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-
1.
Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, Talan DA, 2006. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 355: 666–674.
-
2.
Johnson JK, Khoie T, Shurland S, Kreisel K, Stine OC, Roghmann MC, 2007. Skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus USA300 clone. Emerg Infect Dis 13: 1195–1200.
-
3.
Klein E, Smith DL, Laxminarayan R, 2009. Community-associated methicillin-resistant Staphylococcus aureus in outpatients, United States, 1999–2006. Emerg Infect Dis 15: 1925–1930.
-
4.
Liu C, Graber CJ, Karr M, Diep BA, Basuino L, Schwartz BS, Enright MC, O'Hanlon SJ, Thomas JC, Perdreau-Remington F, Gordon S, Gunthorpe H, Jacobs R, Jensen P, Leoung G, Rumack JS, Chambers HF, 2008. A population-based study of the incidence and molecular epidemiology of methicillin-resistant Staphylococcus aureus disease in San Francisco, 2004–2005. Clin Infect Dis 46: 1637–1646.
-
5.
Enright MC, Robinson DA, Randle G, Feil EJ, Grundmann H, Spratt BG, 2002. The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA). Proc Natl Acad Sci U S A 99: 7687–7692.
-
6.
Golding GR, Levett PN, McDonald RR, Irvine J, Nsungu M, Woods S, Horbal A, Siemens CG, Khan M, Ofner-Agostini M, Mulvey MR, 2010. A comparison of risk factors associated with community-associated methicillin-resistant and -susceptible Staphylococcus aureus infections in remote communities. Epidemiol Infect 138: 730–737.
-
7.
Tong SY, McDonald MI, Holt DC, Currie BJ, 2008. Global implications of the emergence of community-associated methicillin-resistant Staphylococcus aureus in Indigenous populations. Clin Infect Dis 46: 1871–1878.
-
8.
Chheng K, Tarquinio S, Wuthiekanun V, Sin L, Thaipadungpanit J, Amornchai P, Chanpheaktra N, Tumapa S, Putchhat H, Day NP, Peacock SJ, 2009. Emergence of community-associated methicillin-resistant Staphylococcus aureus associated with pediatric infection in Cambodia. PLoS ONE 4: e6630.
-
9.
Clinical and Laboratory Standards Institute, 2009. Performance Standards for Antimicrobial Disk Susceptibility Tests, 10th edition: Approved Standard M02-A10. Wayne, PA: Clinical and Laboratory Standards Institute.
-
10.
Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH, 2003. Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol 41: 4740–4744.
-
11.
Peacock SJ, de Silva GD, Justice A, Cowland A, Moore CE, Winearls CG, Day NP, 2002. Comparison of multilocus sequence typing and pulsed-field gel electrophoresis as tools for typing Staphylococcus aureus isolates in a microepidemiological setting. J Clin Microbiol 40: 3764–3770.
-
12.
Enright MC, Day NP, Davies CE, Peacock SJ, Spratt BG, 2000. Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 38: 1008–1015.
-
13.
World Health Organization. About SAVE LIVES: Clean Your Hands. Available at: http://www.who.int/gpsc/5may/background/en/index.html.
-
14.
Gonzalez BE, Rueda AM, Shelburne SA 3rd, Musher DM, Hamill RJ, Hulten KG, 2006. Community-associated strains of methicillin-resistant Staphylococccus aureus as the cause of healthcare-associated infection. Infect Control Hosp Epidemiol 27: 1051–1056.
-
15.
Yamada N, Saorith K, Yamakami K, Onozaki I, Boran S, Fujiki A, Eang MT, Mori T, 2007. The national tuberculosis drug resistance survey in Cambodia, 2000–2001. Int J Tuberc Lung Dis 11: 1321–1327.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1180 | 973 | 51 |
| Full Text Views | 435 | 12 | 0 |
| PDF Downloads | 98 | 14 | 0 |
Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Carriage in Children in Cambodia
Emma K. Nickerson
Emma K. Nickerson
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Vanaporn Wuthiekanun
Vanaporn Wuthiekanun
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Varun Kumar
Varun Kumar
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Premjit Amornchai
Premjit Amornchai
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Nattavut Wongdeethai
Nattavut Wongdeethai
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Kheng Chheng
Kheng Chheng
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Narisara Chantratita
Narisara Chantratita
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Hor Putchhat
Hor Putchhat
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Janjira Thaipadungpanit
Janjira Thaipadungpanit
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Nicholas P. Day
Nicholas P. Day
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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Sharon J. Peacock
Sharon J. Peacock
Mahidol-Oxford Tropical Medicine Research Unit, and Department of Microbiology and Immunology,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Infectious Diseases, and Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
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We previously described the first reported isolation of methicillin-resistant Staphylococcus aureus (MRSA) (a case series of pediatric community-associated MRSA infections) in Cambodia. We define the rate of pediatric MRSA carriage in the same population and characterize the associated bacterial genotypes by using pulsed-field gel electrophoresis and multilocus sequence typing. A prospective cohort study of MRSA carriage conducted over one month at the Angkor Hospital for Children, Siem Reap, Cambodia, identified MRSA carriage in 87 (3.5%) of 2,485 children who came to the outpatient department, and 6 (4.1%) of 145 inpatients, including at least two with cases of nosocomial acquisition. Genotyping of all 93 MRSA isolates resolved 5 genotypes. Most (91%) isolates were assigned to sequence type 834. Only 28 (32%) of 87 MRSA carriers identified in the outpatient department had no history of recent healthcare contact. The study findings have important implications for healthcare in a setting where diagnostic microbiology and access to antimicrobial drugs with efficacy against MRSA are limited.
Author Notes
Financial support: The study was supported by the Wellcome Trust and the Li Kha Shing Foundation.
Disclosure: None of the authors have any conflicts of interest.
Authors' addresses: Emma K. Nickerson, Department of Infectious Diseases, Addenbrooke's Hospital, Hills Road, Cambridge, United Kingdom, E-mail: emma.nickerson@addenbrookes.nhs.uk. Vanaporn Wuthiekanun, Premjit Amornchai, Nattavut Wongdeethai, Narisara Chantratita, Janjira Thaipadungpanit, and Nicholas P. Day, Mahidol-Oxford Tropical Medicine Research Unit, Chalermprakiat Building, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mails: lek@tropmedres.ac, kung@tropmedres.ac, godgira12@hotmail.com, narisara@tropmedres.ac, janjira@tropmedres.ac, and nickd@tropmedres.ac. Varun Kumar, Kheng Chheng, and Hor Putchhat, Angkor Hospital for Children, Siem Reap, Cambodia, E-mails: varun@angkorhospital.org, kh_chheng@yahoo.com, laboratory@angkorhospital.org. Sharon J. Peacock, Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom, E-mail: sharondt@tropmedres.ac.
Reprint requests: Emma K. Nickerson, Department of Infectious Diseases, Box 25, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, United Kingdom, E-mail: emma.nickerson@addenbrookes.nhs.uk.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, Talan DA, 2006. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 355: 666–674.
-
2.
Johnson JK, Khoie T, Shurland S, Kreisel K, Stine OC, Roghmann MC, 2007. Skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus USA300 clone. Emerg Infect Dis 13: 1195–1200.
-
3.
Klein E, Smith DL, Laxminarayan R, 2009. Community-associated methicillin-resistant Staphylococcus aureus in outpatients, United States, 1999–2006. Emerg Infect Dis 15: 1925–1930.
-
4.
Liu C, Graber CJ, Karr M, Diep BA, Basuino L, Schwartz BS, Enright MC, O'Hanlon SJ, Thomas JC, Perdreau-Remington F, Gordon S, Gunthorpe H, Jacobs R, Jensen P, Leoung G, Rumack JS, Chambers HF, 2008. A population-based study of the incidence and molecular epidemiology of methicillin-resistant Staphylococcus aureus disease in San Francisco, 2004–2005. Clin Infect Dis 46: 1637–1646.
-
5.
Enright MC, Robinson DA, Randle G, Feil EJ, Grundmann H, Spratt BG, 2002. The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA). Proc Natl Acad Sci U S A 99: 7687–7692.
-
6.
Golding GR, Levett PN, McDonald RR, Irvine J, Nsungu M, Woods S, Horbal A, Siemens CG, Khan M, Ofner-Agostini M, Mulvey MR, 2010. A comparison of risk factors associated with community-associated methicillin-resistant and -susceptible Staphylococcus aureus infections in remote communities. Epidemiol Infect 138: 730–737.
-
7.
Tong SY, McDonald MI, Holt DC, Currie BJ, 2008. Global implications of the emergence of community-associated methicillin-resistant Staphylococcus aureus in Indigenous populations. Clin Infect Dis 46: 1871–1878.
-
8.
Chheng K, Tarquinio S, Wuthiekanun V, Sin L, Thaipadungpanit J, Amornchai P, Chanpheaktra N, Tumapa S, Putchhat H, Day NP, Peacock SJ, 2009. Emergence of community-associated methicillin-resistant Staphylococcus aureus associated with pediatric infection in Cambodia. PLoS ONE 4: e6630.
-
9.
Clinical and Laboratory Standards Institute, 2009. Performance Standards for Antimicrobial Disk Susceptibility Tests, 10th edition: Approved Standard M02-A10. Wayne, PA: Clinical and Laboratory Standards Institute.
-
10.
Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH, 2003. Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol 41: 4740–4744.
-
11.
Peacock SJ, de Silva GD, Justice A, Cowland A, Moore CE, Winearls CG, Day NP, 2002. Comparison of multilocus sequence typing and pulsed-field gel electrophoresis as tools for typing Staphylococcus aureus isolates in a microepidemiological setting. J Clin Microbiol 40: 3764–3770.
-
12.
Enright MC, Day NP, Davies CE, Peacock SJ, Spratt BG, 2000. Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 38: 1008–1015.
-
13.
World Health Organization. About SAVE LIVES: Clean Your Hands. Available at: http://www.who.int/gpsc/5may/background/en/index.html.
-
14.
Gonzalez BE, Rueda AM, Shelburne SA 3rd, Musher DM, Hamill RJ, Hulten KG, 2006. Community-associated strains of methicillin-resistant Staphylococccus aureus as the cause of healthcare-associated infection. Infect Control Hosp Epidemiol 27: 1051–1056.
-
15.
Yamada N, Saorith K, Yamakami K, Onozaki I, Boran S, Fujiki A, Eang MT, Mori T, 2007. The national tuberculosis drug resistance survey in Cambodia, 2000–2001. Int J Tuberc Lung Dis 11: 1321–1327.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1180 | 973 | 51 |
| Full Text Views | 435 | 12 | 0 |
| PDF Downloads | 98 | 14 | 0 |