distribution of staphylococcal cassette chromosome mec types and correlation with comorbidity and infection type in patients with mrsa bacteremia葡萄球菌盒式染色体mec分布类型和相关并发症和感染类型耐甲氧西林金黄色葡萄球菌菌血症患者.pdfVIP

Distribution of Staphylococcal Cassette Chromosome mec Types and Correlation with Comorbidity and Infection Type in Patients with MRSA Bacteremia 1,2 . 1. 3 1 1 Jiun-Ling Wang * , Jann-Tay Wang , Shey-Ying Chen , Yee-Chun Chen , Shan-Chwen Chang * 1 Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan, 2 Department of Internal Medicine, E-Da Hospital/I- Shou University, Kaohsiung County, Taiwan, 3 Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan Abstract Background: Molecular epidemiological definitions that are based on staphylococcal cassette chromosome mec (SCCmec) typing and phylogenetic analysis of methicillin-resistant Staphylococcus aureus (MRSA) isolates are considered a reliable way to distinguish between healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA). However, there is little information regarding the clinical features and outcomes of bacteremia patients with MRSA carrying different SCCmec types. Methods: From January 1 through December 31, 2006, we recorded the demographic data and outcomes of 159 consecutive adult MRSA bacteremia patients from whom isolates for SCCmec analysis were collected. All participants were patients at a tertiary care center in Taiwan. Principal Findings: The following SCCmec types were identified in MRSA isolates: 30 SCCmec II (18.9%), 87 SCCmec III (54.7%), 22 SCCmec IV (13.8%), and 20 SCCmec V (12.6%). The time from admission to the first MRSA-positive blood culture for patients infected with isolates with the SCCmec III element (mean/median, 50.7/26 days) was significantly