Genetic Diversity among Community Methicillin-Resistant Staphylococcus aureus Strains Causing Outpatient Infections in Australia

Journal of Clinical Microbiology - Tập 42 Số 10 - Trang 4735-4743 - 2004
Geoffrey W. Coombs1, Graeme R. Nimmo2, Jan M. Bell3, Flavia Huygens4, Frances O’Brien1,5, Mary J. Malkowski1, Julie Pearson1, Alex J. Stephens4, Philip M. Giffard4
1Gram-Positive Bacteria Typing and Research Unit, Royal Perth Hospital
2Microbiology Division, Queensland Health Pathology Service, Princess Alexandra Hospital
3Microbiology and Infectious Diseases Department, Women's and Children's Hospital, Adelaide, Australia
4Cooperative Research Centre for Diagnostics, Queensland University of Technology, Brisbane
5School of Biomedical Sciences, Curtin University, Perth

Tóm tắt

ABSTRACT

Increasing reports of the appearance of novel nonmultiresistant methicillin-resistant Staphylococcus aureus MRSA (MRSA) strains in the community and of the spread of hospital MRSA strains into the community are cause for public health concern. We conducted two national surveys of unique isolates of S. aureus from clinical specimens collected from nonhospitalized patients commencing in 2000 and 2002, respectively. A total of 11.7% of 2,498 isolates from 2000 and 15.4% of 2,486 isolates from 2002 were MRSA. Approximately 54% of the MRSA isolates were nonmultiresistant (resistant to less than three of nine antibiotics) in both surveys. The majority of multiresistant MRSA isolates in both surveys belonged to two strains (strains AUS-2 and AUS-3), as determined by pulsed-field gel electrophoresis (PFGE) and resistogram typing. The 3 AUS-2 isolates and 10 of the 11 AUS-3 isolates selected for multilocus sequence typing (MLST) and staphylococcal chromosomal cassette mec (SCC mec ) analysis were ST239-MRSA-III (where ST is the sequence type) and thus belonged to the same clone as the eastern Australian MRSA strain of the 1980s, which spread internationally. Four predominant clones of novel nonmultiresistant MRSA were identified by PFGE, MLST, and SCC mec analysis: ST22-MRSA-IV (strain EMRSA-15), ST1-MRSA-IV (strain WA-1), ST30-MRSA-IV (strain SWP), and ST93-MRSA-IV (strain Queensland). The last three clones are associated with community acquisition. A total of 14 STs were identified in the surveys, including six unique clones of novel nonmultiresistant MRSA, namely, STs 73, 93, 129, 75, and 80slv and a new ST. SCC mec types IV and V were present in diverse genetic backgrounds. These findings provide support for the acquisition of SCC mec by multiple lineages of S. aureus . They also confirm that both hospital and community strains of MRSA are now common in nonhospitalized patients throughout Australia.

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Journal of Clinical Microbiology

Tập 42 Số 10

4735-4743

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