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Nakano Y, Murata M, Matsumoto Y, Toyoda K, Ota A, Yamasaki S, Otakeno H, Yokoo K, Shimono N. Clinical characteristics and factors related to infection with SCCmec type II and IV Methicillin-resistant Staphylococcus aureus in a Japanese secondary care facility: a single-center retrospective study. J Glob Antimicrob Resist 2022; 31:355-362. [PMID: 36372183 DOI: 10.1016/j.jgar.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Differences in virulence genes, including psm-mec, which is a phenol-soluble modulin-mec (PSM-mec) encoding gene, of predominant staphylococcal cassette chromosome mec (SCCmec) types II and IV Methicillin-resistant Staphylococcus aureus (MRSA) may contribute to the virulence and clinical features of MRSA in Japan. We aimed to clarify the clinical characteristics and risk factors of infection among SCCmec types II and IV MRSA isolates from a Japanese secondary acute care hospital. METHODS We analysed 58 SCCmec type II and 83 SCCmec type IV MRSA isolates collected from blood, central venous catheter tips, deep or superficial tissues, and sputum. RESULTS SCCmec type II MRSA risk factors for progression to infection were seb, enterotoxin gene cluster, psm-mec mutation, and vancomycin minimum inhibitory concentrations (MIC) of 1 or 2 mg/L as virulence factors (adjusted odds ratio [aOR] = 11.8; 95% confidence interval [CI]: 2.49-77.7; P = 0.004); solid tumour was a host factor (aOR = 25.9; 95% CI: 3.66-300; P = 0.003). SCCmec type IV MRSA risk factors were sea, cna, and vancomycin MIC of 1 or 2 mg/L as virulence factors (aOR = 3.14; 95% CI: 1.06-10.6; P = 0.049) and intravascular indwelling catheter as host factors (aOR = 3.78; 95% CI: 1.03-14.5; P = 0.045). Compared with SCCmec type II, SCCmec type IV MRSA resulted in more frequent bloodstream infections and higher Sequential Organ Failure Assessment scores. CONCLUSION We found that factors related to virulence genes and bacteriological and host characteristics are associated with SCCmec types II and IV MRSA infection and severity. These risk factors may be useful criteria for designing infection control programs.
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Affiliation(s)
- Yuki Nakano
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of Pharmacy, Saiseikai Futsukaichi Hospital, Chikushino, Fukuoka, Japan
| | - Masayuki Murata
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan.
| | - Yuji Matsumoto
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
| | - Azusa Ota
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
| | - Sho Yamasaki
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
| | - Hisao Otakeno
- Department of Pharmacy, Saiseikai Futsukaichi Hospital, Chikushino, Fukuoka, Japan
| | - Kenjo Yokoo
- Department of Pharmacy, Saiseikai Futsukaichi Hospital, Chikushino, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
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