Methicillin-Susceptible Staphylococcus aureus as a Predominantly Healthcare-Associated Pathogen: A Possible Reversal of Roles?

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dc.contributor.authorZychowski, Diana L.en
dc.contributor.authorDavid, Michael Z.en
dc.contributor.authorBoyle-Vavra, Susanen
dc.contributor.authorDaum, Robert S.en
dc.date.accessioned2018-02-19T14:10:12Zen
dc.date.available2018-02-19T14:10:12Zen
dc.date.issued2011-04-13en
dc.description.abstract<p>Background<br> Methicillin-resistant Staphylococcus aureus (MRSA) strains have become common causes of skin and soft tissue infections (SSTI) among previously healthy people, a role of methicillin-susceptible (MSSA) isolates before the mid-1990s. We hypothesized that, as MRSA infections became more common among S. aureus infections in the community, perhaps MSSA infections had become more important as a cause of healthcare-associated infection. </p><p> Methods<br> We compared patients, including children and adults, with MRSA and MSSA infections at the University of Chicago Medical Center (UCMC) from all clinical units from July 1, 2004-June 30, 2005; we also compared the genotypes of the MRSA and MSSA infecting bacterial strains. </p><p> Results<br> Compared with MRSA patients, MSSA patients were more likely on bivariate analysis to have bacteremia, endocarditis, or sepsis (p = 0.03), to be an adult (p = 0.005), to be in the intensive care unit (21.9% vs. 15.6%) or another inpatient unit (45.6% vs. 40.7%) at the time of culture. MRSA (346/545) and MSSA (76/114) patients did not differ significantly in the proportion classified as HA-S. aureus by the CDC CA-MRSA definition (p = 0.5). The genetic backgrounds of MRSA and MSSA multilocus sequence type (ST) 1, ST5, ST8, ST30, and ST59 comprised in combination 94.5% of MRSA isolates and 50.9% of MSSA isolates. By logistic regression, being cared for in the Emergency Department (OR 4.6, CI 1.5-14.0, p = 0.008) was associated with MRSA infection. </p><p> Conclusion <br> Patients with MSSA at UCMC have characteristics consistent with a health-care-associated infection more often than do patients with MRSA; a possible role reversal has occurred for MSSA and MRSA strains. Clinical MSSA and MRSA strains shared genotype backgrounds.</p>en
dc.description.notesCitation: David MZ, Boyle-Vavra S, Zychowski DL, Daum RS (2011) Methicillin-Susceptible Staphylococcus aureus as a Predominantly Healthcare-Associated Pathogen: A Possible Reversal of Roles? PLoS ONE 6(4): e18217. https://doi.org /10.1371/journal.pone.0018217en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0018217en
dc.identifier.issue4en
dc.identifier.urihttp://hdl.handle.net/10919/82184en
dc.identifier.volume6en
dc.language.isoenen
dc.publisherPLoSen
dc.rightsCreative Commons Attribution 3.0 United Statesen
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/en
dc.titleMethicillin-Susceptible Staphylococcus aureus as a Predominantly Healthcare-Associated Pathogen: A Possible Reversal of Roles?en
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten

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