Emergence of Community-Genotype Methicillin-Resistant Staphylococcus aureus in Korean Hospitals: Clinical Characteristics of Nosocomial Infections by Community-Genotype Strain

• Published in: Infection & chemotherapy Vol. 49; no. 2; pp. 109 - 116
• Main Authors: Joo, Eun-Jeong, Chung, Doo Ryeon, Kim, So Hyun, Baek, Jin Yang, Lee, Nam Yong, Cho, Sun Young, Ha, Young Eun, Kang, Cheol-In, Peck, Kyong Ran, Song, Jae-Hoon
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 01.06.2017; 대한감염학회
• Subjects: Original; 내과학; Genotyping; Methicillin-resistant Staphylococcus aureus; Nosocomial infections
• ISSN: 2093-2340; 2092-6448
• DOI: 10.3947/ic.2017.49.2.109

As community-genotype methicillin-resistant Staphylococcus aureus (MRSA) strains spread into hospitals, the genotypes of the MRSA strains causing hospital-acquired (HA) infections have become more diverse. We describe clinical characteristics of nosocomial MRSA infections by a community-genotype of sequence type (ST) 72. A case-control study was designed among patients with HA-MRSA infections. Forty patients with infections caused by ST72-MRSA SCCmec type IV were selected as cases. Cases were matched to the controls with 106 patients infected with ST5/ST239 MRSA, which are representative hospital genotypes in Korea. Patients infected with ST72 isolates were younger than those with ST5/ST239 isolates. Female gender predominated among ST72 MRSA group compared to ST5/ST239 MRSA group. Solid tumor was a more frequent underlying disease in MRSA infections by ST72 isolates, whereas underlying renal, lung, heart, and neurologic diseases were more frequently found in those by ST5/ST239 isolates. The most common type of infection was pneumonia in both ST72 and ST5/ST239 groups (45.0% vs. 51.9%), followed by skin and soft tissue infection (SSTI). Female gender and underlying solid tumor were identified to be independent predictors for MRSA infections by ST72 isolates. All-cause mortality rates (20.0% vs. 30.2%) were not different between the groups. A community-genotype MRSA, ST72 isolate has emerged as a nosocomial pathogen presenting as hospital-acquired pneumonia and SSTI. Although differences in underlying disorders were found, the distribution of infection type and mortality rate did not differ between the groups.