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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2009-10-19
pubmed:abstractText
We analysed risk factors for nosocomial meticillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) in three Indian hospitals. We also determined antimicrobial resistance patterns and genotypic characteristics of MRSA isolates using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and staphylococcal cassette chromosome (SCCmec) typing. Medical records of 709 patients admitted to three tertiary hospitals with nosocomial S. aureus SSTIs were clinically evaluated. Antimicrobial susceptibility testing of patient isolates was performed in accordance with Clinical and Laboratory Standards Institute guidelines, with meticillin and mupirocin resistance confirmed by multiplex polymerase chain reaction. PFGE analysis of 220 MRSA isolates was performed, followed by MLST and SCCmec typing of a selected number of isolates. MRSA was associated with 41%, 31% and 7.5% of infections at the three hospitals, respectively. Multiple logistic regression analysis identified longer duration of hospitalisation [odds ratio (OR): 1.78; OR: 2.83 for >or=20 days], intra-hospital transfer (OR: 1.91), non-infectious skin conditions (3.64), osteomyelitis (2.9), neurological disorders (2.22), aminoglycoside therapy (1.74) and clindamycin therapy (4.73) as independent predictors for MRSA SSTIs. MRSA isolates from all three hospitals were multidrug resistant, with fifteen clones (I-XV) recognised. A majority of the strains possessed type III cassette. The common sequence type (ST) 239 was considered the signature MLST sequence for PFGE clone III. This major MRSA clone III was closely related to the UK EMRSA-1 and was significantly more resistant to antibiotics. Dissemination of multidrug-resistant MRSA clones warrants continuous tracking of resistant genotypes in the Indian subcontinent.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1532-2939
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
73
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
253-63
pubmed:meshHeading
pubmed-meshheading:19782432-Adolescent, pubmed-meshheading:19782432-Adult, pubmed-meshheading:19782432-Anti-Bacterial Agents, pubmed-meshheading:19782432-Bacterial Proteins, pubmed-meshheading:19782432-Bacterial Typing Techniques, pubmed-meshheading:19782432-Child, pubmed-meshheading:19782432-Cross Infection, pubmed-meshheading:19782432-Electrophoresis, Gel, Pulsed-Field, pubmed-meshheading:19782432-Female, pubmed-meshheading:19782432-Hospitals, pubmed-meshheading:19782432-Humans, pubmed-meshheading:19782432-India, pubmed-meshheading:19782432-Male, pubmed-meshheading:19782432-Methicillin-Resistant Staphylococcus aureus, pubmed-meshheading:19782432-Microbial Sensitivity Tests, pubmed-meshheading:19782432-Middle Aged, pubmed-meshheading:19782432-Risk Factors, pubmed-meshheading:19782432-Sequence Analysis, DNA, pubmed-meshheading:19782432-Soft Tissue Infections, pubmed-meshheading:19782432-Staphylococcal Skin Infections
pubmed:year
2009
pubmed:articleTitle
Clinical and molecular characteristics of nosocomial meticillin-resistant Staphylococcus aureus skin and soft tissue isolates from three Indian hospitals.
pubmed:affiliation
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India. b_neha2002@yahoo.co.in
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't