Abstract
This study analyzed the clinical features and molecular characteristics of methicillin-susceptible Staphylococcus aureus (MSSA) ocular infections in Taiwan and compared them between community-associated (CA) and health-care-associated (HA) infections. We collected S. aureus ocular isolates from patients at Chang Gung Memorial Hospital between 2010 and 2017. The infections were classified as CA or HA using epidemiological criteria, and the isolates were molecularly characterized using pulsed-field gel electrophoresis, multilocus sequence typing, and Panton-Valentine leukocidin (PVL) gene detection. Antibiotic susceptibility was evaluated using disk diffusion and an E test. A total of 104 MSSA ocular isolates were identified; 46 (44.2%) were CA-MSSA and 58 (55.8%) were HA-MSSA. Compared with HA-MSSA strains, CA-MSSA strains caused a significantly higher rate of keratitis, but a lower rate of conjunctivitis. We identified 14 pulsotypes. ST 7/pulsotype BA was frequently identified in both CA-MSSA (28.3%) and HA-MSSA (37.9%) cases. PVL genes were identified in seven isolates (6.7%). Both CA-MSSA and HA-MSSA isolates were highly susceptible to vancomycin, teicoplanin, tigecycline, sulfamethoxazole–trimethoprim, and fluoroquinolones. The most common ocular manifestations were keratitis and conjunctivitis for CA-MSSA and HA-MSSA, respectively. The MSSA ocular isolates had diverse molecular characteristics; no specific genotype differentiated CA-MSSA from HA-MSSA. Both strains exhibited similar antibiotic susceptibility.
Highlights
Staphylococcus aureus is a major isolated bacterial pathogen that causes various infections in humans [1]
Keratitis was the most common ocular disease caused by CA-methicillinsusceptible Staphylococcus aureus (MSSA), followed by conjunctivitis; this order was reversed in the HA-MSSA group (Table 2)
The rates of keratitis and conjunctivitis caused by the CA-MSSA and HA-MSSA strains were significantly different
Summary
Staphylococcus aureus is a major isolated bacterial pathogen that causes various infections in humans [1]. S. aureus is typically categorized as methicillin resistant or methicillin susceptible based on its susceptibility to methicillin. Methicillin-resistant S. aureus (MRSA), a strain resistant to all β-lactam antibiotics, warrants particular attention because of its potentially limited treatment options and its increasing prevalence [2]. MRSA has conventionally been considered a health-care-associated (HA) pathogen but has been increasingly reported in community-associated (CA) infections, which is a global health concern [3]. HA- and CA-MRSA strains exhibit distinct clinical presentations, genotypes, and phenotypes [2,4]. MRSA has received considerable research attention, methicillin-susceptible
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