Major ArticleEmergence of community-associated methicillin-resistant Staphylococcus aureus USA 300 clone as a cause of health care-associated infections among patients with prosthetic joint infections
Section snippets
Patient population
All patients who had a total knee (TKA) or total hip (THA) arthroplasty performed at Grady Memorial Hospital (a 1000-bed, public inner-city hospital in Atlanta, GA) between 1 January 2003 and 30 January 2004 were included in the study. The study was approved by the Emory University Institutional Review Board (IRB) and the Grady Research Oversight Committee.
Data collection, cultures, and molecular typing
Medical and laboratory records of patients who had a joint arthroplasty performed during the study period were reviewed, and data were
Patients
Over a 13-month period (January 2003-January 2004), 9 (9.5%) of 95 patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) developed a prosthetic joint infection (7 patients with a TKA infection and 2 with a THA infection) (Fig 1). The mean age of patients was 58 years (range, 28-94 years). The majority of patients was African Americans, 78 (82%), 10 (11%) were white, 4 (4%) were Hispanic, and 3 (3%) were other race; overall, 60% of patients were female. All
Discussion
We have demonstrated the occurrence of health care-associated infections due to the CA-MRSA USA300 clone at our institution. Five of 9 patients with prosthetic joint infections had CA-MRSA isolates recovered from the prosthetic joint within 1 month of surgery. All 5 CA-MRSA isolates had identical antibiograms. The presence of this “community-associated” susceptibility pattern for the MRSA isolates suggested that these health care-associated infections were caused by CA-MRSA. Only 2 of 5 MRSA
References (25)
- et al.
Genome and virulence determinants of high virulence community-acquired MRSA
Lancet
(2002) The changing epidemiology of Staphylococcus aureus?
Emerg Infect Dis
(2001)- et al.
Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk
JAMA
(1998) Community-acquired methicillin-resistant Staphylococcus aureus in a rural American Indian community
JAMA
(2001)Outbreaks of community-associated methicillin-resistant Staphylococcus aureus skin infections--Los Angeles County, California, 2002-2003
MMWR Morb Mortal Wkly Rep
(2003)Methicillin-resistant Staphylococcus aureus infections in correctional facilities---Georgia, California, and Texas, 2001-2003
MMWR Morb Mortal Wkly Rep
(2003)- et al.
Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection
JAMA
(2003) - King MD, Terrell BJ, Wang YF, Ray SM, Blumberg HM. Emergence of community-acquired methicillin-resistant S. aureus...
- et al.
Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence
Emerg Infect Dis
(2003) - et al.
Pulsed-field gel electrophoresis typing of oxacillin-resistant Staphylococcus aureus isolates from the United States: establishing a national database
J Clin Microbiol
(2003)
Hospital transmission of community-acquired methicillin-resistant Staphylococcus aureus among postpartum women
Clin Infect Dis
Performance standards for antimicrobial susceptibility testing. NCCLS approved standard M100-S9
Cited by (172)
Effectiveness of active nasal surveillance culture for Methicillin-resistant Staphylococcus aureus in patients undergoing colorectal surgery
2020, Journal of Infection and ChemotherapyLipid-polymer hybrid nanoparticles carrying linezolid improve treatment of methicillin-resistant Staphylococcus aureus (MRSA) harbored inside bone cells and biofilms
2020, European Journal of Pharmaceutics and BiopharmaceuticsMolecular characterisation of methicillin-resistant Staphylococcus aureus isolated from patients at a tertiary care hospital in Hyderabad, South India
2020, Indian Journal of Medical MicrobiologySilicon nitride (SiN): An emerging material for dental implant applications
2020, Dental Implants: Materials, Coatings, Surface Modifications and Interfaces with Oral TissuesPrevention of Infection in Orthopedic Prosthetic Surgery
2017, Infectious Disease Clinics of North America
Supported by the Emory Mentored Clinical Research Scholars Program (NIH/NCRR K12 RR 017643 to H.M.B. and M.D.K. and NIH/NIAID K23 AI054371-01AI to M.D.K.).