Import of community-associated, methicillin-resistant Staphylococcus aureus to Europe through skin and soft-tissue infection in intercontinental travellers, 2011-2016
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Import of community-associated, methicillin-resistant Staphylococcus aureus to Europe through skin and soft-tissue infection in intercontinental travellers, 2011-2016. / Nurjadi, D; Fleck, R; Lindner, A; Schäfer, J; Gertler, M; Mueller, A; Lagler, H; Van Genderen, P J J; Caumes, E; Boutin, S; Kuenzli, E; Gascon, J; Kantele, A; Grobusch, M P; Heeg, K; Zanger, P; StaphTrav Network.
in: CLIN MICROBIOL INFEC, Jahrgang 25, Nr. 6, 06.2019, S. 739-746.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Import of community-associated, methicillin-resistant Staphylococcus aureus to Europe through skin and soft-tissue infection in intercontinental travellers, 2011-2016
AU - Nurjadi, D
AU - Fleck, R
AU - Lindner, A
AU - Schäfer, J
AU - Gertler, M
AU - Mueller, A
AU - Lagler, H
AU - Van Genderen, P J J
AU - Caumes, E
AU - Boutin, S
AU - Kuenzli, E
AU - Gascon, J
AU - Kantele, A
AU - Grobusch, M P
AU - Heeg, K
AU - Zanger, P
AU - StaphTrav Network
AU - Ramharter, Michael
N1 - Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
PY - 2019/6
Y1 - 2019/6
N2 - OBJECTIVES: Recently, following import by travel and migration, epidemic community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has caused nosocomial outbreaks in Europe, sometimes with a fatal outcome. We describe clinico-epidemiological characteristics of CA-MRSA detected by the European Network for the Surveillance of imported S. aureus (www.staphtrav.eu) from May 2011 to November 2016.METHODS: Sentinel surveillance at 13 travel clinics enrolling patients with travel-associated skin and soft-tissue infection (SSTI) and analysing lesion and nose swabs at one central laboratory.RESULTS: A total of 564 independent case-patients with SSTI were enrolled and had 374 (67%) S. aureus-positive lesions, of which 14% (51/374) were MRSA. The majority of CA-MRSA isolates from SSTI were Panton-Valentine leucocidin (PVL) -positive (43/51, 84%). The risk of methicillin-resistance in imported S. aureus varied by travel region (p <0.001) and was highest in Latin America (16/57, 28%, 95% CI 17.0-41.5) and lowest in Sub-Saharan Africa (4/121, 3%, 95% CI 0.9-8.3). Major epidemic clones (USA300 / USA300 Latin-American Variant, Bengal Bay, South Pacific) accounted for more than one-third (19/51, 37%) of CA-MRSA imports. CA-MRSA SSTI in returnees was complicated (31/51 multiple lesions, 61%; 22/50 recurrences, 44%), led to health-care contact (22/51 surgical drainage, 43%; 7/50 hospitalization, 14%), was transmissible (13/47 reported similar SSTI in non-travelling contacts, 28%), and associated with S. aureus nasal colonization (28 of 51 CA-MRSA cases, 55%; 24 of 28 colonized with identical spa-type in nose and lesion, 85%).CONCLUSIONS: Travel-associated CA-MRSA SSTI is a transmissible condition that leads to medical consultations and colonization of the infected host.
AB - OBJECTIVES: Recently, following import by travel and migration, epidemic community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has caused nosocomial outbreaks in Europe, sometimes with a fatal outcome. We describe clinico-epidemiological characteristics of CA-MRSA detected by the European Network for the Surveillance of imported S. aureus (www.staphtrav.eu) from May 2011 to November 2016.METHODS: Sentinel surveillance at 13 travel clinics enrolling patients with travel-associated skin and soft-tissue infection (SSTI) and analysing lesion and nose swabs at one central laboratory.RESULTS: A total of 564 independent case-patients with SSTI were enrolled and had 374 (67%) S. aureus-positive lesions, of which 14% (51/374) were MRSA. The majority of CA-MRSA isolates from SSTI were Panton-Valentine leucocidin (PVL) -positive (43/51, 84%). The risk of methicillin-resistance in imported S. aureus varied by travel region (p <0.001) and was highest in Latin America (16/57, 28%, 95% CI 17.0-41.5) and lowest in Sub-Saharan Africa (4/121, 3%, 95% CI 0.9-8.3). Major epidemic clones (USA300 / USA300 Latin-American Variant, Bengal Bay, South Pacific) accounted for more than one-third (19/51, 37%) of CA-MRSA imports. CA-MRSA SSTI in returnees was complicated (31/51 multiple lesions, 61%; 22/50 recurrences, 44%), led to health-care contact (22/51 surgical drainage, 43%; 7/50 hospitalization, 14%), was transmissible (13/47 reported similar SSTI in non-travelling contacts, 28%), and associated with S. aureus nasal colonization (28 of 51 CA-MRSA cases, 55%; 24 of 28 colonized with identical spa-type in nose and lesion, 85%).CONCLUSIONS: Travel-associated CA-MRSA SSTI is a transmissible condition that leads to medical consultations and colonization of the infected host.
KW - Adult
KW - Africa South of the Sahara
KW - Aged
KW - Community-Acquired Infections/epidemiology
KW - Cross Infection/epidemiology
KW - Cross-Sectional Studies
KW - Epidemiological Monitoring
KW - Europe/epidemiology
KW - Female
KW - Genotype
KW - Hospitalization
KW - Humans
KW - Latin America
KW - Male
KW - Methicillin-Resistant Staphylococcus aureus/classification
KW - Middle Aged
KW - Molecular Typing
KW - Soft Tissue Infections/epidemiology
KW - Staphylococcal Skin Infections/epidemiology
KW - Travel-Related Illness
KW - Young Adult
U2 - 10.1016/j.cmi.2018.09.023
DO - 10.1016/j.cmi.2018.09.023
M3 - SCORING: Journal article
C2 - 30315958
VL - 25
SP - 739
EP - 746
JO - CLIN MICROBIOL INFEC
JF - CLIN MICROBIOL INFEC
SN - 1198-743X
IS - 6
ER -
