MRSA Causing Infections in Hospitals in Greater Metropolitan New York: Major Shift in the Dominant Clonal Type between 1996 and 2014.

Maria Pardos De La Gandara,John Quale,Susan Whittier,Rexie Tan,Virgina Kopetz,Herminia De Lencastre,Judith Berger,Alexander Tomasz,Marie Curry,Guiqing Wang,David Burstein,Eric Spitzer,Phyllis Della-Latta,Carl Urban,Paul J Planet

doi:10.1371/journal.pone.0156924

Abstract

A surveillance study in 1996 identified the USA100 clone (ST5/SCCmecII)–also known as the “New York/Japan” clone—as the most prevalent MRSA causing infections in 12 New York City hospitals. Here we update the epidemiology of MRSA in seven of the same hospitals eighteen years later in 2013/14. Most of the current MRSA isolates (78 of 121) belonged to the MRSA clone USA300 (CC8/SCCmecIV) but the USA100 clone–dominant in the 1996 survey–still remained the second most frequent MRSA (25 of the 121 isolates) causing 32% of blood stream infections. The USA300 clone was most common in skin and soft tissue infections (SSTIs) and was associated with 84.5% of SSTIs compared to 5% caused by the USA100 clone. Our data indicate that by 2013/14, the USA300 clone replaced the New York/Japan clone as the most frequent cause of MRSA infections in hospitals in Metropolitan New York. In parallel with this shift in the clonal type of MRSA, there was also a striking change in the types of MRSA infections from 1996 to 2014.

Highlights

Staphylococcus aureus has remained a leading cause of infections in hospitals and continues to represent the most frequently identified antibiotic-resistant nosocomial pathogen in many parts of the world [1]
In the present study we report on the clonal types of methicillin-resistant S. aureus (MRSA) isolates recovered from infections in several of the same hospitals in New York City that participated in the 1996/98 surveillance
The molecular epidemiology of MRSA in the New York Presbyterian Hospital/Cornell Medical Center will be described in a separate communication

Summary

Introduction

Staphylococcus aureus has remained a leading cause of infections in hospitals and continues to represent the most frequently identified antibiotic-resistant nosocomial pathogen in many parts of the world [1]. Almost twenty years ago–in 1996 –our laboratory organized a multicenter study to investigate the molecular epidemiology of MRSA in 12 hospitals in Metropolitan New York [2]. The most prevalent clone, recovered from 113 of 270 MRSA infections (42%), was the ‘New York/Japan’ clone (USA100/ST5/SCCmecII), which was predominant in the neighboring states of Pennsylvania, New Jersey and Connecticut [6]. In the United States, this clone has been the predominant MRSA clone in hospitals and healthcare institutions (HA-MRSA) countrywide over the last fifteen years [8,9]

Methods

Results

Conclusion