Clinical predictors of community-genotype ST72-methicillin-resistant Staphylococcus aureus-SCCmec type IV in patients with community-onset S. aureus infection.

OBJECTIVES: Community-genotype methicillin-resistant Staphylococcus aureus (MRSA) clones have emerged in the community worldwide and recently have been spreading into the hospitals. To identify predictors of sequence type 72-MRSA-SCCmec type IV (ST72-MRSA-IV) in patients with community-onset (CO) S. aureus infection, a case-control study was conducted among CO S. aureus infections, including healthcare-associated infections.

METHODS: Eighty-four patients with CO infections caused by ST72-MRSA-IV strains in Korea between 2007 and 2009 were selected as cases. Members of the control group were those with CO methicillin-susceptible S. aureus infections and they were matched by the admission date in a 1 : 1 ratio.

RESULTS: The most common type of infection was skin and soft tissue infection in both groups (48.8% versus 52.4%), followed by pneumonia. Female sex (OR 2.55, 95% CI 1.30-5.04), severe sepsis or septic shock (OR 3.05, 95% CI 1.09-8.55), prior hospitalization within the previous year (OR 2.18, 95% CI 1.10-4.32) and surgical site infection (SSI) (OR 4.63, 95% CI 1.38-15.59) were associated with ST72-MRSA-IV infections in multivariate analyses.

CONCLUSIONS: Female sex, SSI, severe sepsis or septic shock and prior hospitalization within the previous year were predictors of ST72-MRSA-IV among patients with CO S. aureus infection.