{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:56:09Z","timestamp":1791039369302,"version":"4.1.0"},"reference-count":51,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":2161,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2009,2]]},"abstract":"<jats:sec id=\"S0195941700027697_abs1\"><jats:title>Background.<\/jats:title><jats:p>The prevalence of community-associated methicillin-resistant<jats:italic>Staphylococcus aureus<\/jats:italic>(CA-MRSA) strains causing bloodstream infection (BSI) has not been studied in Korea.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700027697_abs2\"><jats:title>Objective.<\/jats:title><jats:p>We sought to determine the prevalence of CA-MRSA strains among isolates recovered from patients with MRSA BSIs and to explore epidemiological changes in Korea. We also sought to evaluate clinical characteristics relevant to the development of healthcare-associated BSIs.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700027697_abs3\"><jats:title>Methods.<\/jats:title><jats:p>We prospectively collected consecutive MRSA isolates from patients with BSI at 4 hospitals from July 1 through November 30, 2007, and we also included MRSA isolates recovered from culture of blood samples collected during a previous year (October 1, 2004 through September 30, 2005) at a different hospital. Molecular typing studies were performed, including pulsed-field gel electrophoresis (PFGE), multilocus sequence typing,<jats:italic>Staphylococcus<\/jats:italic>protein A (<jats:italic>spa<\/jats:italic>) typing, and staphylococcal cassette chromosome<jats:italic>mec<\/jats:italic>(SCC<jats:italic>mec<\/jats:italic>) typing. We compared the clinical characteristics and outcomes of patients with healthcare-associated BSI due to CA-MRSA strains with those of patients with healthcare-associated BSI due to healthcare-associated MRSA (HA-MRSA) strains.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700027697_abs4\"><jats:title>Results.<\/jats:title><jats:p>There were 76 cases of MRSA BSI, of which 4 (5.3%) were community-associated and 72 (94.7%) were healthcare-associated. Among the 72 HA-MRSA BSIs, 18 (25%) were community onset, and 54 (75%) were hospital onset. PFGE type D-ST72\u2013<jats:italic>spa<\/jats:italic>B-SCC<jats:italic>mec<\/jats:italic>type IVA MRSA, the predominant genotype of CA-MRSA in Korea, accounted for 19 (25%) of all 76 MRSA BSIs, including 17 (23.6%) of 72 HA-MRSA BSIs and 11 (20.8%) of 53 hospital-onset HA-MRSA BSIs. Patients with healthcare-associated BSIs due to CA-MRSA strains carrying SCC<jats:italic>mec<\/jats:italic>type IVA tended to have fewer healthcare-associated risk factors, compared with patients with healthcare-associated BSIs due to HA-MRSA strains carrying other SCC<jats:italic>mec<\/jats:italic>types. The presence of a central venous catheter or other invasive device was the only independent factor differentiating patients infected with hospital-associated genotype strains from patients infected with other strains. Clinical outcomes were similar between both groups.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700027697_abs5\"><jats:title>Conclusions.<\/jats:title><jats:p>CA-MRSA strains are emerging as a major cause of BSI in healthcare settings in Korea. This changing epidemiology of MRSA poses a challenge to public health and infection control in hospital settings.<\/jats:p><\/jats:sec>","DOI":"10.1086\/593953","type":"journal-article","created":{"date-parts":[[2009,1,7]],"date-time":"2009-01-07T22:55:06Z","timestamp":1231368906000},"page":"146-155","source":"Crossref","is-referenced-by-count":66,"title":["Emergence of Community-Associated Methicillin-Resistant<i>Staphylococcus aureus<\/i>Strains as a Cause of Healthcare-Associated Bloodstream Infections in Korea"],"prefix":"10.1017","volume":"30","author":[{"given":"Sun Hee","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chulmin","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Hong","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Mi","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Hyun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Ho","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Gun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungok","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JaYoung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Eun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Mi","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Shik","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700027697_ref039","unstructured":"Staphylococcus aureus database. 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