Non-multiresistant and multiresistant methicillin-resistant Staphylococcus aureus in community-acquired infections.
OBJECTIVE
To survey Staphylococcus aureus strains isolated from patients presenting from the community, comparing clinical features and antibiotic sensitivity profiles between multiresistant and non-multiresistant methicillin-resistant and methicillin-sensitive isolates.


METHODS
Retrospective case series.


METHODS
Patients who presented to emergency or dermatology departments in hospitals served by the South Western Sydney Area Health Service between 1 May 1998 and 30 April 1999. All patients with methicillin-resistant S. aureus (MRSA) and the first 100 with methicillin-sensitive S. aureus were eligible.


METHODS
Patient demographic characteristics; risk factors; clinical presentation; treatment; outcome; and isolate antibiotic susceptibility.


RESULTS
139 patients were eligible, and 122 had clinical records available. Ten of these 122 (8%) had multiresistant MRSA, 26 (21%) non-multiresistant MRSA and 86 (70%) methicillin-sensitive S. aureus. Among patients with non-multiresistant MRSA, 29% (7/24) were born in New Zealand, Samoa or Tonga, a higher proportion than among those with multiresistant MRSA or methicillin-sensitive S. aureus (P= 0.03). Nearly half (44%) of non-multiresistant MRSA strains were community-acquired in patients with no risk factors. Two-thirds of patients with non-multiresistant MRSA (17/26) presented with cellulitis or abscess, and 58% (11/19 evaluable patients) required surgical treatment.


CONCLUSIONS
Non-multiresistant MRSA strains are common, especially among people born in New Zealand, Samoa or Tonga, and are usually community acquired. Medical practitioners should routinely swab all staphylococcal lesions for culture and sensitivity.
Gosbell
I B
IB
Department of Microbiology and Infectious Diseases, South Western Area Pathology Service, Sydney, NSW. i.gosbell@unsw.edu.au
Mercer
J L
JL
Neville
S A
SA
Crone
S A
SA
Chant
K G
KG
Jalaludin
B B
BB
Munro
R
R
D000328:Adult; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000628:therapy; D018432:Drug Resistance, Multiple; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control; D008297:Male; D016106:Methicillin Resistance; D009517:New South Wales / Q000453:epidemiology; D011159:Population Surveillance; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000628:therapy; D013211:Staphylococcus aureus; D016896:Treatment Outcome