Clinical Epidemiological Studies on Methicillin Resistant and Suscepti ble Staphylococci
Klinisch epidemiologisch onderzoek naar methicilline resistente en gevoelige staphylococcen
Staphylococcus aureus was discovered for the fi rst ti me in the 1880s . Since then, S. aureus has been shown to be a major pathogenic Gram-positi ve bacterium, causing relati vely mild superfi cial infecti ons (e.g., furuncles or boils, post-operati ve wound infecti ons) to lifethreatening invasive infecti ons (e.g., sepsis, endocarditi s) . In the early 1940s, prior to the introducti on of penicillin, the mortality rate of individuals with a severe S. aureus infecti on was about 80% . The emerge of strains with penicillin resistance was reported for the fi rst ti me in 1948 . Since 1960, approximately 80% of all S. aureus strains became resistant to penicillin. Therefore, methicillin was introduced in 1959 to treat infecti ons caused by this penicillin-resistant S. aureus . In 1961, two years aft er the introducti on of methicillin, there were reports from the United Kingdom of S. aureus isolates that had acquired resistance to methicillin (methicillin-resistant S. aureus, MRSA) . The cause of the development of methicillin resistance was the acquisiti on of the mecA gene . During the last decades, MRSA has become the most prevalent anti bioti c-resistant pathogen in hospitals in many parts of the world and a growing number of reports describe the increasing prevalence in various populati ons in the community [8-10]. In additi on, various healthcareassociated methicillin-resistant S. aureus (HA-MRSA) clones disseminated worldwide . Furthermore, since the 1990s, virulent community-associated MRSA (CA-MRSA) clones, characterized by the presence of the toxin Panton-Valenti ne Leukocidin (PVL), have spread worldwide, fi rst in the community, but now they are also emerging in healthcare faciliti es [11, 12]. The CA-MRSA prevalence worldwide remains low, but an increasing prevalence has been reported [10, 13] and, some people tend to believe that the disti ncti on between CA-MRSA and HA-MRSA is beginning to fade [2, 14]. A CA-MRSA clone which is frequently isolated is the socalled USA-300 strain. This strain has proved to be able to transmit between individuals and causes outbreaks of skin infecti ons and boils.
|Promotor||H.A. Verbrugh (Henri)|
|Publisher||Erasmus University Rotterdam|
Mollema, F.P.N. (2009, November 18). Clinical Epidemiological Studies on Methicillin Resistant and Suscepti ble Staphylococci. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/78217