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The Journal of antimicrobial chemotherapy v.72 no.2, 2017년, pp.372 - 375   SCI SCIE
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MRSA infections among patients in the emergency department: a European multicentre study

Bouchiat, C. (National Reference Center for Staphylococci, 59 Bd Louis Pinel, 69677 Bron cedex, Lyon, France ) ; Curtis, S. (Staphylococcus Reference Service, Public Health England, 61 Colindale Avenue London NW9 5EQ, UK ) ; Spiliopoulou, I. (National Reference Laboratory for Staphylococci, University of Patras, University Campus, Rion 26504, Patras, Greece ) ; Bes, M. (National Reference Center for Staphylococci, 59 Bd Louis Pinel, 69677 Bron cedex, Lyon, France ) ; Cocuzza, C. (Laboratory of Clinical Microbiology and Virology, University of Milano-Bicocca, Via Cadore 48, Monza, Italy ) ; Codita, I. (Cantacuzino National Institute of Research, Splaiul Independentei 103, RO-050096 Bucharest, Romania ) ; Dupieux, C. (National Reference Center for Staphylococci, 59 Bd Louis Pinel, 69677 Bron cedex, Lyon, France ) ; Giormezis, N. (National Reference Laboratory for Staphylococci, University of Patras, University Campus, Rion 26504, Patras, Greece ) ; Kearns, A. (Staphylococcus Reference Service, Public Health England, 61 Colindale Avenue London NW9 5EQ, UK ) ; Laurent, F. (National Reference Center for Staphylococci, 59 Bd Louis Pinel, ) ; Molinos, S. ; Musumeci, R. ; Prat, C. ; Saadatian-Elahi, M. ; Tacconelli, E. ; Tristan, A. ; Schulte, B. ; Vandenesch, F. ; Monneuse, Olivier ; de Francisco, Toni ; Casella, Pietro ; Erbizzoni, Serena ; Melzi, Sara ; Oggioni, Davide ; Sala, Roberta ; Calaresu, Enrico ; Efthimia, Petinaki ; Markos, Marangos ; Petinaki, Efthimia ; Schroeder, Wiebke ;
  • 초록  

    Background MRSA is a therapeutic concern worldwide, and a major agent of community-acquired skin and soft tissue infections (CA-SSTIs). While the US epidemiology of MRSA in CA-SSTIs is well described and reports the high prevalence of the USA300 clone, data on the European situation are lacking. Objectives To determine the prevalence and clonal characteristics of MRSA in CA-SSTIs in seven European emergency departments. Patients and methods From April to June 2015, patients presenting to the tertiary hospital emergency department with a Staphylococcus aureus CA-SSTI were prospectively enrolled. S. aureus isolates were characterized by antimicrobial susceptibility testing, detection of Panton–Valentine leucocidin encoding genes and spa -typing, MLST and/or DNA microarray. Results Two-hundred and five cases of S. aureus -associated CA-SSTIs were included, comprising folliculitis, furuncles, abscesses, paronychia, impetigo, carbuncles and cellulitis. Of the 205 cases, we report an MRSA prevalence rate of 15.1%, with a north (0%) to south (29%) increasing gradient. Fifty-one isolates were Panton–Valentine leucocidin-positive (24.9%), whether MSSA or MRSA, with a heterogeneous distribution between countries. Clonal distribution of MSSA and MRSA showed high diversity, with no predominant circulating clone and no archetypical USA300 CA-MRSA clone. Conclusions This original prospective multicentre study highlights stark differences in European MRSA epidemiology compared with the USA, and that the USA300 CA-MRSA clone is not predominant among community-infected patients in Europe.


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