Methicillin-Resistant Staphylococcus aureus Ocular Infection in Taiwan: Clinical Features, Genotying, and Antibiotic Susceptibility.
Methicillin-resistant Staphylococcus aureus (MRSA) infection is an important public health issue. This observational study aimed to characterize clinical features, antibiotic susceptibility, and genotypes of ocular infections caused by MRSA based on the clinical and molecular definitions of community-associated (CA) and healthcare-associated (HA) strains.Fifty-nine patients with culture-proven S aureus ocular infection were enrolled from January 1, 2010 to December 31, 2011 at Chang Gung Memorial Hospital, Taiwan. Antibiotic susceptibility was verified using disk diffusion/E test. For characterization, staphylococcal cassette chromosome mec (SCCmec), pulsed-field gel electrophoresis (PFGE), multilocus sequence type (MLST), and Panton-Valentine leukocidin (PVL) gene, were performed. MRSA isolates from the patients with HA factors were classified as clinically defined HA-MRSA, and those carrying SCCmec type I to III as molecularly defined HA-MRSA.Thirty-four patients with MRSA ocular infection were identified. The most common clone of CA-MRSA and HA-MRSA isolates was ST59/PFGE type D/SCCmec IV,VT/PVL (+) (n = 12) and CC 239/PFGE type A/SCCmec III, IIIA/PVL(-) (n = 10), respectively. All the 11 patients with molecularly defined HA-MRSA infections and 50% of the 22 patients with molecularly defined CA-MRSA infections were found to have HA factors (P = .005). CA-MRSA tended to cause lid infections, whereas HA-MRSA tended to cause corneal infections. Contrary to HA-MRSA isolates, nearly all the CA-MRSA isolates were susceptible to trimethoprim/sulfamethoxazole and fluoroquinolones under either clinical or molecular classifications.In Taiwan, CA-MRSA isolates exhibited considerably higher susceptibility to fluoroquinolones when compared with HA-MRSA isolates. A strong correlation was observed between the HA factors and molecularly defined HA-MRSA isolates.
From the College of Medicine, Chang Gung University (Y-CK, C-HH, L-KY, DHM, PYC, H-CL, H-YT, H-CC, S-YC, Y-CH); Department of Education (Y-CK); Department of Ophthalmology (C-HH, L-KY, DHM, PYC, H-CL, H-YT, H-CC, S-YC); and Department of Pediatrics, Division of Pediatric Infectious Diseases, Chang Gung Memorial Hospital, Taoyuan, Taiwan (Y-C H).
Yu-Chuan
YC
Kang
Ching-Hsi
CH
Hsiao
Lung-Kun
LK
Yeh
David H K
DHK
Ma
Phil Y F
PYF
Chen
Hsin-Chiung
HC
Lin
Hsin-Yuan
HY
Tan
Hung-Chi
HC
Chen
Shin-Yi
SY
Chen
Yhu-Chering
YC
Huang
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy*; D013624:Taiwan
D000900:Anti-Bacterial Agents