Dissemination of methicillin-resistant-Staphylococcus aureus/(MRSA) is a worldwide concern both in hospitals [healthcare-associated-(HA)-MRSA] and communities [community-associated-(CA)-MRSA]. Knowledge on when and where MRSA colonization is acquired and what clones are involved is necessary, to focus efforts for prevention of hospital-acquired MRSA-infections. METHODS A prospective/longitudinal cohort study was performed in eight Argentina hospitals (Cordoba/ October-December/2014). Surveillance cultures for MRSA (nose-throat-inguinal) were obtained on admission and at discharge. MRSA strains were genetically typed as CA-MRSAG and HA-MRSAG genotypes. RESULTS Overall, 1419 patients were screened and 534 stayed at hospital for ≥3 days. S. aureus admission prevalence was 30.9% and 4.2% for MRSA. Overall MRSA acquisition rate was 2.3/1000 patient-days-at-risk with a MRSA acquisition prevalence of 1.96% (95%CI: 1.0%-3.4%); 3.2% of patients were discharged back to community with MRSA. CA-MRSAG accounted for 84.6% of imported, 100.0% of hospital-acquired and 94% of discharged MRSA strains. Most imported and acquired MRSA strains belonged to two major epidemic CA-MRSA clones spread in Argentina: PFGEtypeI-ST5-IVa-t311-PVL+ and PFGEtypeN/ST30-IVc-t019-PVL+. CONCLUSIONS CA-MRSA clones, particularly ST5-IV-PVL+ and ST30-IV-PVL+, with main reservoir in the community, not only enter but also are truly acquired within hospital, causing healthcare-associated-hospital-onset infections, having a transmission capacity greater or similar than HA-MRSAG. This information is essential to develop appropriate MRSA infection prevention-control programs, considering hospital and community.

中文翻译：

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社区和医院环境之间的MRSA动态流通：来自队列研究的新见解。

耐甲氧西林金黄色葡萄球菌/（MRSA）的传播在医院[卫生保健相关-（HA）-MRSA]和社区[社区相关-（CA）-MRSA]中都是全球关注的问题。必须了解何时何地获得MRSA定植以及涉及哪些克隆，以集中精力预防医院获得的MRSA感染。方法在阿根廷的八家医院中进行了前瞻性/纵向队列研究（科尔多瓦/ 2014年10月至12月）。入院时和出院时均获得了针对MRSA（鼻咽喉）的监测培养物。MRSA菌株的基因型为CA-MRSAG和HA-MRSAG基因型。结果总体上，对1419例患者进行了筛查，其中534例住院≥3天。金黄色葡萄球菌的入院率为MRSA，分别为30.9％和4.2％。MRSA总体获得率为2。风险为3/1000的患者天数，MRSA采集患病率为1.96％（95％CI：1.0％-3.4％）；3.2％的患者因MRSA出院返回社区。CA-MRSAG占进口的84.6％，医院获得的100.0％和出院的MRSA菌株的94％。大多数进口和获得的MRSA菌株属于在阿根廷传播的两个主要的流行CA-MRSA克隆：PFGEtypeI-ST5-IVa-t311-PVL +和PFGEtypeN / ST30-IVc-t019-PVL +。结论CA-MRSA克隆，特别是ST5-IV-PVL +和ST30-IV-PVL +，在社区中具有主要的宿主，不仅进入医院，而且在医院内真正获得，从而引起医疗相关的医院发作感染，并传播容量大于或相似于HA-MRSAG。考虑到医院和社区，此信息对于制定适当的MRSA感染预防控制程序至关重要。