MRSA and 15 (8%) by HCA-MRSA; one patient was lost to follow-up and could not be classified. CA-MRSA and HCA-MRSA had different epidemiological, clinical and biological characteristics. CA-MRSA infections were more severe than HCA-MRSA infections: all the CA-MRSA infections (six of six, 100%) required surgical treatment, compared with only two (15%) of 13 with HCA-MRSA infection (P < 0.001). CA-MRSA all belonged to the same clonal strain, harbouring an agr type 3 allele and the Panton-Valentine leucocidin genes (not detected in HCA-MRSA) and possessing a specific antibiotype. Conclusions Two populations of MRSA causing skin infections are emerging in the French community, with distinct epidemiological, clinical and biological characteristics.
引用
收藏
页码:118 / 124
页数:7
相关论文
共 39 条
[1]   Community-associated MRSA - Resistance and virulence converge [J].
Chambers, HF .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 352 (14) :1485-1487
[2]   Population-based community prevalence of methicillin-resistant Staphylococcus aureus in the urban poor of San Francisco [J].
Charlebois, ED ;
Bangsberg, DR ;
Moss, NJ ;
Moore, MR ;
Moss, AR ;
Chambers, HF ;
Perdreau-Remington, F .
CLINICAL INFECTIOUS DISEASES, 2002, 34 (04) :425-433
[3]   Community-acquired methicillin-resistant Staphylococcus aureus skin infection:: An emerging clinical problem [J].
Cohen, PR ;
Kurzrock, R .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2004, 50 (02) :277-280
[4]   LEUKOCIDIN FROM STAPHYLOCOCCUS-AUREUS AND CUTANEOUS INFECTIONS - AN EPIDEMIOLOGIC-STUDY [J].
COUPPIE, P ;
CRIBIER, B ;
PREVOST, G ;
GROSSHANS, E ;
PIEMONT, Y .
ARCHIVES OF DERMATOLOGY, 1994, 130 (09) :1208-1209
[5]  
DEBUYSER ML, 1989, J GEN MICROBIOL, V135, P989
[6]   Community-acquired methicillin-resistant Staphylococcus aureus infections in France:: Emergence of a single clone that produces Panton-Valentine leukocidin [J].
Dufour, P ;
Gillet, Y ;
Bes, M ;
Lina, G ;
Vandenesch, F ;
Floret, D ;
Etienne, J ;
Richet, H .
CLINICAL INFECTIOUS DISEASES, 2002, 35 (07) :819-824
[7]   Comparative molecular analysis of community- or hospital-acquired methicillin-resistant Staphylococcus aureus [J].
Fey, PD ;
Saïd-Salim, B ;
Rupp, ME ;
Hinrichs, SH ;
Boxrud, DJ ;
Davis, CC ;
Kreiswirth, BN ;
Schlievert, PM .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2003, 47 (01) :196-203
[8]   High prevalence of methicillinresistant Staphylococcus aureus in emergency department skin and soft tissue infections [J].
Frazee, BW ;
Lynn, J ;
Charlebois, ED ;
Lambert, L ;
Lowery, D ;
Perdreau-Remington, F .
ANNALS OF EMERGENCY MEDICINE, 2005, 45 (03) :311-320
[9]   Methicillin-resistant staphylococcus aureus disease in three communities [J].
Fridkin, SK ;
Hageman, JC ;
Morrison, M ;
Sanza, LT ;
Como-Sabetti, K ;
Jernigan, JA ;
Harriman, K ;
Harrison, LH ;
Lynfield, R ;
Farley, MM .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 352 (14) :1436-1444
[10]   Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients [J].
Gillet, Y ;
Issartel, B ;
Vanhems, P ;
Fournet, JC ;
Lina, G ;
Bes, M ;
Vandenesch, F ;
Piémont, Y ;
Brousse, N ;
Floret, D ;
Etienne, J .
LANCET, 2002, 359 (9308) :753-759