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CA-MRSA Infection in China: Epidemiology, Molecular Characteristics, Treatment, and Outcome

Conditions
Community-Acquired Infections
Methicillin-resistant Staphylococcus Aureus
Interventions
Other: None Intervention
Registration Number
NCT03064464
Lead Sponsor
Sir Run Run Shaw Hospital
Brief Summary

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), strains of MRSA that are able to infect otherwise healthy people outside of hospital settings, emerged in the late 1990s and have recently arisen in many countries around the globe. CA-MRSA strains are usually distinguished from their HA-MRSA counterparts by the following characteristics: Firstly, CA-MRSA strains are usually susceptible to non-lactam antibiotics. Secondly, CA-MRSA harbors type IV and V SCCmec elements, which are shorter than the traditional type I, II, and III SCCmec elements found in HA-MRSA strains. Thirdly, certain successful clones are associated with outbreaks of CA-MRSA infections reported in specific geographical locations. For example, ST1 and ST8 isolates are mostly reported in the USA and Canada, ST80 isolates are commonly found in Europe, and ST59 isolates are encountered in the Asia-Pacific region. Notably, all these characteristics have substantial limitations for discriminating CA-MRSA isolates due to their complex backgrounds. Although there were more and more studies of CA-MRSA in European countries and the US, few national epidemiological data were available about China. In this study, we investigated the epidemiological, clinical and molecular characteristics of CA-MRSA isolates recovered in Chinese hospitals, in order to understand the changing epidemiology of MRSA in China.

Detailed Description

Eligibility criteria:

1. Inclusion criteria: Patients (Child, Adult) with infections caused by S. aureus from the sites as follows: blood stream, skin or soft tissue, cerebrospinal fluid, bone and joint, genitourinary tract, infection of indwelling intravascular device, surgical wound, respiratory tract (organism grown from sputum and infiltrate on chest X-ray), peritoneal fluid or other otherwise sterile body fluids.

2. Exclusion criteria: Patients with S. aureus from anterior nares or throat swabs cultures (colonization).

Outcome measures:

1. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection rates in patients with S. aureus infections in Chinese hospitals.

2. Risk factors and clinical outcomes of CA-MRSA infection

3. Molecular characteristics of CA-MRSA isolates recovered in Chinese hospitals.

Definition:

A MRSA infection was considered to be HA-MRSA by the CDC epidemiologic definitions if, in the year prior to culture, the subject had surgery, hospitalization, hemodialysis or a stay in a long-term care facility, if an indwelling vascular catheter was in place at the time of culture, or if the subject was an inpatient hospitalized for 2 days at the time of culture. Otherwise, the subject was considered to have a CA-MRSA infection.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
5400
Inclusion Criteria
  • Patients (Child, Adult) with infections caused by S. aureus from the sites as follows: blood stream, skin or soft tissue, cerebrospinal fluid, bone and joint, genitourinary tract, infection of indwelling intravascular device, surgical wound, respiratory tract (organism grown from sputum and infiltrate on chest X-ray), peritoneal fluid or other otherwise sterile body fluids.
Exclusion Criteria
  • Patients with S. aureus from anterior nares or throat swabs cultures for colonization screening purpose.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
CA-MRSA infectionNone InterventionNone intervention
HA-MRSA infectionNone InterventionNone intervention
CA-MSSA infectionNone InterventionNone intervention
Primary Outcome Measures
NameTimeMethod
The incidence of CA-MRSA infections in ChinaDuring the study period (Two years)

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection rates in patients with S. aureus infections in Chinese hospitals

Secondary Outcome Measures
NameTimeMethod
Clonal Distribution of CA-MRSA in ChinaDuring the study period (Two years)

The distribution of sequence types in CA-MRSA isolates from China

Trial Locations

Locations (1)

Sir Run Run Shaw Hospital

🇨🇳

Hangzhou, Zhejiang, China

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