Epidemiology of European community-associated methicillin-resistant Staphylococcus aureus clonal complex 80 type IV strains isolated in Denmark from 1993 to 2004
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Epidemiology of European community-associated methicillin-resistant Staphylococcus aureus clonal complex 80 type IV strains isolated in Denmark from 1993 to 2004. / Larsen, A R; Böcher, S; Stegger, M; Goering, R; Pallesen, L V; Skov, R.
I: Journal of clinical microbiology, Bind 46, Nr. 1, 01.2008, s. 62-8.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Epidemiology of European community-associated methicillin-resistant Staphylococcus aureus clonal complex 80 type IV strains isolated in Denmark from 1993 to 2004
AU - Larsen, A R
AU - Böcher, S
AU - Stegger, M
AU - Goering, R
AU - Pallesen, L V
AU - Skov, R
PY - 2008/1
Y1 - 2008/1
N2 - In Europe, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have been caused predominantly by isolates belonging to the "European CA-MRSA" clone (sequence type 80, staphylococcal cassette chromosome mec type IV). In this study, the epidemiology of European CA-MRSA was investigated on a nationwide scale, covering the period from 1993 to 2004. Denmark has been a low-prevalence country regarding MRSA since the mid-1970s but has experienced an increase in the number of new MRSA cases in recent years. Our results show that European CA-MRSA contributed to this increase. The isolates primarily caused skin and soft tissue infections (SSTIs) in patients outside hospitals, and transmission between household members was the predominant mode of spread. Although some of the isolates were found in hospitalized patients, nosocomial transmission seemed likely in only one instance, pointing to endogenous infections as an important factor. Compared to the CA-MRSA clone most common in the United States (USA300), the European CA-MRSA clone seems less well adapted to persist in hospital environments. Patients with a recent history of travel or family relation to the Mediterranean or Middle East were highly overrepresented. The epidemiological data indicated that the European CA-MRSA isolates were introduced into Denmark on multiple occasions, paralleled by an increasing level of genetic diversity of the isolates found during the study period. European CA-MRSA has previously been described as a rather uniform clone. However, we found pronounced, diverse pulsed-field gel electrophoresis subtypes, staphylococcal protein A gene (spa) types, and susceptibility patterns.
AB - In Europe, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have been caused predominantly by isolates belonging to the "European CA-MRSA" clone (sequence type 80, staphylococcal cassette chromosome mec type IV). In this study, the epidemiology of European CA-MRSA was investigated on a nationwide scale, covering the period from 1993 to 2004. Denmark has been a low-prevalence country regarding MRSA since the mid-1970s but has experienced an increase in the number of new MRSA cases in recent years. Our results show that European CA-MRSA contributed to this increase. The isolates primarily caused skin and soft tissue infections (SSTIs) in patients outside hospitals, and transmission between household members was the predominant mode of spread. Although some of the isolates were found in hospitalized patients, nosocomial transmission seemed likely in only one instance, pointing to endogenous infections as an important factor. Compared to the CA-MRSA clone most common in the United States (USA300), the European CA-MRSA clone seems less well adapted to persist in hospital environments. Patients with a recent history of travel or family relation to the Mediterranean or Middle East were highly overrepresented. The epidemiological data indicated that the European CA-MRSA isolates were introduced into Denmark on multiple occasions, paralleled by an increasing level of genetic diversity of the isolates found during the study period. European CA-MRSA has previously been described as a rather uniform clone. However, we found pronounced, diverse pulsed-field gel electrophoresis subtypes, staphylococcal protein A gene (spa) types, and susceptibility patterns.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anti-Bacterial Agents/pharmacology
KW - Child
KW - Child, Preschool
KW - Cross Infection/epidemiology
KW - DNA Fingerprinting
KW - DNA, Bacterial/genetics
KW - Denmark/epidemiology
KW - Electrophoresis, Gel, Pulsed-Field
KW - Family Health
KW - Genotype
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Methicillin Resistance
KW - Microbial Sensitivity Tests
KW - Middle Aged
KW - Sequence Analysis, DNA
KW - Soft Tissue Infections/epidemiology
KW - Staphylococcal Infections/epidemiology
KW - Staphylococcal Protein A/genetics
KW - Staphylococcal Skin Infections/epidemiology
KW - Staphylococcus aureus/classification
KW - Travel
U2 - 10.1128/JCM.01381-07
DO - 10.1128/JCM.01381-07
M3 - Journal article
C2 - 17989197
VL - 46
SP - 62
EP - 68
JO - Journal of clinical microbiology
JF - Journal of clinical microbiology
SN - 0095-1137
IS - 1
ER -
ID: 325463586