Methicillin resistance in S. aureus is defined as an Oxacillin (MIC) > 4microgram/mL. Isolates resistant to oxacillin or methicillin are alsoresistant to all beta - lactam agents including cephalosporins.
The mecA gene responsible for methicillin resistance
Staphylococcal cassette chromosome (SCCmec).
There are five SCCmec types (I-V) that vary in geneticmakeup and size.
Hospital AssociatedMRSA
Community Associated MRSA
HA - MRSA CA - MRSA
type I, II, or III SCCmec type IV SCCmec
Multiple antibiotic resistance
does not carry the multiple antibiotic resistance
Sensitive to Bactrim, Clindamycin & 50% fluoroquinolones.
Panton-Valentine leukocidin•SCCmec type IV CA-MRSA •skin •soft tissue•necrotizing pneumonia •MRSA USA300Prolonged hospitalization
12-29%
Prior skin infection
Previous antibiotic use
Illicit drug use
Tattoo recipients
Prison residence
Military personnel
A higher body mass index
Cosmetic body shaving
Physical contact with a person who has a draining lesion or is a carrier of MRSA
Sharing equipment that is not cleaned or laundered between users
Antibiotic use within three months before admission.
Hospitalization during the past 12 months.
Diagnosis of skin or soft-tissue infection at admission
HIV infection
Skin or soft tissue infections.
Necrotizing pneumonia.
Necrotizing fasciitis
Rapidly fatal septicemia
Endocarditis
Osteomyelitis
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