Abstract
BackgroundCommunity Acquired Methicillin Resistant Staphylococcus aureus (CA-MRSA) is a strain of MRSA that can cause infections in patients in the community, in which these patients had no previous risk factors for MRSA infection and the patient received 72 hours prior to infection when admitted to hospital. This study aims to determine and compare the characteristics of epidemiological, clinical, and molecular biology of CA-MRSA with HA-MRSA.MethodsA total of 11 clinical strains of Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Stapylococcus aureus (MSSA) were collected from 2 hospitals in Jakarta, Indonesia in 2012. SCCmec typing was performed by multiplex polymerase chain reaction (PCR) and the presence of six genes (vraR, vraG, vraA, vraF,fruA, and fruB) associated with vancomycin resistance was examined by simple PCR analysis.ResultsWe found three strains of community-acquired MRSA with SCCmec type II and one strain of hospital-acquired MRSA with SCCmec type IV. The other seven strains did not contain mecA genes and SCCmec. Plasmid pUB110 was found in one strain of community-acquired MRSA and two strains of hospital-acquired MRSA. vraA genes were present in 9 of the 11 strains, vraF in 4, vraG in 5, and vraR in 4. Note worthily, three quarters of strains without pUB110 contained vraR and vraF, and 70% contained vraA, whereas 60% of strains with pUB110 contained vraG.ConclusionBased on these results, we should be concerned about the possibility of transition from MRSA strains sensitive to vancomycin in VISA strains of MRSA strains obtained in clinical trials. But first we need to look the existence of natural VISA or hVISA among these MRSA strains.
Highlights
Community Acquired Methicillin Resistant Staphylococcus aureus (CA-Methicillin-resistant Staphylococcus aureus (MRSA)) is a strain of MRSA that can cause infections in patients in the community, in which these patients had no previous risk factors for MRSA infection and the patient received 72 hours prior to infection when admitted to hospital
Sensitivity testing showed that all isolates had good sensitivity to vancomycin, teicoplanin, linezolid, tigecycline, and amikacin
Most strains of MRSA: 75% (3/4) contains a Type II Staphylococcal cassette chromosome mec (SCCmec), and only 1(25%) strain containing SCCmec type IV and the overall of S.aureus isolates containing all six genes associated vancomycin-intermediate S. aureus (VISA) with different frequencies
Summary
Community Acquired Methicillin Resistant Staphylococcus aureus (CA-MRSA) is a strain of MRSA that can cause infections in patients in the community, in which these patients had no previous risk factors for MRSA infection and the patient received 72 hours prior to infection when admitted to hospital. Data from the previous study showed higher prevalence and variations of MRSA in countries of the Asia-Pacific region than in Europe [2] In some countries, such as Korea, Hong Kong, and Japan, the MRSA is resistant to methicillin and other related βlactam antibiotics, such as cefoxitin and oxacillin [1]. Two decades ago, Communityacquired MRSA (CA-MRSA) started to emerge among MRSA isolates from individuals with no or minimal exposure to health care facilities [8,9] This strain tends to be more common among S. aureus infections as it is increasingly reported, among children and young adults [8,9,10,11]. The CA-MRSA strains can be isolated from severe infections such as osteomyelitis, bacteremia, endocarditis, and pneumonia [14,15,16,17]
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