{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:35:33Z","timestamp":1695573333912},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":488,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec id=\"S0195941700033762_abs1\"><jats:title>Background.<\/jats:title><jats:p>Of the 13 US vancomycin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the <jats:italic>vanA<\/jats:italic> gene from vancomycin-resistant enterococcus (VRE) transfers to <jats:italic>S. aureus.<\/jats:italic> Incl8-like plasmids in VRE and pSK41-like plasmids in <jats:italic>S. aureus<\/jats:italic> appear to be important precursors to this transfer.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700033762_abs2\"><jats:title>Objective.<\/jats:title><jats:p>Identify the prevalence of VRSA precursor organisms.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700033762_abs3\"><jats:title>Design.<\/jats:title><jats:p>Prospective cohort with embedded case-control study.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700033762_abs4\"><jats:title>Participants.<\/jats:title><jats:p>Southeastern Michigan adults with chronic lower-extremity wounds.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700033762_abs5\"><jats:title>Methods.<\/jats:title><jats:p>Adults presenting to 3 southeastern Michigan medical centers during the period February 15 through March 4, 2011, with chronic lower-extremity wounds had wound, nares, and perirectal swab specimens cultured for S. <jats:italic>aureus<\/jats:italic> and VRE, which were tested for pSK41-like and Incl8-like plasmids by polymerase chain reaction. We interviewed participants and reviewed clinical records. Risk factors for pSK41-positive <jats:italic>S. aureus<\/jats:italic> were assessed among all study participants (cohort analysis) and among only <jats:italic>S.<\/jats:italic> aureus-colonized participants (case-control analysis).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700033762_abs6\"><jats:title>Results.<\/jats:title><jats:p>Of 179 participants with wound cultures, 26% were colonized with methicillin-susceptible <jats:italic>S. aureus, 27%<\/jats:italic> were colonized with methicillin-resistant <jats:italic>S. aureus,<\/jats:italic> and 4% were colonized with VRE, although only 17% consented to perirectal culture. Six participants (3%) had pSK41-positive <jats:italic>S. aureus,<\/jats:italic> and none had Incl8-positive VRE. Having chronic wounds for over 2 years was associated with pSK41-positive <jats:italic>S. aureus<\/jats:italic> colonization in both analyses.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700033762_abs7\"><jats:title>Conclusions.<\/jats:title><jats:p>Colonization with VRSA precursor organisms was rare. Having long-standing chronic wounds was a risk factor for pSK41-positive <jats:italic>S. aureus<\/jats:italic> colonization. Additional investigation into the prevalence of VRSA precursors among a larger cohort of patients is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1086\/671735","type":"journal-article","created":{"date-parts":[[2013,7,27]],"date-time":"2013-07-27T05:06:37Z","timestamp":1374901597000},"page":"954-960","source":"Crossref","is-referenced-by-count":17,"title":["Prevalence and Risk Factors Associated with Vancomycin-Resistant <i>Staphylococcus aureus<\/i> Precursor Organism Colonization among Patients with Chronic Lower-Extremity Wounds in Southeastern Michigan"],"prefix":"10.1017","volume":"34","author":[{"given":"Pritish K.","family":"Tosh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Agolory","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethany 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