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Korean J healthc assoc Infect Control Prev 2009; 14(1): 24-35

Published online January 1, 2009 https://doi.org/10.14192/kjicp.2009.14.1.24

Copyright © Korean Society for Healthcare-associated infection Control and Prevention

Community and Hospital Onset Methicillin-resistant Staphylococcus aureus in a Tertiary Care Teaching Hospital

Hyang Mi Mun1,6, Soon duck Kim2, Byung-chul Chun2, Sang-oh Lee3, Mi-Na Kim4, Jeong Jae Sim5,
Hye Ran Choi6, Hye Jin Park6, Min Kyoung Han6, Sun Hee Kwak6, Min Jee Hong6, and Jun Hee Woo3,6

Graduate School of Public Health, Korea University1, Department of Preventive Medicine, College of Medicine, Korea University2,
Division of Infectious Diseases, University of Ulsan College of Medicine and Asan Medical Center3,
Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center4,
Department of Clinical Nursing The Graduate school of Industrial Technology University of Ulsan5,
Department of Infection Control, Asan Medical Center6, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: This study evaluated the clinical characteristics and risk factors associated with community and hospital onset MRSA isolated from patients admitted to a tertiary care teaching hospital.
Methods: The study was carried out on MRSA isolated from clinical specimens of patients admitted into the wards and the intensive care unit in a 2,200-bed tertiary care teaching hospital from January 1st through December 31st, 2007. In order to identify the risk factors associated with MRSA acquisition, the medical records were reviewed. All statistics were computed using SPSS version 14.0.
Results: Of the 835 MRSA isolates, 179 (21.4%) were CO-MRSA and 656 (78.6%) were HO-MRSA. Of the 179 CO-MRSA isolates, 6 (3.4%) were CA-MRSA. Multiple logistic regression analysis showed that a history of using medical device or antibiotics within 1 year before the isolation of MRSA were significant risk factors for HO-MRSA, and a history of hospitalization within 1 year before the isolation of MRSA was a significant risk factor for CO-MRSA. Analysis on the antibiotics administered within 1 year before the isolation of MRSA showed that levofloxacin, macrolides, 1st generation cephalosporins, 3rd generation cephalosporins, 4th generation cephalosporins, vancomycin, metronidazole, and carbapenem were all significant risk factors for HO-MRSA and that TMP/SMX was a significant risk factor for CO-MRSA. Of the 6 (3.4%) CA-MRSA isolates, 1 (16.7%) was the pathogen responsible for soft tissue infection. No patients died from the CA-MRSA infection.
Conclusion: MRSA isolated from clinical specimens of patients admitted into the wards and the ICU in a tertiary care teaching hospital was usually HO-MRSA, CO-MRSA and HO-MRSA usually had at least one of the risk factors associated with MRSA acquisition, and CO-MRSA was mainly HACO-MRSA.

Keywords: Methicillin-resistant Staphylococcus aureus (MRSA), Community-onset MRSA (CO-MRSA), Hospital-onset MRSA (HO-MRSA), Community-associated MRSA (CA-MRSA), Healthcare-associated community-onset MRSA (HACO-MRSA)

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