Community-acquired methicillin-resistant Staphylococcus aureus: what do we need to know?
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a matter of concern worldwide, in particular in the USA. For the analysis of emergence and spread, clear definitions based on epidemiological origin are needed for discrimination between CA-MRSA, healthcare-associated community MRSA, and healthcare-associated MRSA (HA-MRSA). Although its role in pathogenesis is currently under debate, the capability for Panton-Valentine leukocidin formation is associated with the majority of CA-MRSA isolates from North America and from Europe. Most CA-MRSA isolates are attributed to clonal lineages different from HA-MRSA; there are, however, clonal lineages from which both HA-MRSA and CA-MRSA have been reported (e.g. ST1, ST5, ST8, and ST22); CA-MRSA ST8 (USA300), which is most frequent in the USA, has meanwhile been reported from Europe. CA-MRSA ST80 is widely disseminated in Europe; because of its pronounced oxacillin heteroresistance phenotype, cefoxitin-based assays are advisable for reliable detection. So far, CA-MRSA infections seem to be much less frequent in Europe than in the USA, where patients with particular predispositions and low social status are at especial risk.
Witte
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National Reference Centre for Staphylococci, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany. wittew@rki.de
D001427:Bacterial Toxins / Q000096:biosynthesis; D015373:Bacterial Typing Techniques; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D016172:DNA Fingerprinting; D005060:Europe / Q000453:epidemiology; D005098:Exotoxins / Q000096:biosynthesis; D005838:Genotype; D006801:Humans; D007956:Leukocidins / Q000096:biosynthesis; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000302:isolation & purification* / Q000472:pathogenicity*; D008826:Microbial Sensitivity Tests / Q000379:methods; D009656:North America / Q000453:epidemiology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D037521:Virulence Factors / Q000096:biosynthesis; D047090:beta-Lactams / Q000494:pharmacology
D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D037521:Virulence Factors; D047090:beta-Lactams