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CAMRSACommunity Associated Methicillin-Resistant Staphylococcus Aureus
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A small percentage of the temporally defined CAMRSA isolates (i.e., those either from outpatients or cultured <72 hours after admission from inpatients) was resistant only to [beta]-lactam antimicrobial drugs; this resistance pattern was more common among pediatric (9.6%) than adult (3.6%) isolates (p = 0.001) (Table 3).
Although part of this increase in the metropolitan area from 1998 was due to an increase in EMRSA notifications, most can be attributed to CAMRSA (unpub.
In conclusion, our report suggests that mecA (or PBP2a) detection may help manage serious, community-acquired, non-multidrug-resistant MRSA infections because of the potential contusion between BORSA and CAMRSA.
This suggests that the initial differences in susceptibility were not due to more resistant CA-MRSA strains causing invasive disease, but rather that more of the invasive disease isolates classified as CAMRSA were actually HA-MRSA strains, which are typically resistant to more antimicrobial agents.
(17,19) Our findings corroborate these data, since CAMRSA isolates have been identified only in the anal and oropharyngeal sites.
reported that 8% of isolates were nontypeable for SCCmec.3 Some studies have reported the spread of CAMRSA SCCmec type IV strains in hospital settings in Europe United States and Switzerland.1617 CAMRSA is most likely carried in the upper respiratory tract or various cutaneous and mucosal sites and introduced into the hospital by patients or nursing staff.1819Another genetic feature of CA-MRSA is the high prevalence of the PVL gene which encodes a cytotoxin that causes leukocyte destruction and tissue necrosis.
In clinical settings it is important to differentiate between HA-MRSA and CAMRSA infections to help determine the most effective treatment and to reduce the rate of infections in hospitals and the community.
CAMRSA has been recognized as a pathogen in adults and children without traditional risk factors for MRSA acquisition.
As atuais recomendacoes tem como objetivo diminuir a taxa de transmissao do MRSA dentro dos hospitais, porem a efetividade das intervencoes para controlar as cepas CAMRSA sao desconhecidas.
Similarly, Harris et al (45) used whole-genome sequencing to construct a high-resolution map tracing the intercontinental spread and evolution of epidemic CAMRSA strains for more than 4 decades.
(SCANVIC et al, 2001, PAPIA et al, 1999 apud CAVALCANTI, et al, 2006) Desse modo, existe a possibilidade de que muitos pacientes portadores ou infectados por CAMRSA que nao passem por triagem para MRSA, favorecam a disseminacao comunitaria dessa cepa.