title: Clinical characteristics, virulence factors and molecular typing of methicillin-resistant Staphylococcus aureus infections in Shenzhen City, China.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious hospital and community-acquired infection and some strains are associated with greater severity. We investigated the clinical variability and molecular characteristics of MRSA infections in Shenzhen, China through a study at nine sentinel hospitals from January to December 2014. MRSA infections were classified as community-associated (CA-MRSA), healthcare-associated (HA-MRSA), and healthcare-associated community-onset (HACO-MRSA). In total, 812 MRSA isolates were collected and 183 of these were selected for further study. Patients with HA-MRSA infections were generally of greater age compared to other groups. Distinct body site and clinical presentations were evident in infected patients, e.g. CA-MRSA (skin and soft tissue, 53%), HA-MRSA (respiratory tract, 22%; surgical site, 20%; trauma wounds, 20%) and HACO-MRSA (mastitis, 47%). In contrast to HA-MRSA, other categories of strains were significantly more susceptible to gentamicin, sulfamethoxazole/trimethoprim, and tetracycline. No resistance to vancomycin or linezolid was recorded. The predominant clonal lineage within each strain category was CC59-t437-SCCmec IV/V-agr I (CA, 51·4%; HA, 28·9%; HACO, 52·9%) which exhibited characteristics of a traditional CA clone together with agr I which is more often associated with HA clones. In conclusion, for the three categories of MRSA infections, there were significant differences in clinical characteristics of patients, but the predominant clone in each category shared a similar genetic background which suggests that transmission of MRSA strains has occurred between the community and hospitals in Shenzhen.
authors.affiliation: College of Life Sciences,Shenzhen University,Shenzhen,Guangdong,China.
authors.forename: L
authors.initials: L
authors.lastname: Hu
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Lu
authors.affiliation: United States Centers for Disease Control and Prevention,Beijing,China.
authors.forename: J D
authors.initials: JD
authors.lastname: Klena
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: M
authors.initials: M
authors.lastname: Jiang
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: X
authors.initials: X
authors.lastname: Shi
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: H
authors.initials: H
authors.lastname: Ma
authors.affiliation: Shenzhen Major Infectious Disease Control Key Laboratory,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong Province,China.
authors.forename: J
authors.initials: J
authors.lastname: Cheng
authors.affiliation: United States Centers for Disease Control and Prevention,Beijing,China.
authors.forename: S
authors.initials: S
authors.lastname: Wu
authors.affiliation: Key Laboratory of Surveillance and Early-warning on Infectious Disease,Division of Infectious Disease,Chinese Center for Disease Control and Prevention,Beijing,China.
authors.forename: B
authors.initials: B
authors.lastname: Kan
authors.affiliation: College of Life Sciences,Shenzhen University,Shenzhen,Guangdong,China.
authors.forename: Q
authors.initials: Q
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005798:Genes, Bacterial / Q000235:genetics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000472:pathogenicity / Q000502:physiology*; D008875:Middle Aged; D058889:Molecular Typing; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D037521:Virulence Factors / Q000235:genetics*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D037521:Virulence Factors; D008712:Methicillin
keywords: CA-MRSA; HA-MRSA; HACO-MRSA; clinical characteristics; methicillin-resistant Staphylococcus aureus
              ; molecular typing; virulence factors