Comparison of Community‐Associated and Health Care‐Associated Methicillin‐Resistant <i>Staphylococcus aureus</i> in Canada: Results from CANWARD 2007
Bibliographic record
Abstract
BACKGROUND: Community‐associated methicillin‐resistant Staphylococcus aureus (CA‐MRSA) differ from health care‐associated MRSA (HA‐MRSA) in their genotypic and phenotypic characteristics. The purpose of the present study was to compare the demographics, antimicrobial susceptibilities and molecular epidemiology of CA‐MRSA and HA‐MRSA in Canada. METHODS: In 2007, 385 MRSA isolates were collected from Canadian patients attending hospital clinics, emergency rooms, medical/ surgical wards and intensive care units. Susceptibilities to betalactams, clarithromycin, clindamycin, daptomycin, levofloxacin, linezolid, moxifloxacin, tigecycline, trimethoprim‐sulfamethoxazole and vancomycin were determined by Clinical and Laboratory Standards Institute broth microdilution. Strain typing was performed by pulsed‐field gel electrophoresis (PFGE) and the mecA, nuc and pvl genes were detected by polymerase chain reaction. RESULTS: Of the 385 MRSA, 19.5% were CA‐MRSA and 79.2% were HA‐MRSA as determined by PFGE. CA‐MRSA belonged to PFGE types CMRSA10/USA300 (66.7%) and CMRSA7/USA400 (33.3%); PFGE types identified among HA‐MRSA included CMRSA2/USA100/800 (81.6%), CMRSA6 (13.1%), CMRSA1/ USA600 (3.3%), CMRSA5/USA500 (1.3%), CMRSA3 (0.3%) and CMRSA9 (0.3%). Panton‐Valentine leukocidin (PVL) was detected in 94.7% of CA‐MRSA and 0.7% of HA‐MRSA. Resistance rates (CA‐MRSA versus HA‐MRSA) were 61.3% versus 97.7% to levofloxacin, 73.3% versus 96.7% to clarithromycin, 12.0% versus 74.8% to clindamycin and 0.0% versus 15.4% to trimethoprim‐sulfamethoxazole. No MRSA were resistant to vancomycin, linezolid, tigecycline or daptomycin. CONCLUSIONS: CA‐MRSA represented 19.5% of all MRSA. CA‐MRSA was significantly more susceptible to levofloxacin, clarithromycin, clindamycin and trimethoprim‐sulfamethoxazole than HA‐MRSA. Of CA‐MRSA, 94.7% were PVL‐positive while 99.3% of HA‐MRSA were PVL‐negative. CA‐MRSA is an emerging pathogen in Canadian hospitals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| 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 source (direct Gemma or distilled Codex), 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".