Characterization of Clinical Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates From Canadian Hospitals, 2010–2015
Bibliographic record
Abstract
Background. The Canadian Nosocomial Infection Surveillance Program (CNISP) has been performing prospective laboratory-based surveillance for MRSA infections since 1995. In this study we investigated the changes in MRSA genotypes and antimicrobial susceptibilities from 2010 to 2015. Methods. Clinical (non-screening) MRSA isolates from patients in 59 acute-care Canadian hospitals were included in the study. Pulsed-field gel electrophoresis (PFGE) epidemic type was assigned using spa typing. Spa types t002 and t008 correspond to CMRSA2 (USA100/800) and CMRSA10 (USA300), respectively. Antibiotic susceptibilities were determined by broth microdilution in accordance with CLSI guidelines. Results. A total of 3589 MRSA isolates were submitted: 49.1% were CMRSA2 and 35.5% CMRSA10. Infection sites were as follows: 48.4% bloodstream infections, 18.6% skin/soft tissue, 11.3% respiratory, 9.2% surgical site, 7.9% urine and 4.5% other sites. CMRSA10 was more likely to be recovered from skin/soft tissue, while CAMRSA2 from all other sites. The proportion of CMRSA10 isolates increased from 28.1% in 2010 to 42.2% in 2015 (p < 0.001), whereas CMRSA2 decreased (Figure 1A). Regional differences in genotype distribution were noted: CMRSA10 was predominant in western Canada (Figure 1A). Antimicrobial resistance profiles are shown in Figure 1B. Resistance to clindamycin decreased (from 93.1% in 2010 to 58.8% 2015; p < 0.001), whereas resistance to fusidic acid and high-level resistance to mupirocin increased (6.8% to 12.3%, p < 0.001; and 0.9% to 5.6%, p = 0.001; respectively). Figure 1. A. PFGE type per year/region (CMRSA2 blue; CMRSA10 red). B. CMRSA2/CMRSA10 antibiogram. CLD, clindamycin; ERY, erythromycin; CIP, ciprofloxacin; GEN, gentamicin; LIN, linezolid; RIF, rifampin; TET, tetracycline; SXT, trimethoprim-sulfamethoxazole; VAN, vancomycin; TIG, tigecycline; FUS, fusidic acid; MUP, mupirocin; DAP, daptomycin. Overall resistance rate is shown (blue line). Conclusion. There has been a change in genotypes over the past few years with an increased incidence of CMRSA10 as a cause of infection in Canadian hospitals. This has been associated with increased susceptibility to clindamycin. Resistance to trimethoprim-sulfamethoxazole and tetracycline remains stable and low. Disclosures. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".