Community-acquired methicillin-resistant Staphylococcus aureus in Taiwan
Chih-Jung Chen, Yhu-Chering Huang
Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan
Received: September 28, 2005
Revised: September 30, 2005
Accepted: October 4, 2005
Corresponding author:
Dr. Yhu-Chering Huang, Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital, 5, Fu-Shin Street, Kweishan 333, Taoyuan, Taiwan. E-mail: ychuang@adm.cgmh.org.tw
Methods:
Staphylococcus aureus is a major cause of infections in both hospitals and communities, and is exhibiting increasing resistance to methicillin (methicillin-resistant S. aureus, MRSA) and related β-lactams. MRSA is usually considered a nosocomial pathogen, but increasingly it is acquired in the community. In Taiwan, MRSA was colonized in a substantial proportion of healthy children and accounted for 25% to 75% of childhood community-acquired (CA) S. aureus infections. From the preliminary data, the isolates of sequence type (ST) 59 by multilocus sequence typing method appeared to be the major clone of CA-MRSA in northern Taiwan. Compared with those reported from the US and other countries, CA-MRSA isolates in Taiwan did not always harbor type IV staphylococcal cassette chromosome (SCCmec) and were resistant to multiple non-β-lactam antibiotics, including clindamycin and macrolides. Molecular evidence suggested transmission of the community strain of MRSA into the hospital setting, and that the community strain had became a health care-associated pathogen. The treatment of putative CA S. aureus infection should be stratified according to the severity and the disease entity.
Key words:
Community-acquired infections, methicillin resistance, review, Staphylococcus aureus, Taiwan
J Microbiol Immunol Infect 2005;38:376-382.
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