For the retrospective part of the study (Figure 1), we determined monthly incidence of the output variables (HAMRSA
, HA-CDI) and input variables (other MRSA; other CDI; antimicrobial and infection control agent use; pharmacy, medical, and nursing staffing levels [full-time equivalents (FTEs), where 1 FTE equals 1 full-time worker]; and age-adjusted Charlson comorbidity index of all patients discharged from AAH).
(5) The presence and emergence of pvl-positive MRSA has been previously described in clinical isolates or hospital-associated MRSA (HAMRSA
There is little information about the clones of either HAMRSA
or CA-MRSA circulating in Ecuador.
The types of I, II, III are called hospital related strains (HAMRSA
), and the types and subtypes of IV and V are called community related strains (CAMRSA) (9,19).
Moreover prevalence of MLSB and MSB resistant phenotypes in CA MRSA and HAMRSA
strains in our community should be evaluated especially in the background of high constitutive MLSB and MSB resistance when selection of resistant mutants can be fast.
cases were compared before and after the intervention, using Epidat v4.0 to calculate the cumulative incidence of HA-MRSA before and after the implementation of decolonization therapy at the hospital.
CA-MRSA strains carry SCCmec type IV or V whereas the majority of HAMRSA
strains carry SCCmec type I II or III.12Various molecular typing techniques have been developed for investigating the spread and evolution of MRSA the most common of which is SCCmec typing.
The strains of MRSA found in patients in the community are distinct from those strains seen in hospitals and it now called 'community-associated MRSA (CA-MRSA) which has evolved independently of hospital acquired MRSA (HAMRSA
CA-MRSA has unique microbiologic and genetic properties relative to health care-associated MRSA (HAMRSA
), which allow the bacteria to spread more easily and therefore cause more skin infections (CDC, 2005).
MRSA may be present in wounds, blood, urine, or sputum, and may have its origin in the community (CA-MRSA) or hospital (HAMRSA
Linezolid may be used for hospital- or health care-associated MRSA (HAMRSA