title: Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections.
abstract: The aim of this study was to determine the prevalence of Staphylococcus aureus and risk factors for the acquisition of MRSA (Methicillin Resistant Staphylococcus aureus) as the main cause of skin and soft tissue infections. S. aureus were characterized for the presence of PVL, TSST-1 and mecA genes. SCCmec typing was carried out in mecA positive strains and PFGE was performed only in these strains. During the study period, 127 outpatients attending a dermatology clinical the Botucatu Medical School, a regional tertiary hospital in Botucatu, Sao Paulo, Brazil, were diagnosed with active skin infections. A total 66 (56.9%) S. aureus strains were isolated. The methicillin resistance gene mecA was detected in seven (10.6%) S. aureus strains. The SCCmec types detected in the seven mecA-positive S. aureus strains were type Ia in one, type II in three, and type IV in three. The PVL gene was detected in 10 (15.1%) in sensitive strains. Pulsed field gel electrophoresis revealed non-clonal diversity among the isolates. The risk factors associated with MRSA acquisition in this study were previous ciprofloxacin use and working in a healthcare environment. The risk factors indicate plausible routes of CA-MRSA transmission among the subjects studied.
authors.affiliation: Departamento de Microbiologia e Imunologia Instituto de Biociencias de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Microbiologia e Imunologia, Instituto de Biociencias de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil. ; Departamento de Doenças Tropicais Faculdade de Medicina de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Mariana Fávero
authors.initials: MF
authors.lastname: Bonesso
authors.affiliation: Departamento de Dermatologia e Radiologia Faculdade de Medicina de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Dermatologia e Radiologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Silvio Alencar
authors.initials: SA
authors.lastname: Marques
authors.affiliation: Departamento de Microbiologia e Imunologia Instituto de Biociencias de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Microbiologia e Imunologia, Instituto de Biociencias de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Camargo
authors.affiliation: Departamento de Doenças Tropicais Faculdade de Medicina de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Carlos Magno Castelo Branco
authors.initials: CM
authors.lastname: Fortaleza
authors.affiliation: Departamento de Microbiologia e Imunologia Instituto de Biociencias de Botucatu Universidade Estadual Paulista "Júlio de Mesquita Filho" BotucatuSP Brazil Departamento de Microbiologia e Imunologia, Instituto de Biociencias de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Maria de Lourdes Ribeiro de Souza
authors.initials: Mde L
authors.lastname: da Cunha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000235:genetics; D001427:Bacterial Toxins / Q000235:genetics; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology*; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004768:Enterotoxins / Q000235:genetics; D005098:Exotoxins / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D006801:Humans; D007223:Infant; D007956:Leukocidins / Q000235:genetics; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification*; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D046915:Penicillin-Binding Proteins; D015995:Prevalence; D012307:Risk Factors; D012867:Skin / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000382:microbiology*; D018089:Superantigens / Q000235:genetics; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D046915:Penicillin-Binding Proteins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; C487789:mecA protein, Staphylococcus aureus
keywords: Staphylococcus aureus; epidemiology; resistance; skin infections; virulence