{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T18:12:52Z","timestamp":1788372772019,"version":"build-2803163510"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T00:00:00Z","timestamp":1430438400000},"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":["J Clin Microbiol"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Methicillin-resistant\n            <jats:named-content content-type=\"genus-species\">Staphylococcus aureus<\/jats:named-content>\n            (MRSA) bloodstream infections (BSI) are classified epidemiologically as health care-associated hospital onset (HAHO)-, health care-associated community onset (HACO)-, or community-associated (CA)-MRSA. Clinical and molecular differences between HAHO- and HACO-MRSA BSI are not well known. Thus, we evaluated clinical and molecular characteristics of MRSA BSI to determine if distinct features are associated with HAHO- or HACO-MRSA strains. Molecular genotyping and medical record reviews were conducted on 282 MRSA BSI isolates from January 2007 to December 2009. MRSA classifications were 38% HAHO-, 54% HACO-, and 8% CA-MRSA. Comparing patients with HAHO-MRSA to those with HACO-MRSA, HAHO-MRSA patients had significantly higher rates of malignancy, surgery, recent invasive devices, and mortality and longer hospital stays. Patients with HACO-MRSA were more likely to have a history of renal failure, hemodialysis, residence in a long-term-care facility, long-term invasive devices, and higher rate of MRSA relapse. Distinct MRSA molecular strain differences also were seen between HAHO-MRSA (60% staphylococcal cassette chromosome\n            <jats:italic>mec<\/jats:italic>\n            type II [SCC\n            <jats:italic>mec<\/jats:italic>\n            II], 30% SCC\n            <jats:italic>mec<\/jats:italic>\n            III, and 9% SCC\n            <jats:italic>mec<\/jats:italic>\n            IV) and HACO-MRSA (47% SCC\n            <jats:italic>mec<\/jats:italic>\n            II, 35% SCC\n            <jats:italic>mec<\/jats:italic>\n            III, and 16% SCC\n            <jats:italic>mec<\/jats:italic>\n            IV) (\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). In summary, our study reveals significant clinical and molecular differences between patients with HAHO- and HACO-MRSA BSI. In order to decrease rates of MRSA infection, preventive efforts need to be directed toward patients in the community with health care-associated risk factors in addition to inpatient infection control.\n          <\/jats:p>","DOI":"10.1128\/jcm.03147-14","type":"journal-article","created":{"date-parts":[[2015,3,5]],"date-time":"2015-03-05T03:12:43Z","timestamp":1425525163000},"page":"1599-1608","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":16,"title":["Molecular and Clinical Characteristics of Hospital and Community Onset Methicillin-Resistant Staphylococcus aureus Strains Associated with Bloodstream Infections"],"prefix":"10.1128","volume":"53","author":[{"given":"Shu-Hua","family":"Wang","sequence":"first","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Hines","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joany","family":"van Balen","sequence":"additional","affiliation":[{"name":"The Ohio State University, College of Veterinary Medicine, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 R.","family":"Mediavilla","sequence":"additional","affiliation":[{"name":"Public Health Research Institute, Rutgers University, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueliang","family":"Pan","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando E.","family":"Hoet","sequence":"additional","affiliation":[{"name":"The Ohio State University, College of Veterinary Medicine, Columbus, Ohio, USA"},{"name":"The Ohio State University, College of Public Health, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry N.","family":"Kreiswirth","sequence":"additional","affiliation":[{"name":"Public Health Research Institute, Rutgers University, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preeti","family":"Pancholi","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt B.","family":"Stevenson","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"},{"name":"The Ohio State University, College of Public Health, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0702.010204"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.22.2976"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199808203390806"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.11.5113-5120.2003"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/507923"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1212.060505"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/520088"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.10423"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.15.1763"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1115"},{"key":"e_1_3_2_12_2","volume-title":"49th Annu Meet Infect Dis Soc Am","author":"Wang S-H","year":"2011","unstructured":"Wang S-H, Khan Y, Mediavilla JR, Hines L, Kreiswirth BN, Pancholi P, Stevenson K. 2011. Comparison of community-onset and healthcare-associated methicillin-resistant Staphylococcus aureus blood stream infections at an academic medical center for 3 years, abstr 31995, poster 1248. 49th Annu Meet Infect Dis Soc Am, Boston, MA, 22 October 2011."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1810.120468"},{"key":"e_1_3_2_14_2","volume-title":"Performance standards for antimicrobial susceptibility testing; 19th informational supplement","author":"Clinical and Laboratory Standards Institute","year":"2009","unstructured":"Clinical and Laboratory Standards Institute. 2009. Performance standards for antimicrobial susceptibility testing; 19th informational supplement, vol 29, no. 3. M100-S19. 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