title: Community strains of methicillin-resistant Staphylococcus aureus as potential cause of healthcare-associated infections, Uruguay, 2002-2004.
abstract: Community-associated MRSA (CA-MRSA) strains have emerged in Uruguay. We reviewed Staphylococcus aureus isolates from a large healthcare facility in Montevideo (center A) and obtained information from 3 additional hospitals on patients infected with CA-MRSA. An infection was defined as healthcare-onset if the culture was obtained >48 hours after hospital admission. At center A, the proportion of S. aureus infections caused by CA-MRSA increased from 4% to 23% over 2 years; the proportion caused by healthcare-associated MRSA (HA-MRSA) decreased from 25% to 5%. Of 182 patients infected with CA-MRSA, 38 (21%) had healthcare-onset infections. Pulsed-field gel electrophoresis determined that 22 (92%) of 24 isolates were USA1100, a community strain. CA-MRSA has emerged in Uruguay and appears to have replaced HA-MRSA strains at 1 healthcare facility. In addition, CA-MRSA appears to cause healthcare-onset infections, a finding that emphasizes the need for infection control measures to prevent transmission within healthcare settings.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. sbenoit@cdc.gov
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Benoit
authors.forename: Concepción
authors.initials: C
authors.lastname: Estivariz
authors.forename: Cristina
authors.initials: C
authors.lastname: Mogdasy
authors.forename: Walter
authors.initials: W
authors.lastname: Pedreira
authors.forename: Antonio
authors.initials: A
authors.lastname: Galiana
authors.forename: Alvaro
authors.initials: A
authors.lastname: Galiana
authors.forename: Homero
authors.initials: H
authors.lastname: Bagnulo
authors.forename: Rachel
authors.initials: R
authors.lastname: Gorwitz
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Fosheim
authors.forename: Linda K
authors.initials: LK
authors.lastname: McDougal
authors.forename: Daniel
authors.initials: D
authors.lastname: Jernigan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology*; D003428:Cross Infection / Q000382:microbiology*; D005260:Female; D006268:Health Facilities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D013997:Time Factors; D014583:Uruguay / Q000453:epidemiology