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Dissemination of methicillin-resistant Staphylococcus aureus SCCmec type IV and SCCmec type V epidemic clones in a tertiary hospital: challenge to infection control.

Abstract
Two-hundred MRSA strains from inpatients with healthcare-associated (HA) and 100 MRSA strains from outpatients with community-associated (CA) skin and soft tissue infections (SSTIs) were tested for antimicrobial susceptibility, staphylococcal cassette chromosome mec (SCCmec) typing, Panton-Valentine leucocidin (PVL) toxin, seh and arcA genes. Based on SCCmec typing, HA-MRSA isolates were further divided into HA-SCCmec I/II/III MRSA and HA-SCCmec IV/V MRSA, and CA-MRSA isolates into CA-SCCmec I/II/III MRSA and CA-SCCmec IV/V MRSA. SCCmec types were further characterized by pulsed-field gel electrophoresis, spa typing and multi-locus sequence typing. Seventy-five (37·5%) HA-MRSA isolates and 83/100 CA-MRSA isolates were SCCmec IV/V genotype. HA-SCCmec IV/V MRSA was associated with malignancy (P = 0·03) and bone fractures (P = 0·02) compared to CA-SCCmec IV/V MRSA. HA-SCCmec IV/V MRSA was associated with PVL gene carriage compared to HA-SCCmec I/II/III MRSA (P < 0·001). ST22-MRSA-IV (EMRSA-15), ST772-MRSA-V, and ST36-MRSA-IV and ST239:EMRSA-I:III were the major clones identified. Our study documents the emergence of SCCmec IV and SCCmec V MRSA clones in an Indian hospital.
AuthorsB Dhawan, C Rao, E E Udo, R Gadepalli, S Vishnubhatla, A Kapil
JournalEpidemiology and infection (Epidemiol Infect) Vol. 143 Issue 2 Pg. 343-53 (Jan 2015) ISSN: 1469-4409 [Electronic] England
PMID24690229 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Bacterial Toxins
  • Enterotoxins
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin
  • Staphylococcal enterotoxin H
Topics
  • Adolescent
  • Adult
  • Anti-Bacterial Agents (pharmacology)
  • Bacterial Proteins (genetics)
  • Bacterial Toxins (genetics)
  • Child
  • Cross Infection (epidemiology, microbiology, prevention & control)
  • Enterotoxins (genetics)
  • Exotoxins (genetics)
  • Female
  • Humans
  • Infection Control
  • Leukocidins (genetics)
  • Male
  • Methicillin Resistance (genetics)
  • Methicillin-Resistant Staphylococcus aureus (classification, drug effects, genetics, isolation & purification)
  • Microbial Sensitivity Tests
  • Middle Aged
  • Multilocus Sequence Typing
  • Staphylococcal Infections (epidemiology, microbiology, prevention & control)
  • Tertiary Care Centers (statistics & numerical data)
  • Young Adult

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