[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]
MRSA infections among patients in the emergency department: a European multicentre study
C. Bouchiat1,*, S. Curtis2, I. Spiliopoulou3, M. Bes1, C. Cocuzza4, I. Codita5, C. Dupieux1, N. Giormezis3, A. Kearns2, F. Laurent1, S. Molinos6,7, R. Musumeci4, C. Prat6,7, M. Saadatian-Elahi8, E. Tacconelli9, A. Tristan1, B. Schulte10 and F. Vandenesch1 on behalf of the ESCMID Study Group on Staphylococci and Staphylococcal Infections (ESGS)
Author Affiliations: 1National Reference Center for Staphylococci, 59 Bd Louis Pinel, 69677 Bron cedex, Lyon, France; 2Staphylococcus Reference Service, Public Health England, 61 Colindale Avenue London NW9 5EQ, UK; 3National Reference Laboratory for Staphylococci, University of Patras, University Campus, Rion 26504, Patras, Greece; 4Laboratory of Clinical Microbiology and Virology, University of Milano-Bicocca, Via Cadore 48, Monza, Italy; 5Cantacuzino National Institute of Research, Splaiul Independentei 103, RO-050096 Bucharest, Romania; 6Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Badalona, Spain; 7CIBER Enfermedades Respiratorias. Carretera del Canyet s/n. 08916 Badalona, Spain; 8Epidemiology unit, Hospices Civils de Lyon, Place d’Arsonval, 69008 Lyon, France; 9Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tuebingen, Geissweg 3, 72076 Tuebingen, Germany; 10Institut für Mikrobiologie und Infektionsmedizin, University Hospital Tuebingen, Auf der Morgenstelle 28, 72076 Tuebingen, Germany
*Corresponding author. CNR des Staphylocoques—Centre de Biologie Est, 59 Boulevard Louis Pinel, 69677 Bron cedex, France. Tel: +33-4-27-85-52-57; Fax: +33-4-72-35-73-35; E-mail: firstname.lastname@example.org
Received July 26, 2016. Revision requested August 26, 2016. Revision received September 9, 2016. Accepted September 13, 2016.
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.
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.
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.
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.
© The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: email@example.com
Keywords: Staphylococcus Aureus; MRSA; Antibiotics; Drugs Resistance; European Region.