Clinical characteristics and factors related to infection with SCCmec type II and IV Methicillin-resistant Staphylococcus aureus in a Japanese secondary care facility: a single-center retrospective study

Yuki Nakano, Murata Masayuki, Yuji Matsumoto, Kazuhiro Toyoda, Azusa Ota, Sho Yamasaki, Hisao Otakeno, Kenjo Yokoo, Nobuyuki Shimono

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Differences in virulence genes, including psm-mec, which is a phenol-soluble modulin-mec (PSM-mec) encoding gene, of predominant staphylococcal cassette chromosome mec (SCCmec) types II and IV Methicillin-resistant Staphylococcus aureus (MRSA) may contribute to the virulence and clinical features of MRSA in Japan. We aimed to clarify the clinical characteristics and risk factors of infection among SCCmec types II and IV MRSA isolates from a Japanese secondary acute care hospital. Methods: We analysed 58 SCCmec type II and 83 SCCmec type IV MRSA isolates collected from blood, central venous catheter tips, deep or superficial tissues, and sputum. Results: SCCmec type II MRSA risk factors for progression to infection were seb, enterotoxin gene cluster, psm-mec mutation, and vancomycin minimum inhibitory concentrations (MIC) of 1 or 2 mg/L as virulence factors (adjusted odds ratio [aOR] = 11.8; 95% confidence interval [CI]: 2.49–77.7; P = 0.004); solid tumour was a host factor (aOR = 25.9; 95% CI: 3.66–300; P = 0.003). SCCmec type IV MRSA risk factors were sea, cna, and vancomycin MIC of 1 or 2 mg/L as virulence factors (aOR = 3.14; 95% CI: 1.06–10.6; P = 0.049) and intravascular indwelling catheter as host factors (aOR = 3.78; 95% CI: 1.03–14.5; P = 0.045). Compared with SCCmec type II, SCCmec type IV MRSA resulted in more frequent bloodstream infections and higher Sequential Organ Failure Assessment scores. Conclusion: We found that factors related to virulence genes and bacteriological and host characteristics are associated with SCCmec types II and IV MRSA infection and severity. These risk factors may be useful criteria for designing infection control programs.

Original languageEnglish
Pages (from-to)355-362
Number of pages8
JournalJournal of Global Antimicrobial Resistance
Volume31
DOIs
Publication statusPublished - Dec 2022

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Immunology and Allergy
  • Immunology
  • Microbiology (medical)

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