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Epidemiology

Trends in Antibiotic Susceptibility in Staphylococcus aureus in Boston, Massachusetts, from 2000 to 2014

Sanjat Kanjilal, Mohamad R. Abdul Sater, Maile Thayer, Georgia K. Lagoudas, Soohong Kim, Paul C. Blainey, Yonatan H. Grad
Nathan A. Ledeboer, Editor
Sanjat Kanjilal
aDivision of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
bHarvard Medical School, Boston, Massachusetts, USA
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Mohamad R. Abdul Sater
cDepartment of Immunology & Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Maile Thayer
cDepartment of Immunology & Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Georgia K. Lagoudas
dMIT Department of Biological Engineering, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
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Soohong Kim
dMIT Department of Biological Engineering, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
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Paul C. Blainey
dMIT Department of Biological Engineering, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
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Yonatan H. Grad
cDepartment of Immunology & Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
eDivision of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Nathan A. Ledeboer
Medical College of Wisconsin
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DOI: 10.1128/JCM.01160-17
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ABSTRACT

The rate of infection by methicillin-resistant Staphylococcus aureus (MRSA) has declined over the past decade, but it is unclear whether this represents a decline in S. aureus infections overall. To evaluate the trends in the annual rates of infection by S. aureus subtypes and mean antibiotic resistance, we conducted a 15-year retrospective observational study at two tertiary care institutions in Boston, MA, of 31,753 adult inpatients with S. aureus isolated from clinical specimens. We inferred the gain and loss of methicillin resistance through genome sequencing of 180 isolates from 2016. The annual rates of infection by S. aureus declined from 2003 to 2014 by 4.2% (2.7% to 5.6%), attributable to an annual decline in MRSA of 10.9% (9.3% to 12.6%). Penicillin-susceptible S. aureus (PSSA) increased by 6.1% (4.2% to 8.1%) annually, and rates of methicillin-susceptible penicillin-resistant S. aureus (MSSA) did not change. Resistance in S. aureus decreased from 2000 to 2014 by 0.8 antibiotics (0.7 to 0.8). Within common MRSA clonal complexes, 3/14 MSSA and 2/21 PSSA isolates arose from the loss of resistance-conferring genes. Overall, in two tertiary care institutions in Boston, MA, a decline in S. aureus infections has been accompanied by a shift toward increased antibiotic susceptibility. The rise in PSSA makes penicillin an increasingly viable treatment option.

FOOTNOTES

    • Received 25 July 2017.
    • Returned for modification 14 September 2017.
    • Accepted 25 October 2017.
    • Accepted manuscript posted online 1 November 2017.
  • Supplemental material for this article may be found at https://doi.org/10.1128/JCM.01160-17.

  • Copyright © 2017 Kanjilal et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

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Trends in Antibiotic Susceptibility in Staphylococcus aureus in Boston, Massachusetts, from 2000 to 2014
Sanjat Kanjilal, Mohamad R. Abdul Sater, Maile Thayer, Georgia K. Lagoudas, Soohong Kim, Paul C. Blainey, Yonatan H. Grad
Journal of Clinical Microbiology Dec 2017, 56 (1) e01160-17; DOI: 10.1128/JCM.01160-17

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Trends in Antibiotic Susceptibility in Staphylococcus aureus in Boston, Massachusetts, from 2000 to 2014
Sanjat Kanjilal, Mohamad R. Abdul Sater, Maile Thayer, Georgia K. Lagoudas, Soohong Kim, Paul C. Blainey, Yonatan H. Grad
Journal of Clinical Microbiology Dec 2017, 56 (1) e01160-17; DOI: 10.1128/JCM.01160-17
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KEYWORDS

Staphylococcus aureus
MRSA
antibiotic resistance
genomic epidemiology

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