title: Origins of community strains of methicillin-resistant Staphylococcus aureus.
abstract: To characterize methicillin-resistant Staphylococcus aureus (MRSA) strains circulating in the community, we identified predictors of isolating community MRSA and genotyped a sample of MRSA collected from a community-based, high-risk population. Computerized databases of the Community Health Network of San Francisco and the Clinical Microbiology Laboratory were searched electronically for the years 1992-1999 to identify community-onset infections caused by MRSA. Sequential analyses were performed to identify predictors of MRSA strains. The majority (58%) of infections were caused by strains traceable to the hospital or to long-term care facilities. Injection drug use was associated with infections that were not associated with health care settings. Genotypes for 20 of 35 MRSA isolates recovered from injection drug users did not match any of >600 genotypes of clinical isolates. In a nonoutbreak setting, the hospital was the main source of community MRSA; however, the presence of genetically distinct and diverse MRSA strains indicates MRSA strains now also originate from the community.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, UCSF and Clinical Laboratory, San Francisco General Hospital, San Francisco, CA 94143, USA.
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Charlebois
authors.forename: Françoise
authors.initials: F
authors.lastname: Perdreau-Remington
authors.forename: Barry
authors.initials: B
authors.lastname: Kreiswirth
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.forename: Daniel
authors.initials: D
authors.lastname: Ciccarone
authors.forename: Binh A
authors.initials: BA
authors.lastname: Diep
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Ng
authors.forename: Kimberly
authors.initials: K
authors.lastname: Chansky
authors.forename: Brian R
authors.initials: BR
authors.lastname: Edlin
authors.forename: Brian
authors.initials: B
authors.lastname: Edlin
authors.forename: Henry F
authors.initials: HF
authors.lastname: Chambers
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017714:Community-Acquired Infections / Q000382:microbiology; D005838:Genotype; D006801:Humans; D016106:Methicillin Resistance / Q000502:physiology*; D008826:Microbial Sensitivity Tests; D012111:Residence Characteristics; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents