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Volume 12, Number 1—January 2006
Letter

Community Case of Methicillin-resistant Staphylococcus aureus Infection

Lee Nelson*, Clive S. Cockram*, Grace Lui*, Rebecca Lam*, Edman Lam*, Raymond Lai*, and Margaret Ip*Comments to Author 
Author affiliations: *Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China

Main Article

Table

Comparison between methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus

Strain and major resistance mechanism*
MSSA/penicillinase production BORSA/novel methicillinase ± penicillinase hyperproduction CA-MRSA/PBP alteration HA-MRSA/PBP alteration
PBP2a detection (e.g., latex-agglutination method) + +
mecA gene detection (e.g., PCR method) + (SCCmec IVa) +
PVL gene detection (PCR method) Infrequent (<5%) Data limited Frequent (>66%–100%) Infrequent (<5%)
Coresistance to non–β-lactam antimicrobial drugs ± ± + +++
Usual antimicrobial drugs to which MSSA is susceptible PRP (e.g., cloxacillin), β-lactam/β-lactamase–inhibitor combinations (e.g., ampicillin /sulbactam); linezolid, vancomycin, erythromycin, clindamycin, trimethoprim-sulfamethoxazole, fluoroquinolones, rifampin, gentamicin, fusidic acid, tetracyclines PRP (e.g., cloxacillin), β-lactam/β-lactamase–inhibitor combinations (e.g., ampicillin/sulbactam), other drugs to which MSSA is potentially susceptible Vancomycin, linezolid, rifampin, gentamicin, trimethoprim-sulfamethoxazole, fusidic acid, tetracyclines, fluoroquinolone, clindamycin† Vancomycin, linezolid; ± fusidic acid, rifampin, gentamicin, trimethoprim-sulfamethoxazole, fluoroquinolones‡

*MSSA, methicillin-susceptible Staphylococcus aureus; BORSA, borderline oxacillin-resistant S. aureus; MRSA, methicillin-resistant S. aureus; CA-MRSA, community-associated MRSA; HA-MRSA, hospital-associated MRSA; PBP, penicillin-binding protein; PCR, polymerase chain reaction; PVL, Panton-Valentine leukocidin; PRP, penicillinase-resistant penicillins; +, positive; –, negative. ±, occasionally present; +++, usually present.
†Concern over inducible clindamycin resistance; also, macrolide resistance is common.
‡Fluoroquinolone resistance increasing.

Main Article

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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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