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In order to determine the prevalence of methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) colonization among adults in community settings in Taiwan and identify its risk factors, we conducted the present study. For each MRSA isolate, we performed multilocus sequence typing, identification of the staphylococcal cassette chromosome mec, tests for the presence of the Panton-Valentine leukocidin gene, and tests for drug susceptibilities.
For a 3-month period, we enrolled all adults who attended mandatory health examinations at three medical centers and signed the informed consent. Risk factors for MRSA colonization were determined.
To analyze the risk factors for carrying MRSA, we used polytomous logistic regression to compare people with MRSA to those without . Fridkin, and Active Bacterial Core surveillance (ABCs) MRSA Investigators. The MICs of all MRSA isolates were determined for gentamicin, clindamycin, erythromycin, ciprofloxacin, minocycline, rifampin (rifampicin), trimethoprim-sulfamethoxazole, and vancomycin using the agar dilution method proposed by the Clinical and Laboratory Standards Institute (CLSI) (10). In brief, a Steers' replicator was used to apply 10 CFU of bacteria onto Mueller-Hinton agar containing serial twofold dilutions of each antimicrobial agent (256 to 0.03 mg/liter). The agar plates were incubated at 35°C for 18 h before reading. The MIC was defined as the lowest concentration of antimicrobial agents completely inhibiting the growth of bacteria.
CA-MRSA strains carry type IV or V staphylococcal cassette chromosome elements, are usually not PVL producing, and are multidrug resistant (15, 22, 28).