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JAC Advance Access originally published online on May 12, 2008
Journal of Antimicrobial Chemotherapy 2008 62(1):212-213; doi:10.1093/jac/dkn203
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Letters to the Editor

Survey of community-associated methicillin-resistant Staphylococcus aureus in Korea—authors' response

Eu Suk Kim1, Hong Bin Kim2,3,* and Myoung-don Oh2

1 Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Republic of Korea 2 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea 3 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

* Correspondence address. Department of Internal Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si 463-707, Republic of Korea. Tel: +82-31-787-7021; Fax: +82-31-787-4052; E-mail: hbkimmd{at}snu.ac.kr

Keywords: S. aureus , CA-MRSA , multidrug resistance

Sir,

We thank Park et al.1 for their thoughtful comments on our study on community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Korea.2 We agree that our finding of multidrug-resistant (MDR) CA-MRSA should be interpreted with caution. When we re-analysed our data on antibiotic resistance according to the clinical significance of the CA-MRSA isolates, the MDR rate was 47% in the pathogen group, 38% in the colonizer group and 97% in the group of undetermined significance (Table 1). The rates of MDR were also very different depending on the sequence types (STs) of the CA-MRSA isolates. For instance, only 1 of 25 isolates of the ST72 clone was MDR, whereas all the isolates of the ST5 and ST239 clones were MDR. Of the 31 isolates of the staphylococcal cassette chromosome mec (SCCmec) IVa clone, 8 (26%) were MDR.


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  		Table 1. Antibiotic susceptibilities of 72 community-associated methicillin-resistant S. aureus isolates according to the clinical significance; no. (%) of susceptible isolates

 
Even though all of our isolates met the definition of CA-MRSA,3 we cannot exclude the possibility that some were actually hospital-associated, as we mentioned in the Discussion section of the previous study.2 To rule out this possibility, we also re-calculated the MDR rate after excluding the isolates of the ST5 and ST239 clones, the two most prevalent clones among hospital-associated MRSA in Korea, and it was then only 26% (9/35).


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1 Park C, Lee DG, Choi SM, et al. Comment on: A survey of community-associated methicillin-resistant Staphylococcus aureus in Korea. J Antimicrob Chemother (2008) 211–12. doi:10.1093/jac/dkn135.

2 Kim ES, Song JS, Lee HJ, et al. A survey of community- associated methicillin-resistant Staphylococcus aureus in Korea. J Antimicrob Chemother (2007) 60:1108–14.[Abstract/Free Full Text]

3 Fridkin SK, Hageman JC, Morrison M, et al. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med (2005) 352:1436–44.[Abstract/Free Full Text]


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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
62/1/212    most recent
dkn203v1
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