Emergence of two populations of methicillin-resistant Staphylococcus aureus with distinct epidemiological, clinical and biological features, isolated from patients with community-acquired skin infections
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作者:
Del Giudice, P
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
Del Giudice, P
Blanc, V
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
Blanc, V
Durupt, F
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
Durupt, F
Bes, M
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
Bes, M
Martinez, JP
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
Martinez, JP
Counillon, E
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
Counillon, E
Lina, G
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
Lina, G
Vandenesch, F
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
Vandenesch, F
Etienne, J
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机构:Hop Bonnet, Unite Infectiol Dermatol, F-83700 Frejus, France
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
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.
机构:
Univ Calif San Francisco, San Francisco Gen Hosp, Div Infect Dis, San Francisco, CA 94110 USAUniv Calif San Francisco, San Francisco Gen Hosp, Div Infect Dis, San Francisco, CA 94110 USA
机构:
Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USAUniv Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Fey, PD
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Saïd-Salim, B
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Saïd-Salim, B
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Rupp, ME
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Rupp, ME
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Hinrichs, SH
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Hinrichs, SH
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Boxrud, DJ
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Boxrud, DJ
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Davis, CC
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Davis, CC
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Kreiswirth, BN
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Kreiswirth, BN
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Schlievert, PM
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
机构:
Univ Calif San Francisco, San Francisco Gen Hosp, Div Infect Dis, San Francisco, CA 94110 USAUniv Calif San Francisco, San Francisco Gen Hosp, Div Infect Dis, San Francisco, CA 94110 USA
机构:
Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USAUniv Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Fey, PD
;
Saïd-Salim, B
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Saïd-Salim, B
;
Rupp, ME
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Rupp, ME
;
Hinrichs, SH
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Hinrichs, SH
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Boxrud, DJ
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Boxrud, DJ
;
Davis, CC
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Davis, CC
;
Kreiswirth, BN
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA
Kreiswirth, BN
;
Schlievert, PM
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机构:Univ Nebraska, Med Ctr, Dept Internal Med, Nebraska Med Ctr 985400, Omaha, NE 68198 USA