SUNG-CHING PANJANN-TAY WANGLauderdale T.-L.Ko W.-C.Chen Y.-S.Liu J.-W.Lau Y.-J.Wang L.-H.Liu K.-S.Liao C.-H.Lin S.-Y.Hu B.-S.SHAN-CHWEN CHANG2020-09-302020-09-3020140929-6646https://www.scopus.com/inward/record.uri?eid=2-s2.0-84902796979&doi=10.1016%2fj.jfma.2012.05.012&partnerID=40&md5=c13504d9400892c95cc5ddba87c23668https://scholars.lib.ntu.edu.tw/handle/123456789/515785Background/Purpose: After community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified, new community-onset, healthcare-associated MRSA (HA-MRSA-CO) infections have been noticed as MRSA infection in patients with community-onset infection who have underlying conditions resulting in frequent exposure to the healthcare system. However, previous studies have not thoroughly investigated whether HA-MRSA-CO has characteristics resembling those of CA-MRSA or hospital-onset, healthcare-associated MRSA (HA-MRSA-HO) infection. Methods: A multicenter, retrospective study was conducted to analyze the clinical and microbiological data of patients with clinical isolates of MRSA from nine hospitals in Taiwan. Results: In total, 203 patients with MRSA isolates, including 27 patients with CA-MRSA (13.3%), 59 with HA-MRSA-CO (29.1%), and 117 with HA-MRSA-HO (57.6%), were studied. Compared to HA-MRSA-HO isolates, the CA-MRSA and HA-MRSA-CO isolates were associated with a higher proportion of skin and soft tissue infections (81.8% and 65.3% vs. 40.5%, p=. 0.001 and p=. 0.002) as well as lesser rate of resistance to ciprofloxacin (33.3% and 50.9% vs. 74.4%, p<. 0.001 and p=. 0.002), gentamicin (44.4% and 64.4% vs. 84.6%, p<. 0.001 and p=. 0.002), and trimethoprim/sulfamethoxazole (33.3% and 42.4% vs. 58.1%, p=. 0.02 and p=. 0.048), and a lower 30-day all-cause mortality rate (7.4% and 0% vs. 20.9%, p<. 0.001). Most of the CA-MRSA isolates were classified as staphylococcal cassette chromosome mec (SCC. mec) type VT (11/27, 40.7%), whereas most HA-MRSA-HO isolates were classified as SCC. mec type III (66/117, 56.4%). Conclusion: The CA-MRSA, HA-MRSA-CO, and HA-MRSA-HO clinical isolates significantly differed in their clinical presentations and molecular characteristics. ? 2012.[SDGs]SDG3chloramphenicol; ciprofloxacin; clindamycin; cotrimoxazole; erythromycin; gentamicin; linezolid; rifampicin; teicoplanin; tetracycline; vancomycin; antiinfective agent; adult; aged; antibiotic resistance; article; bacterial chromosome; bacteriophage typing; bacterium examination; bacterium isolate; bloodstream infection; catheter infection; community acquired infection; controlled study; disease association; female; hospital infection; human; major clinical study; male; medical record review; methicillin resistant Staphylococcus aureus; methicillin resistant Staphylococcus aureus infection; middle aged; minimum inhibitory concentration; molecular epidemiology; mortality; nonhuman; respiratory tract infection; retrospective study; soft tissue infection; staphylococcal cassette chromosome mec; staphylococcal skin infection; surgical infection; Taiwan; urinary tract infection; clinical trial; Community-Acquired Infections; cross infection; drug effects; genetics; methicillin resistant Staphylococcus aureus; microbial sensitivity test; microbiology; molecular typing; multicenter study; Staphylococcal Infections; very elderly; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Chromosomes, Bacterial; Community-Acquired Infections; Cross Infection; Female; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Middle Aged; Molecular Typing; Retrospective Studies; Staphylococcal Infections; Taiwanjournal article10.1016/j.jfma.2012.05.012249611812-s2.0-84902796979