OBJECTIVES: In 2000, the Minnesota Department of Health (MDH) implemented active, sentinel site surveillance for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Data from 2000-2005 were analyzed to determine trends in case characteristics, pulsed-field types (PFTs), and antimicrobial susceptibilities including inducible clindamycin resistance (ICR). METHODS: Active sentinel site surveillance was initiated in 2000 at 12 hospital laboratories that served inpatients and outpatients. Patient medical records were reviewed to determine if they met the epidemiologic case criteria for CA-MRSA; isolates were obtained from patients meeting these criteria. The MDH Public Health Laboratory performed pulsed-field gel electrophoresis subtyping and antimicrobial susceptibility testing, including ICR. RESULTS: The proportion of MRSA cases classified as CA increased from 11% to 33% (p<0.01). The proportion of cases with skin or soft tissue infections also increased compared with other infection types from 75% to 87% (p<0.01). During the surveillance period, USA300 replaced USA400 as the dominant PFT. With the change in dominant PFT, the proportion of isolates susceptible to erythromycin (45% to 13%, p<0.01) and ciprofloxacin (80% to 59%, p<0.01) decreased. The proportion of erythromycin-resistant/clindamycin-susceptible isolates with ICR (93% to 14%, p<0.01) decreased. The proportion of susceptible isolates also changed within the USA300 PFT; the proportion of isolates susceptible to erythromycin (33% vs. 3%) and the proportion susceptible to ciprofloxacin (67% to 62%) decreased significantly. CONCLUSION: CA-MRSA increased dramatically from 2000 to 2005. Changes in the predominant PFT have impacted susceptibility profiles of CA-MRSA, including ICR. Continued surveillance is needed to monitor the changing epidemiology of CA-MRSA and to inform clinical decisions.
OBJECTIVES: In 2000, the Minnesota Department of Health (MDH) implemented active, sentinel site surveillance for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Data from 2000-2005 were analyzed to determine trends in case characteristics, pulsed-field types (PFTs), and antimicrobial susceptibilities including inducible clindamycin resistance (ICR). METHODS: Active sentinel site surveillance was initiated in 2000 at 12 hospital laboratories that served inpatients and outpatients. Patient medical records were reviewed to determine if they met the epidemiologic case criteria for CA-MRSA; isolates were obtained from patients meeting these criteria. The MDH Public Health Laboratory performed pulsed-field gel electrophoresis subtyping and antimicrobial susceptibility testing, including ICR. RESULTS: The proportion of MRSA cases classified as CA increased from 11% to 33% (p<0.01). The proportion of cases with skin or soft tissue infections also increased compared with other infection types from 75% to 87% (p<0.01). During the surveillance period, USA300 replaced USA400 as the dominant PFT. With the change in dominant PFT, the proportion of isolates susceptible to erythromycin (45% to 13%, p<0.01) and ciprofloxacin (80% to 59%, p<0.01) decreased. The proportion of erythromycin-resistant/clindamycin-susceptible isolates with ICR (93% to 14%, p<0.01) decreased. The proportion of susceptible isolates also changed within the USA300 PFT; the proportion of isolates susceptible to erythromycin (33% vs. 3%) and the proportion susceptible to ciprofloxacin (67% to 62%) decreased significantly. CONCLUSION: CA-MRSA increased dramatically from 2000 to 2005. Changes in the predominant PFT have impacted susceptibility profiles of CA-MRSA, including ICR. Continued surveillance is needed to monitor the changing epidemiology of CA-MRSA and to inform clinical decisions.
Authors: Arthur L Frank; John F Marcinak; P Daisy Mangat; Joyce T Tjhio; Swathi Kelkar; Paul C Schreckenberger; John P Quinn Journal: Pediatr Infect Dis J Date: 2002-06 Impact factor: 2.129
Authors: Nisha Nair; Ekaterina Kourbatova; Katharine Poole; Charmaine M Huckabee; Patrick Murray; W Charles Huskins; Henry M Blumberg Journal: Infect Control Hosp Epidemiol Date: 2011-09-20 Impact factor: 3.254
Authors: John S Bradley; Carrie L Byington; Samir S Shah; Brian Alverson; Edward R Carter; Christopher Harrison; Sheldon L Kaplan; Sharon E Mace; George H McCracken; Matthew R Moore; Shawn D St Peter; Jana A Stockwell; Jack T Swanson Journal: Clin Infect Dis Date: 2011-08-31 Impact factor: 9.079
Authors: M A Guimarães; M S Ramundo; M A Américo; M C de Mattos; R R Souza; E S Ramos-Júnior; L R Coelho; A Morrot; P A Melo; S E L Fracalanzza; F A Ferreira; A M S Figueiredo Journal: Eur J Clin Microbiol Infect Dis Date: 2014-10-14 Impact factor: 3.267
Authors: Joshua B Parsons; Maciej Kukula; Pamela Jackson; Mark Pulse; Jerry W Simecka; David Valtierra; William J Weiss; Nachum Kaplan; Charles O Rock Journal: Antimicrob Agents Chemother Date: 2013-03-04 Impact factor: 5.191
Authors: Cheryl Y M Okumura; Andrew Hollands; Dan N Tran; Joshua Olson; Samira Dahesh; Maren von Köckritz-Blickwede; Wdee Thienphrapa; Courtney Corle; Seung Nam Jeung; Anna Kotsakis; Robert A Shalwitz; Randall S Johnson; Victor Nizet Journal: J Mol Med (Berl) Date: 2012-02-28 Impact factor: 4.599
Authors: Jasmine R Marcelin; Douglas W Challener; Eugene M Tan; Brian D Lahr; Larry M Baddour Journal: Mayo Clin Proc Date: 2017-07-08 Impact factor: 7.616
Authors: Nina M Haste; Varahenage R Perera; Katherine N Maloney; Dan N Tran; Paul Jensen; William Fenical; Victor Nizet; Mary E Hensler Journal: J Antibiot (Tokyo) Date: 2010-03-26 Impact factor: 2.649
Authors: George Sakoulas; Cheryl Y Okumura; Wdee Thienphrapa; Joshua Olson; Poochit Nonejuie; Quang Dam; Abhay Dhand; Joseph Pogliano; Michael R Yeaman; Mary E Hensler; Arnold S Bayer; Victor Nizet Journal: J Mol Med (Berl) Date: 2013-12-03 Impact factor: 4.599