title: Adult methicillin-resistant Staphylococcus aureus bacteremia in Taiwan: clinical significance of non-multi-resistant antibiogram and Panton-Valentine leukocidin gene.
abstract: It is poorly defined whether or not adult patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with a non-multi-resistant antibiogram phenotype and Panton-Valentine leukocidin (PVL) gene carriage have different clinical syndromes. Clinical characteristics of 95 adult patients of MRSA bacteremia, with isolates that were non-multi-resistant to non-beta-lactam, were compared with a contemporaneous multiresistant group. Independent risk factors other than community-associated MRSA bacteremia patients associated with recovery of non-multi-resistant MRSA isolates by multivariate analysis included deep-seated infection and catheter insertion site infection. Older age, intensive care unit-onset bacteremia, and postoperative infection were negative independent risk factors associated with non-multi-resistant MRSA isolates. Most of the 60 recoverable non-multi-resistant MRSA isolates belonged to multilocus sequence type 59, and all isolates belonged to staphylococcal chromosomal cassette mec (SCCmec) element type IV or type V. Most PVL-positive MRSA isolates belonged to SCCmec V. PVL-positive CA-MRSA isolates could cause more deep-seated infections in patients presented with non-multi-resistant MRSA bacteremia.
authors: Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
authors: Jiun-Ling
authors: JL
authors: Wang
authors: Jann-Tay
authors: JT
authors: Wang
authors: Shey-Ying
authors: SY
authors: Chen
authors: Po-Ren
authors: PR
authors: Hsueh
authors: Hsiang-Chi
authors: HC
authors: Kung
authors: Yee-Chun
authors: YC
authors: Chen
authors: Shan-Chwen
authors: SC
authors: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D001427:Bacterial Toxins / Q000235:genetics*; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D005098:Exotoxins / Q000235:genetics*; D005260:Female; D006801:Humans; D007956:Leukocidins / Q000235:genetics*; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin