title: Community-associated methicillin-resistant and methicillin-sensitive Staphylococcus aureus: skin and soft tissue infections in Hong Kong.
abstract: This prospective study assessed the epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among patients with purulent skin and soft tissue infections (SSTIs) in Hong Kong. Among 298 patients with SSTIs, 10.4% (13/125) of all S. aureus isolates and 5% (12/241) of all abscesses were attributed to pvl-positive CA-MRSA. Overall, 77% and 69.9% of CA-MRSA and methicillin-sensitive S. aureus (MSSA) were susceptible to erythromycin, 77% and 74.8% to clindamycin, 100% and 97.1% to minocycline, and 100% and 98.1% to rifampin, respectively. Filipino ethnicity was the only clinical and epidemiologic factor significantly associated with CA-MRSA infection (odds ratio, 14.8; 95% confidence interval, 3.3-70.0; P < 0.001). Pulsed-field gel electrophoresis analysis showed that 6 CA-MRSA isolates belonged to the ST30-HKU100 clone, 5 belonged to the ST59-HKU200 clone, and 1 was singleton. Features of HKU100 isolates include SCCmec type IV, agr3, spa t019, and pan-susceptibility to non-beta-lactam antibiotics. In contrast, HKU200 isolates are characterized by having SCCmec type IV or V, agr4, spa t437, and variable non-beta-lactam susceptibility profiles. The major CA-MRSA spa types were shared by a minority of the MSSA.
authors.affiliation: Division of Infectious Diseases, Department of Microbiology and Centre of Infection, The University of Hong Kong, Hong Kong SAR, China. plho@hkucc.hku.hk
authors.forename: Pak-Leung
authors.initials: PL
authors.lastname: Ho
authors.forename: Shuk-Kwan
authors.initials: SK
authors.lastname: Chuang
authors.forename: Yu-Fai
authors.initials: YF
authors.lastname: Choi
authors.forename: Rodney A
authors.initials: RA
authors.lastname: Lee
authors.forename: Albert C H
authors.initials: AC
authors.lastname: Lit
authors.forename: Tak-Keung
authors.initials: TK
authors.lastname: Ng
authors.forename: Tak-Lun
authors.initials: TL
authors.lastname: Que
authors.forename: Kam-Chuen
authors.initials: KC
authors.lastname: Shek
authors.forename: Hon-Kuan
authors.initials: HK
authors.lastname: Tong
authors.forename: Cindy W S
authors.initials: CW
authors.lastname: Tse
authors.forename: Wai-Kit
authors.initials: WK
authors.lastname: Tung
authors.forename: Raymond W H
authors.initials: RW
authors.lastname: Yung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001427:Bacterial Toxins / Q000096:biosynthesis; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005006:Ethnicity; D005098:Exotoxins / Q000096:biosynthesis; D005260:Female; D005838:Genotype; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007956:Leukocidins / Q000096:biosynthesis; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004269:DNA, Bacterial; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin