Abstract
Introduction and Objectives: Highly virulent community acquired methicillin resistant Staphylococcus aureus (MRSA) strains emerged recently causing infections in healthy young adults without predisposing factors. This descriptive cross-sectional study was conducted to compare socio-demography of patients and microbiology and molecular characteristics of Community acquired (CA) and Hospital acquired (HA) methicillin resistant S. aureus strains isolated at the National Hospital of Sri Lanka. Methods and Results: Antimicrobial susceptibility test and Panton Valentine Leukocidine (PVL) gene detection was carried out on 100 MRSA isolates. CDC epidemiological criteria were used for differentiation of CA and HA MRSA. Of those 100 isolates, 21(21%) were CA-MRSA and 79(79%) were HA-MRSA. Patients did not show any significant difference in acquiring CA MRSA and HA MRSA in relation to their age, sex and gender except ethnicity. The majority of these isolates were from pus samples. CA-MRSA isolates were significantly more sensitive to ciprofloxacin, fusidic acid, tetracycline, cotrimoxazole, and gentamicin compared with HA-MRSA isolates (p Conclusion: This study highlights the importance of accurate differentiation of CA and HA MRSA using epidemiological, microbiological and molecular characteristics. Further, awareness of the existence of these types will optimise individual treatment strategies.
Highlights
Introduction and ObjectivesHighly virulent community acquired methicillin resistant Staphylococcus aureus (MRSA) strains emerged recently causing infections in healthy young adults without predisposing factors
This study highlights the importance of accurate differentiation of Community acquired (CA) and Hospital acquired (HA) MRSA using epidemiological, microbiological and molecular characteristics
A descriptive cross-sectional study was conducted from November 2013 to March 2014 for statistically calculated 100 consecutive, non-repetitive MRSA isolates collected from the microbiology laboratory, National Hospital of Sri Lanka (NHSL)
Summary
Introduction and ObjectivesHighly virulent community acquired methicillin resistant Staphylococcus aureus (MRSA) strains emerged recently causing infections in healthy young adults without predisposing factors. Prevalence of MRSA in Sri Lanka varies among the hospital settings from 47% to 62% while most are resistant to many antimicrobials tested.[1,2,3] In the late 1990s, a phenotypically and genotypically distinct highly virulent MRSA clone emerged as communityacquired/associated MRSA (CA-MRSA) causing skin and soft tissue infection, and severe haemorrhagic pneumonia in children and young adults without any predisposing conditions.[4] It usually carries smaller staphylococcal cassette chromosome mec (SCCmec) elements e.g. IV, V that do not contain other resistance genes and many clones spread independently worldwide They produce PantonValentine Leukocidin toxin (PVL) which is responsible for both skin infection and severe haemorrhagic necrotizing pneumonia through tissue necrosis and abscess formation.[5] Many studies have shown significant association of PVL gene with CAMRSA isolates compared with HA-MRSA isolates despite its controversial significance.[5,6] the prevalence of CA-MRSA varies markedly worldwide. Local studies to assess the burden and characteristics of CA-MRSA and HAMRSA infections in the country are lacking
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