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Ten-Year Prevalence Trends of Phenotypically Identified Community-Associated Methicillin-Resistant Staphylococcus aureus Strains in Clinical Specimensopen access

Authors
Yu, So HyunLee, Jeong HyunKim, Min-ChulChoi, Seong-HoChung, Jin-WonLee, Mi-Kyung
Issue Date
Jul-2021
Publisher
KOREAN SOC LABORATORY MEDICINE
Keywords
Community-associated methicillin-resistant Staphylococcus aureus; Prevalence; Phenotypic changes; Antimicrobial resistance
Citation
ANNALS OF LABORATORY MEDICINE, v.41, no.4, pp 386 - 393
Pages
8
Journal Title
ANNALS OF LABORATORY MEDICINE
Volume
41
Number
4
Start Page
386
End Page
393
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/48056
DOI
10.3343/alm.2021.41.4.386
ISSN
2234-3806
2234-3814
Abstract
Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains were first detected in hospitals in Korea between the late 2000s and early 2010s. However, there is limited information regarding the prevalence of CA-MRSA strains among hospital isolates and their phenotypic changes over the last decade. We investigated the prevalence trend of CA-MRSA strains isolated from different clinical specimens and their phenotypic changes between September 2009 and September 2019. Methods: CA-MRSA strains were phenotypically identified by confirming their resistance to penicillin (PCN) and oxacillin (OXA) and evaluating their susceptibility to trimethoprim-sulfamethoxazole, rifampin, fusidic acid, tetracycline, and at least one of the following four antimicrobials: clindamycin (CLI), erythromycin (ERY), ciprofloxacin (CIP), and gentamicin (GEN). A CA-MRSA strain that exhibited resistance to ERY, CLI, CIP, or GEN was classified as having resistance pattern I, II, Ill, or IV, respectively, regardless of its resistance to other antimicrobial agents. Results: Of the 8,278 MRSA isolates identified in specimens obtained two days after admission, 1,385 (16.73%) were CA-MRSA strains. The prevalence of CA-MRSA strains increased from 12.2% to 26.6% (3.21% per period, P=0.05). Resistance type analysis revealed an increasing trend in the prevalence of PCN/OXA-resistant (1.84%; P=0.049) and PCN/OXA/ERY/CLI/CIP-resistant (0.98%; P=0.04) CA-MRSA strains and in resistance pattern III strains (2.08%; P=0.004). Conclusions: The prevalence of CA-MRSA strains in Korea has increased significantly over the last decade, and CA-MRSA strains have gained phenotypic diversity beyond PCN/OXA-resistance, including antimicrobial resistance to non-beta-lactams, especially CIP.
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