Abstract
Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important cause of infection. We conducted a longitudinal study to evaluate changes in clinical and microbiological characteristics as well as outcomes of sequence type (ST) 72 MRSA bacteremia. We reviewed adult patients enrolled in a prospective cohort with ST72 MRSA bacteremia from August 2008 to December 2018 at Asan Medical Center, Seoul, South Korea. Changes in clinical characteristics, outcomes, and microbiological characteristics of patients over time were evaluated. Generalized linear and linear regression models were used to evaluate changes. Of the 1,760 isolates, 915 (62%) were MRSA bacteremia and 292 (31.9%) were ST72 MRSA. During the study period, the relative risk (RR) of MRSA bacteremia decreased annually by 3.7%; however, among MRSA bacteremia, RR of ST72 MRSA increased annually by 8.5%. Vancomycin minimum inhibitory concentration (MIC) decreased over the study period. Metastatic infection, persistent bacteremia, and recurrence of bacteremia within 12 weeks decreased significantly. There were no significant changes in 30-d and 12-week mortality. Antibiotic susceptibility of ST72 MRSA was evaluated, and the resistance rate to erythromycin decreased significantly. ST72 MRSA incidence increased annually; its vancomycin MIC and erythromycin resistance rate decreased over the 11 years.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of community- and healthcare-associated infections
We evaluated the clinical, microbiological, and genotypic changes in ST72 methicillin-resistant Staphylococcus aureus (MRSA) bacteremia over 11 years
The relative risk (RR) of MRSA bacteremia decreased and among these, the RR of ST72 MRSA increased during the study period
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of community- and healthcare-associated infections. In recent years, CA-MRSA has spread and emerged as an important cause of healthcare-associated infection[2,3]. USA300-sequence type (ST)[8], a highly prominent Panton-Valentine leucocidin (PVL)-positive CA-MRSA, is the dominant CA-MRSA in North America and is progressively increasing in nosocomial s ettings[4,5]. The ST72 MRSA strain has become an important pathogen in hospitals as well as in the community[8,9,10]. We hypothesized that there were changes in the properties of ST72 MRSA and analyzed changes in the clinical characteristics of patients with ST72 MRSA bacteremia as well as changes in microbiological characteristics and the genotype of ST72 MRSA isolates in our institution over 11 years
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