Displaying publications 21 - 40 of 54 in total

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  1. Predominance of Three Closely Related Methicillin-Resistant Staphylococcus aureus Clones Carrying a Unique ccrC-Positive SCCmec type III and the Emergence of spa t304 and t690 SCCmec type IV pvl(+) MRSA Isolates in Kinta Valley, Malaysia
    Ho WY, Choo QC, Chew CH
    Microb Drug Resist, 2017 Mar;23(2):215-223.
    PMID: 27203527 DOI: 10.1089/mdr.2015.0250
    We investigated the epidemiology and clonality of 175 nonrepetitive methicillin-resistant Staphylococcus aureus (MRSA) isolates from clinical specimens collected between 2011 and 2012 in Kinta Valley in Malaysia. Molecular tools such as polymerase chain reaction, pulsed-field gel electrophoresis, and staphylococcal protein A (spa) typing were used. Our study revealed the predominance of three closely related ermA(+) SCCmec type III pulsotypes belonging to spa type t037 (Brazilian-Hungarian clone), which were deficient in the locus F, but positive for the ccrC gene in majority (65.7%) of the MRSA infections in this region. The first evidence of SCCmec type II MRSA in the country, belonging to spa type t2460, was also noted. Although the carriage of pvl gene was uncommon (8.6%) and mostly confined to either SCCmec type IV or SCCmec type V isolates, most of these isolates belonged to spa types t345 or t657, which are associated with the Bengal-Bay CA-MRSA clone. Interestingly, spa t304 and t690 SCCmec type IV pvl(+) were also detected among the MRSA isolates. Data from this study show the rise of uncommon clones among MRSA isolates in Malaysia.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  2. Fulltext Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur
    Jalaludin MA
    Singapore Med J, 1993 Oct;34(5):435-7.
    PMID: 8153693
    Fourteen patients who presented to the University Hospital of Kuala Lumpur between June 1981 and June 1991 were reviewed retrospectively. Nasal septal abscesses are uncommon and therefore there are limited reports in the medical literature. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection. Two out of the fourteen patients developed saddle nose deformity and septal perforation because of delay in treatment, the cases were misdiagnosed by non-otolaryngologist as turbinates swelling. The leading cause of nasal septal abscess was non-surgical trauma which accounted for about 85.7%. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.
    Matched MeSH terms: Staphylococcal Infections/epidemiology
  3. Short communication: prevalence and antibiotic resistance of Staphylococcus aureus isolated from bovine clinical mastitis
    Jamali H, Radmehr B, Ismail S
    J Dairy Sci, 2014;97(4):2226-30.
    PMID: 24534509 DOI: 10.3168/jds.2013-7509
    The aims of this study were to determine the prevalence and antibiotic resistance of Staphylococcus aureus isolated from bovine clinical mastitis in Varamin, Tehran Province, Iran. All of the isolated Staph. aureus were identified by morphology and culture and confirmed using the API Staph identification system (bioMérieux, Marcy-l'Étoile, France). Antibiotic resistance genes were detected by PCR with oligonucleotide primers specific for each gene. Staphylococcus aureus was recovered from 43 of 207 (20.1%) bovine clinical milk samples. Using disk diffusion, methicillin-resistant Staph. aureus was detected in 5 of 43 (11.6%) samples. The pathogen showed high resistance against penicillin G (86%) and tetracycline (76.7%). The blaZ (penicillin) (86%), tetM (tetracycline), and ermC (erythromycin) genes (39.5% each) were the most prevalent antibiotic resistance genes. The findings of this study are useful for designing specific control programs for bovine clinical mastitis caused by Staph. aureus in this region of Iran.
    Matched MeSH terms: Staphylococcal Infections/epidemiology
  4. Low levels of meticillin-resistant Staphylococcus aureus in pigs in Malaysia
    Khalid KA, Zakaria Z, Toung OP, McOrist S
    Vet Rec, 2009 May 16;164(20):626-7.
    PMID: 19448256
    Matched MeSH terms: Staphylococcal Infections/epidemiology
  5. Causative Pathogens of Febrile Neutropaenia in Children Treated for Acute Lymphoblastic Leukaemia
    Lam JC, Chai JY, Wong YL, Tan NW, Ha CT, Chan MY, et al.
    Ann Acad Med Singap, 2015 Nov;44(11):530-4.
    PMID: 27089960
    INTRODUCTION: Treatment of acute lymphoblastic leukaemia (ALL) using intensive chemotherapy has resulted in high cure rates but also substantial morbidity. Infective complications represent a significant proportion of treatment-related toxicity. The objective of this study was to describe the microbiological aetiology and clinical outcome of episodes of chemotherapy-induced febrile neutropaenia in a cohort of children treated for ALL at our institution.

    MATERIALS AND METHODS: Patients with ALL were treated with either the HKSGALL93 or the Malaysia-Singapore (Ma-Spore) 2003 chemotherapy protocols. The records of 197 patients who completed the intensive phase of treatment, defined as the period of treatment from induction, central nervous system (CNS)-directed therapy to reinduction from June 2000 to January 2010 were retrospectively reviewed.

    RESULTS: There were a total of 587 episodes of febrile neutropaenia in 197 patients, translating to an overall rate of 2.98 episodes per patient. A causative pathogen was isolated in 22.7% of episodes. An equal proportion of Gram-positive bacteria (36.4%) and Gram-negative bacteria (36.4%) were most frequently isolated followed by viral pathogens (17.4%), fungal pathogens (8.4%) and other bacteria (1.2%). Fungal organisms accounted for a higher proportion of clinically severe episodes of febrile neutropaenia requiring admission to the high-dependency or intensive care unit (23.1%). The overall mortality rate from all episodes was 1.5%.

    CONCLUSION: Febrile neutropaenia continues to be of concern in ALL patients undergoing intensive chemotherapy. The majority of episodes will not have an identifiable causative organism. Gram-positive bacteria and Gram-negative bacteria were the most common causative pathogens identified. With appropriate antimicrobial therapy and supportive management, the overall risk of mortality from febrile neutropaenia is extremely low.

    Matched MeSH terms: Staphylococcal Infections/epidemiology
  6. Methicillin-resistant Staphylococcus aureus in surgical patients: Malaysian experience
    Lee SH, Yii NW, Hanifah YA
    J R Coll Surg Edinb, 1991 Oct;36(5):323-7.
    PMID: 1757914
    Methicillin-resistant Staphylococcus aureus has emerged as an important cause of nosocomial infections in recent years. During 1988 in the Department of Surgery of the University Hospital in Kuala Lumpur, Malaysia, 148 patients were shown to be infected or colonized with these organisms. The patients at risk were those who stay in hospital for greater than 14 days, those over 50 years of age, patients who underwent neurosurgery, cardiothoracic surgery, or were admitted with major burns. Of the 148 patients, 78 (52.7%) were clinically infected, the remaining 70 being colonized. A total of 28 patients died (18.9%) but only five (3.4%) as a direct result of this infection. The estimated annual cost of controlling the organism was found to be approximately MR$250,000. (50,000 pounds). This nosocomial infection therefore represents a serious problem, especially in developing countries where health funding and health facilities are limited.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  7. Mutations in rpoB and fusA cause resistance to rifampicin and fusidic acid in methicillin-resistant Staphylococcus aureus strains from a tertiary hospital in Malaysia
    Lim KT, Teh CS, Yusof MY, Thong KL
    Trans R Soc Trop Med Hyg, 2014 Feb;108(2):112-8.
    PMID: 24336696 DOI: 10.1093/trstmh/trt111
    The prevalence of resistance to rifampicin and fusidic acid among Malaysian strains of methicillin-resistant Staphylococcus aureus (MRSA) is increasing. This study aimed to determine the mechanisms of rifampicin and fusidic acid resistance and the genetic diversity of MRSA strains from a Malaysian tertiary hospital.
    Matched MeSH terms: Staphylococcal Infections/epidemiology
  8. Fulltext Comparison of methicillin-resistant Staphylococcus aureus strains isolated in 2003 and 2008 with an emergence of multidrug resistant ST22: SCCmec IV clone in a tertiary hospital, Malaysia
    Lim KT, Hanifah YA, Mohd Yusof MY, Ito T, Thong KL
    J Microbiol Immunol Infect, 2013 Jun;46(3):224-33.
    PMID: 23523045 DOI: 10.1016/j.jmii.2013.02.001
    Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) continue to be a problem for clinicians worldwide. The objective of this study was to determine the changes in antibiograms of MRSA and their genotypic characteristics.
    Matched MeSH terms: Staphylococcal Infections/epidemiology
  9. Temporal changes in the genotypes of methicillin-resistant Staphylococcus aureus strains isolated from a tertiary Malaysian hospital based on MLST, spa, and mec-associated dru typing
    Lim KT, Hanifah YA, Yusof MY, Goering RV, Thong KL
    Diagn Microbiol Infect Dis, 2012 Oct;74(2):106-12.
    PMID: 22770652 DOI: 10.1016/j.diagmicrobio.2012.05.033
    Methicillin-resistant Staphylococcus aureus (MRSA) is one of the main bacterial pathogens responsible for nosocomial infections leading to pneumonia, bloodstream, skin, and soft tissue infections. The objective of this study was to investigate the genomic changes of MRSA in a tertiary hospital between the years 2003, 2004, 2007, and 2008. One hundred fifty-four MRSA strains were characterized by multilocus sequence typing (MLST), spa, and mec-associated dru typing. Among the 154 strains, 29 different dru, 15 spa, and 8 MLST types were identified. Seven sequence types (STs) (ST239, ST22, ST5, ST6, ST80, ST573, and ST241) were identified among 2007-08 strains, although only 2 STs (ST239 and ST20) were observed among 2003 strains. Clones ST239-t037-dt13g, ST22-t032-(dt10a and dt10aw), and 28 other MRSA clones being introduced in 2007-2008 have replaced the ST239-t037 (dt13d, 14h, 13i, 13l, 13m, 15m, 15l, and 11al) clones present in 2003. The predominant MLST clone, ST239 (90.3%), was further distinguished into 7 different spa types and 26 different dru types, including 17 novel dru types. Maximum parsimony tree based on dru repeats revealed that 10 dru types (dt11am, dt13j, dt15n, dt13q, dt13n, dt13p, dt13f, dt13ao, dt12j, dt7v) shared the same MLST-spa types with dt13d, suggesting that these MRSA clones might have evolved from ST239-t037-dt13d. In conclusion, our data showed that the ST239-t037-dt13d clone and other MRSA clones in 2003 were replaced by ST239-t037-dt13g and other new emerging spa and dru types.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  10. Fulltext Investigation of toxin genes among methicillin-resistant Staphylococcus aureus strains isolated from a tertiary hospital in Malaysia
    Lim KT, Hanifah YA, Mohd Yusof MY, Thong KL
    Trop Biomed, 2012 Jun;29(2):212-9.
    PMID: 22735842 MyJurnal
    Staphylococcus aureus is a persistent human pathogen responsible for a variety of infections ranging from soft-tissue infections to bacteremia. It produces a variety of virulence factors which are responsible for specific acute staphylococcal toxaemia syndromes. The objective of this study was to determine the prevalence of a repertoire of toxin genes among Malaysian MRSA strains and their genetic diversity by PCR-RFLP of coa gene. One hundred eighty-eight strains (2003, 2004, 2007 and 2008) of methicillin-resistant S. aureus (MRSA) were screened for 20 genes encoding for extracellular virulence determinant (sea, seb, sec, sed, see, seg, seh, sei, sej, tst, eta, etb, etd) and adhesins (cna, etb, fnbA, fnbB, hlg, ica, sdrE). The genetic relatedness of these strains was determined by PCR-RFLP of coa gene and agr grouping. Majority of the strains were tested positive for efb and fnbA (96% each), ica (78%) and hlg (59%) genes. A total of 101 strains were positive for at least one type of staphylococcal enterotoxin genes with sea being the predominant. Genes for seb, sed, see, seh, sej, eta and etb were not detected in any of the MRSA strains. The prevalence of sea, sec and ica among strains isolated in 2008 was increased significantly (p< 0.05) compared to 2003. Most of the strains were of agr type I (97.5%) followed by agr type II (1.2%) and agr type III (0.6%). All sea, sei and tst gene-positive strains were of agr type I. The only etd positive strain was agr type III. PCR-RFLP of coa produced 47 different patterns. The number of strains with virulence factors (sea, sec and ica) had increased over the years. No direct correlation between PCR-RFLP- coa profiles and virulotypes was observed.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  11. Staphylococcal infection in Malaysian hospitals
    Lim VK
    J Hosp Infect, 1988 Feb;11 Suppl A:103-8.
    PMID: 2896692
    Staphylococcal infection is common in Malaysian hospitals. A recent survey of 22 Malaysian hospitals revealed that staphylococci were isolated from almost 40% of positive blood cultures. A more detailed analysis of such cases in our own hospital showed that almost 70% of Staphylococcus aureus and about 16% of coagulase-negative staphylococcal isolates were associated with clinically-significant disease. Staphylococcal bacteraemia was seen mainly in neonatal sepsis, skin and soft tissue infections, pneumonia, arthritis, osteomyelitis, endocarditis and postoperative sepsis. Multiply-resistant S. aureus were encountered in all the hospitals surveyed. Resistance rates to penicillin ranged from 40% to almost 100% while methicillin resistance rates of up to 25% were reported from several hospitals.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  12. Fulltext Methicillin resistant Staphylococcus aureus in a Malaysian neonatal unit
    Lim VKE, Zulkifli HI
    Singapore Med J, 1987 Apr;28(2):176-9.
    PMID: 3629274
    Methicillin resistant Siaphylococcus aureus Is a common isolate from clinical specimens obtained from babies at the special care nursery of the Kuala Lumpur Maternity Hospital. Major Infections due to this organism were, however uncommon and the organism had in the majority of cases been present as a coloniser or as a cause of superficial infection. Netilmicin is a valuable antibiotic in the treatment of the severe infections.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  13. Fulltext A persistent antimicrobial resistance pattern and limited methicillin-resistance-associated genotype in a short-term Staphylococcus aureus carriage isolated from a student population
    Mat Azis N, Pung HP, Abdul Rachman AR, Amin Nordin S, Sarchio SNE, Suhaili Z, et al.
    J Infect Public Health, 2017 Mar-Apr;10(2):156-164.
    PMID: 27033676 DOI: 10.1016/j.jiph.2016.02.013
    The aim of the present study was to assess and compare the antimicrobial susceptibility pattern against a panel of antibiotics and molecular and methicillin resistance-associated genotypes of 120 carriage S. aureus isolates previously isolated from a student population at two isolation events within a one-month interval. The antibiotic susceptibility of isolates was determined using the Kirby-Bauer disc-diffusion method (cefoxitin by Etest). The MRSA was screened using polymerase chain reaction for the presence of the mecA gene. The mecA-positive isolates were subjected to staphylococcal cassette chromosome (SCC) mec typing, multilocus sequence typing (MLST) and eBURST analysis. All isolates were characterized for the presence of the Panton-Valentine leukocidin (PVL) gene, an enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) pattern and the spa type. For the two occasions where S. aureus was isolated, the highest frequency of resistance was observed for penicillin (70% and 65%, respectively), with a lower rate against erythromycin and tetracycline (<12%). All isolates were susceptible to ciprofloxacin and gentamycin. As for methicillin resistance, eight isolates had minimum inhibitory concentrations (MIC) of resistant categories, but 10 isolates (8.33%) were positive for the mecA gene. The mecA-positive isolates belonged to SCCmec types I (n=9) and V (n=1). MLST was resolved for only three MRSAs, ST508 (n=1), ST88 (n=1) and ST96 (n=1). The results of the eBURST analysis showed that the MRSA isolates analyzed in the present study were potentially related to MRSA identified in other countries. Approximately half of the persistent S. aureus carriers harbored S. aureus of a similar spa type in the respective individuals during both isolation events. A persistent antimicrobial pattern and limited distinct MRSAs were observed over the short study period. The latter frequently exhibited SCCmec type I, commonly associated with hospital-acquired (HA) characteristics, but further delineation is needed to justify the origins of these bacteria.
    Matched MeSH terms: Staphylococcal Infections/epidemiology
  14. Fulltext Emergence of SCCmec type III with variable antimicrobial resistance profiles and spa types among methicillin-resistant Staphylococcus aureus isolated from healthcare- and community-acquired infections in the west of Iran
    Mohammadi S, Sekawi Z, Monjezi A, Maleki MH, Soroush S, Sadeghifard N, et al.
    Int J Infect Dis, 2014 Aug;25:152-8.
    PMID: 24909489 DOI: 10.1016/j.ijid.2014.02.018
    Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen of public health importance. The prevalence of MRSA and its antimicrobial resistance pattern, as well as SCCmec and spa types, remain unclear both in the community and in the hospitals of the western region of Iran.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  15. Fulltext First report on methicillin-resistant Staphylococcus aureus of Spa type T037, Sequence Type 239, SCCmec type III/IIIA in Malaysia
    Neela V, Ghasemzadeh Moghaddam H, van Belkum A, Horst-Kreft D, Mariana NS, Ghaznavi Rad E
    Eur J Clin Microbiol Infect Dis, 2010 Jan;29(1):115-7.
    PMID: 19779745 DOI: 10.1007/s10096-009-0813-6
    Methicillin-resistant Staphylococcus aureus (MRSA) from Malaysia were shown to possess staphylococcal cassette chromosome mec (SCCmec)-III and IIIA. Spa sequencing and multi-locus sequence typing (MLST) documented t037 and ST 239 (CC8) for 83.3% of the isolates. This confirms observations in several other Far Eastern countries and corroborates the epidemicity of this clone.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  16. Fulltext Prevalence of ST9 methicillin-resistant Staphylococcus aureus among pigs and pig handlers in Malaysia
    Neela V, Mohd Zafrul A, Mariana NS, van Belkum A, Liew YK, Rad EG
    J Clin Microbiol, 2009 Dec;47(12):4138-40.
    PMID: 19812280 DOI: 10.1128/JCM.01363-09
    Methicillin-resistant Staphylococcus aureus (MRSA) of sequence type 398 (ST398) has frequently been detected in pigs and pig handlers. However, in Malaysia, sampling 360 pigs and 90 pig handlers from 30 farms identified novel ST9-spa type t4358-staphylococcal cassette chromosome mec type V MRSA strains that were found to transiently colonize more than 1% of pigs and 5.5% of pig handlers.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  17. Fulltext Predominance of ST22-MRSA-IV Clone and Emergence of Clones for Methicillin-Resistant Staphylococcus aureus Clinical Isolates Collected from a Tertiary Teaching Hospital Over a Two-Year Period
    Niek WK, Teh CSJ, Idris N, Thong KL, Ponnampalavanar S
    Jpn J Infect Dis, 2019 Jul 24;72(4):228-236.
    PMID: 30814457 DOI: 10.7883/yoken.JJID.2018.289
    Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens, causing mild to severe infections. This study aimed to determine the genotypic and phenotypic characteristics of clinical MRSA isolates collected from a teaching hospital from 2014 - 2015. These isolates were genotyped by multilocus sequence typing, staphylococcal cassette chromosomal mec (SCCmec) typing, virulence genes detection, and pulsed-field gel electrophoresis; they were phenotyped based on their antibiotics susceptibility profiles. The most prevalent sequence type was ST22. ST3547 was identified from a blood isolate from 2015. Three SCCmec types (III in 26.26%, IV in 70.71%, and V in 3.03% isolates) were detected. Agr type I, II, and III were also detected among the isolates. The most prevalent virulence genes found were hemolysin (100%) and intracellular adhesion (91.9%). At least one staphylococcal enterotoxin was detected in 83 (83.8%) isolates. All the isolates were susceptible to vancomycin (minimum inhibitory concentration ≤ 2 μg/mL). Statistical analysis revealed a significant increase in hypertension (p = 0.035), dyslipidemia and obesity (p = 0.046), and previous exposure to any quinolone (p = 0.010) cases over the two-year period. The emergence and circulation of community-associated MRSA variants were observed in our hospital.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  18. Methicillin-resistant Staphylococcus aureus bacteraemia, 2003-2015: Comparative evaluation of changing trends in molecular epidemiology and clinical outcomes of infections
    Niek WK, Teh CSJ, Idris N, Sit PS, Lee YQ, Thong KL, et al.
    Infect Genet Evol, 2020 11;85:104567.
    PMID: 32980576 DOI: 10.1016/j.meegid.2020.104567
    Methicillin-resistant Staphylococcus aureus (MRSA) is a prominent pathogen causing invasive infections such as bacteraemia. The continued excessive use of antibiotics to treat MRSA infections has resulted in the evolution of antimicrobial resistant of S. aureus. This study aims to perform a comparative evaluation of changing trends in molecular epidemiology of MRSA and clinical characteristics of patients. This study shows that ST22-MRSA-IV has gradually replaced ST239-MRSA-III as the predominant MRSA clone in the tertiary teaching hospital studied. Independent predictors of mortality among patients included devices in situ at the time of infection, pre-exposure to macrolides, catheter-related bloodstream infection and mono-microbial infection. Hence, our study affirmed community-associated MRSA, which was previously identified from individuals without any exposure to healthcare settings, has now emerged in healthcare settings, causing healthcare-associated MRSA infections.
    Matched MeSH terms: Staphylococcal Infections/epidemiology*
  19. Antimicrobial resistance profiling and molecular typing of methicillin-resistant Staphylococcus aureus isolated from a Malaysian teaching hospital
    Noordin A, Sapri HF, Mohamad Sani NA, Leong SK, Tan XE, Tan TL, et al.
    J Med Microbiol, 2016 Dec;65(12):1476-1481.
    PMID: 27902380 DOI: 10.1099/jmm.0.000387
    The annual prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Malaysia has been estimated to be 30 % to 40 % of all S. aureus infections. Nevertheless, data on the antimicrobial resistance and genetic diversity of Malaysian MRSAs remain few. In 2009, we collected 318 MRSA strains from various wards of our teaching hospital located in Kuala Lumpur, the capital city of Malaysia, and performed antimicrobial susceptibility testing on these strains. The strains were then molecularly characterized via staphylococcal cassette chromosome (SCC) mec and virulence gene (cna, sea, seb, sec, sed, see, seg, seh, sei, eta, etb, Panton-Valentine leukocidin and toxic shock syndrome toxin-1) typing; a subset of 49 strains isolated from the intensive care unit was also typed using PFGE. Most strains were found to be resistant to ciprofloxacin (92.5 %), erythromycin (93.4 %) and gentamicin (86.8 %). The majority (72.0 %) of strains were found to harbour SCCmec type III-SCCmercury with the presence of ccrC, and carried the sea+cna gene combination (49.3 %), with cna as the most prevalent virulence gene (94.0 %) detected. We identified four PFGE clusters, with pulsotype C (n=19) as the dominant example in the intensive care unit, where this pulsotype was found to be associated with carriage of SCCmec type III and the sea gene (P=0.05 and P=0.02, respectively). In summary, the dominant MRSA circulating in our hospital in 2009 was a clone that was ciprofloxacin, erythromycin and gentamicin resistant, carried SCCmec type III-SCCmercury with ccrC and also harboured the sea+cna virulence genes. This clone also appears to be the dominant MRSA circulating in major hospitals in Kuala Lumpur.
    Matched MeSH terms: Staphylococcal Infections/epidemiology
  20. First community-acquired meticillin-resistant Staphylococcus aureus in Malaysia
    Nor Shamsudin M, Sekawi Z, van Belkum A, Neela V
    J Med Microbiol, 2008 Sep;57(Pt 9):1180-1181.
    PMID: 18719195 DOI: 10.1099/jmm.0.47844-0
    Matched MeSH terms: Staphylococcal Infections/epidemiology
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