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