Population dynamics among methicillin-resistant Staphylococcus aureus isolates in Germany during a 6-year period

TY - JOUR

T1 - Population dynamics among methicillin-resistant Staphylococcus aureus isolates in Germany during a 6-year period

AU - Schaumburg, Frieder

AU - Köck, Robin

AU - Mellmann, Alexander

AU - Richter, Laura

AU - Hasenberg, Felicitas

AU - Kriegeskorte, André

AU - Friedrich, Alexander W

AU - Gatermann, Sören

AU - Peters, Georg

AU - von Eiff, Christof

AU - Becker, Karsten

AU - Study Group

PY - 2012/10

Y1 - 2012/10

N2 - Methicillin-resistant Staphylococcus aureus (MRSA) originated from the health care setting but is now emerging in communities without health care contact (CA-MRSA) or in livestock (LA-MRSA). The impact on the whole MRSA population was assessed in a German prospective multicenter study. Thirty-three laboratories consecutively collected up to 50 MRSA isolates from infection or carriage during two sampling periods in 2004 to 2005 and 2010 to 2011. Patient-related data were collected using a standardized questionnaire. Methicillin resistance was confirmed by the detection of mecA or its homologue mecA(LGA251). The spa type and major virulence factors were analyzed for each isolate. In total, 1,604 (2004 to 2005) and 1,603 (2010 to 2011) MRSA isolates were analyzed; one isolate from each sampling period harbored mecA(LGA251). LA-MRSA increased significantly (odds ratio [OR] = 22.67, 95% confidence interval [CI] = 8.51 to 85.49, P < 0.0005) and spread over Germany, originating from northwestern regions. Panton-Valentine leukocidin-positive CA-MRSA rose significantly, particularly in southern Germany, but the proportion in 2010 to 2011 remained low (2.7%, OR = 2.80, 95% CI = 1.54 to 5.34, P < 0.0005). The emerging MRSA clones changed the MRSA population in Germany during a 6-year period significantly. The ongoing epidemiological shift and changes of MRSA sources create a need for revision of guidelines for MRSA infection control and treatment.

AB - Methicillin-resistant Staphylococcus aureus (MRSA) originated from the health care setting but is now emerging in communities without health care contact (CA-MRSA) or in livestock (LA-MRSA). The impact on the whole MRSA population was assessed in a German prospective multicenter study. Thirty-three laboratories consecutively collected up to 50 MRSA isolates from infection or carriage during two sampling periods in 2004 to 2005 and 2010 to 2011. Patient-related data were collected using a standardized questionnaire. Methicillin resistance was confirmed by the detection of mecA or its homologue mecA(LGA251). The spa type and major virulence factors were analyzed for each isolate. In total, 1,604 (2004 to 2005) and 1,603 (2010 to 2011) MRSA isolates were analyzed; one isolate from each sampling period harbored mecA(LGA251). LA-MRSA increased significantly (odds ratio [OR] = 22.67, 95% confidence interval [CI] = 8.51 to 85.49, P < 0.0005) and spread over Germany, originating from northwestern regions. Panton-Valentine leukocidin-positive CA-MRSA rose significantly, particularly in southern Germany, but the proportion in 2010 to 2011 remained low (2.7%, OR = 2.80, 95% CI = 1.54 to 5.34, P < 0.0005). The emerging MRSA clones changed the MRSA population in Germany during a 6-year period significantly. The ongoing epidemiological shift and changes of MRSA sources create a need for revision of guidelines for MRSA infection control and treatment.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Bacterial Proteins

KW - Bacterial Toxins

KW - Carrier State

KW - Exotoxins

KW - Female

KW - Genetic Variation

KW - Genotype

KW - Germany

KW - Humans

KW - Leukocidins

KW - Male

KW - Methicillin-Resistant Staphylococcus aureus

KW - Middle Aged

KW - Molecular Epidemiology

KW - Molecular Typing

KW - Penicillin-Binding Proteins

KW - Prospective Studies

KW - Staphylococcal Infections

KW - Staphylococcal Protein A

KW - Journal Article

KW - Multicenter Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1128/JCM.01174-12

DO - 10.1128/JCM.01174-12

M3 - SCORING: Journal article

C2 - 22814464

VL - 50

SP - 3186

EP - 3192

JO - J CLIN MICROBIOL

JF - J CLIN MICROBIOL

SN - 0095-1137

IS - 10

ER -