{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:30:35Z","timestamp":1790317835980,"version":"4.1.0"},"reference-count":39,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2003,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Community-acquired methicillin-resistant\n            <jats:italic>Staphylococcus aureus<\/jats:italic>\n            (CA-MRSA) is a growing public health concern that has been associated with pediatric fatalities. It is hypothesized that the evolution of CA-MRSA is a recent event due to the acquisition of\n            <jats:italic>mec<\/jats:italic>\n            DNA by previously methicillin-susceptible strains that circulated in the community. This study investigated the genetic relatedness between CA-MRSA, hospital-associated MRSA (HA-MRSA), and nonmenstrual toxic shock syndrome (nmTSS) isolates. Thirty-one of 32 CA-MRSA isolates were highly related as determined by pulsed-field gel electrophoresis and\n            <jats:italic>spa<\/jats:italic>\n            typing yet were distinguishable from 32 HA-MRSA strains. The 31 related CA-MRSA isolates produced either staphylococcal enterotoxin B (\n            <jats:italic>n<\/jats:italic>\n            = 5) or C (\n            <jats:italic>n<\/jats:italic>\n            = 26), and none made TSS toxin 1. All CA-MRSA isolates tested contained a type IV staphylococcal cassette chromosome\n            <jats:italic>mec<\/jats:italic>\n            (SCC\n            <jats:italic>mec<\/jats:italic>\n            ) element. In comparison, none of the HA-MRSA isolates (\n            <jats:italic>n<\/jats:italic>\n            = 32) expressed the three superantigens. Antibiotic susceptibility patterns were different between the CA-MRSA and HA-MRSA isolates; CA-MRSA was typically resistant only to \u03b2-lactam antibiotics. Six of twenty-one nmTSS isolates were indistinguishable or highly related to the CA-MRSA isolates. MnCop, an nmTSS isolate obtained in Alabama in 1986, was highly related to the CA-MRSA isolates except that it did not contain an SCC\n            <jats:italic>mec<\/jats:italic>\n            element. These data suggest that CA-MRSA strains may represent a new acquisition of SCC\n            <jats:italic>mec<\/jats:italic>\n            DNA in a previously susceptible genetic background that was capable of causing nmTSS. CA-MRSA poses a serious health risk not only because it is resistant to the antibiotics of choice for community-acquired staphylococcal infections but also because of its ability to cause nmTSS via superantigen production.\n          <\/jats:p>","DOI":"10.1128\/aac.47.1.196-203.2003","type":"journal-article","created":{"date-parts":[[2002,12,24]],"date-time":"2002-12-24T04:39:08Z","timestamp":1040704748000},"page":"196-203","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":257,"title":["Comparative Molecular Analysis of Community- or Hospital-Acquired Methicillin-Resistant\n            <i>Staphylococcus aureus<\/i>"],"prefix":"10.1128","volume":"47","author":[{"given":"P. D.","family":"Fey","sequence":"first","affiliation":[{"name":"Department of Internal Medicine"},{"name":"the Nebraska Public Health Laboratory, Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Sai\u0308d-Salim","sequence":"additional","affiliation":[{"name":"Public Health Research Institute, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. E.","family":"Rupp","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. H.","family":"Hinrichs","sequence":"additional","affiliation":[{"name":"the Nebraska Public Health Laboratory, Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J.","family":"Boxrud","sequence":"additional","affiliation":[{"name":"Acute Disease Epidemiology Section and the Division of Public Health Laboratories, Minnesota Public Health Laboratory"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. C.","family":"Davis","sequence":"additional","affiliation":[{"name":"FemCare Microbiology Product Safety and Regulatory Affairs, The Procter &amp; Gamble Company, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. N.","family":"Kreiswirth","sequence":"additional","affiliation":[{"name":"Public Health Research Institute, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. M.","family":"Schlievert","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Minnesota Medical School, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08713-5"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.33.3.551-555.1995"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/10408419009105728"},{"key":"e_1_3_1_5_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/BF00329830","volume":"209","year":"1987","unstructured":"Bohach, G. A., and P. M. Schlievert. 1987. Nucleotide sequence of the staphylococcal enterotoxin C1 gene and relatedness to other pyrogenic toxin genes. Mol. Gen. Genet.209:15-20.","journal-title":"Mol. Gen. 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