Community-acquired methicillin-resistant staphylococcus aureus (ca-mrsa)
Abstract
Background: Community acquired MRSA (CAMRSA) infections affect patients without risk factors. CAMRSA infections can be serious and also fatal even in previously healthy subjects. CA-MRSA differs from hospital acquired MRSA (HA-MRSA). CA-MRSA is more susceptible for non-beta-lactam antibiotics than HA-MRSA, has different PFGE subtypes, and can produce Panton-Valentine leukocidine.
Methods: In Institute of Public Health Kranj we routinely perform epidemiologic survey of MRSA positive patients. We compared MRSA isolates from patients with and without risk factors for acquisition of MRSA. We tested all S. aureus for their susceptibility to antibiotics (penicillin, oxacillin, vancomycin, gentamicin, erythromycin, clindamycin, tetracycline, ciprofloxacine, chloramphenicol, trimethoprim – sulfamethoxazole and rifampin). All CA-MRSA isolates were tested for susceptibility to fusidic acid staphylococcal enterotoxin (SE) production. We performed macrorestriction chromosome analysis with pulse field gel electrophoresis (PFGE). We compared CA-MRSA characteristics with epidemic MRSA strains.
Results: In the period from 1999 to 2004 we isolated 1439 MRSA including 10 isolates suspicious for CA-MRSA. This isolates were susceptible for more than 5 antibiotics in contrast to epidemic MRSA which were susceptible for 3 or 5 antibiotics. Eight of 10 CA-MRSA produced SE C or D or no SE, in contrast to epidemic MRSA, which produced exclusively SE A. In PFGE CA-MRSA showed different patterns compared to epidemic HA-MRSA.
Conclusions: With exclusion of risk factors for MRSA acquisition in patient’s history testing for antibiotic susceptibility, SE production and PFGE we proved that our MRSA isolates differed from ordinary epidemic strains. We identified CA-MRSA also in Slovenia.
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