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Differences in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Pediatric and Adult Patients from Hospitals in a Large County in California

Differences in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Pediatric and... Differences in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Pediatric and Adult Patients from Hospitals in a Large County in California Lyndsey O. Hudson a , Courtney R. Murphy b , Brian G. Spratt a , Mark C. Enright c , Leah Terpstra d , Adrijana Gombosev d , Paul Hannah e , Lydia Mikhail e , Richard Alexander e , Douglas F. Moore e and Susan S. Huang d a Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom b School of Social Ecology, and Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California, USA c AmpliPhi Biosciences, Colworth Science Park, Sharnbrook, Bedfordshire, United Kingdom d Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California, USA e Orange County Health Care Agency, Santa Ana, California, USA ABSTRACT Studies of U.S. epidemics of community- and health care-associated methicillin-resistant Staphylococcus aureus (MRSA) suggested differences in MRSA strains in adults and those in children. Comprehensive population-based studies exploring these differences are lacking. We conducted a prospective cohort study of inpatients in Orange County, CA, collecting clinical MRSA isolates from 30 of 31 Orange County hospitals, to characterize differences in MRSA strains isolated from children compared to those isolated from adults. All isolates were characterized by spa typing. We collected 1,124 MRSA isolates from adults and 159 from children. Annual Orange County population estimates of MRSA inpatient clinical cultures were 119/100,000 adults and 22/100,000 children. spa types t008, t242, and t002 accounted for 83% of all isolates. The distribution of these three spa types among adults was significantly different from that among children (χ 2 = 52.29; P < 0.001). Forty-one percent of adult isolates were of t008 (USA300), compared to 69% of pediatric isolates. In multivariate analyses, specimens from pediatric patients, wounds, non-intensive care unit (ICU) wards, and hospitals with a high proportion of Medicaid-insured patients were significantly associated with the detection of t008 strains. While community- and health care-associated MRSA reservoirs have begun to merge, significant differences remain in pediatric and adult patient populations. Community-associated MRSA spa type t008 is significantly more common in pediatric patients. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Clinical Microbiology American Society For Microbiology

Differences in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Pediatric and Adult Patients from Hospitals in a Large County in California

Differences in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Pediatric and Adult Patients from Hospitals in a Large County in California

Journal of Clinical Microbiology , Volume 50 (3): 573 – Mar 1, 2012

Abstract

Differences in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Pediatric and Adult Patients from Hospitals in a Large County in California Lyndsey O. Hudson a , Courtney R. Murphy b , Brian G. Spratt a , Mark C. Enright c , Leah Terpstra d , Adrijana Gombosev d , Paul Hannah e , Lydia Mikhail e , Richard Alexander e , Douglas F. Moore e and Susan S. Huang d a Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom b School of Social Ecology, and Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California, USA c AmpliPhi Biosciences, Colworth Science Park, Sharnbrook, Bedfordshire, United Kingdom d Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California, USA e Orange County Health Care Agency, Santa Ana, California, USA ABSTRACT Studies of U.S. epidemics of community- and health care-associated methicillin-resistant Staphylococcus aureus (MRSA) suggested differences in MRSA strains in adults and those in children. Comprehensive population-based studies exploring these differences are lacking. We conducted a prospective cohort study of inpatients in Orange County, CA, collecting clinical MRSA isolates from 30 of 31 Orange County hospitals, to characterize differences in MRSA strains isolated from children compared to those isolated from adults. All isolates were characterized by spa typing. We collected 1,124 MRSA isolates from adults and 159 from children. Annual Orange County population estimates of MRSA inpatient clinical cultures were 119/100,000 adults and 22/100,000 children. spa types t008, t242, and t002 accounted for 83% of all isolates. The distribution of these three spa types among adults was significantly different from that among children (χ 2 = 52.29; P < 0.001). Forty-one percent of adult isolates were of t008 (USA300), compared to 69% of pediatric isolates. In multivariate analyses, specimens from pediatric patients, wounds, non-intensive care unit (ICU) wards, and hospitals with a high proportion of Medicaid-insured patients were significantly associated with the detection of t008 strains. While community- and health care-associated MRSA reservoirs have begun to merge, significant differences remain in pediatric and adult patient populations. Community-associated MRSA spa type t008 is significantly more common in pediatric patients.

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Publisher
American Society For Microbiology
Copyright
Copyright © 2012 by the American society for Microbiology.
ISSN
0095-1137
eISSN
1098-660X
DOI
10.1128/JCM.05336-11
pmid
22205805
Publisher site
See Article on Publisher Site

Abstract

Differences in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Pediatric and Adult Patients from Hospitals in a Large County in California Lyndsey O. Hudson a , Courtney R. Murphy b , Brian G. Spratt a , Mark C. Enright c , Leah Terpstra d , Adrijana Gombosev d , Paul Hannah e , Lydia Mikhail e , Richard Alexander e , Douglas F. Moore e and Susan S. Huang d a Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom b School of Social Ecology, and Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California, USA c AmpliPhi Biosciences, Colworth Science Park, Sharnbrook, Bedfordshire, United Kingdom d Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California, USA e Orange County Health Care Agency, Santa Ana, California, USA ABSTRACT Studies of U.S. epidemics of community- and health care-associated methicillin-resistant Staphylococcus aureus (MRSA) suggested differences in MRSA strains in adults and those in children. Comprehensive population-based studies exploring these differences are lacking. We conducted a prospective cohort study of inpatients in Orange County, CA, collecting clinical MRSA isolates from 30 of 31 Orange County hospitals, to characterize differences in MRSA strains isolated from children compared to those isolated from adults. All isolates were characterized by spa typing. We collected 1,124 MRSA isolates from adults and 159 from children. Annual Orange County population estimates of MRSA inpatient clinical cultures were 119/100,000 adults and 22/100,000 children. spa types t008, t242, and t002 accounted for 83% of all isolates. The distribution of these three spa types among adults was significantly different from that among children (χ 2 = 52.29; P < 0.001). Forty-one percent of adult isolates were of t008 (USA300), compared to 69% of pediatric isolates. In multivariate analyses, specimens from pediatric patients, wounds, non-intensive care unit (ICU) wards, and hospitals with a high proportion of Medicaid-insured patients were significantly associated with the detection of t008 strains. While community- and health care-associated MRSA reservoirs have begun to merge, significant differences remain in pediatric and adult patient populations. Community-associated MRSA spa type t008 is significantly more common in pediatric patients.

Journal

Journal of Clinical MicrobiologyAmerican Society For Microbiology

Published: Mar 1, 2012

References