| Title | The Emergence and Importation of Diverse Genotypes of MRSA Harboring the Panton-Valentine Leukocidin Gene pvl Reveals that pvl is a Poor Marker for Community-Acquired MRSA in Ireland. | | Author(s) | Rossney AS, Shore AC, Morgan PM, Fitzgibbon MM, O'connell B, Coleman DC | | Institution | National MRSA Reference Laboratory, St. James's Hospital, James's St., Dublin 8, Ireland; Department of Clinical Microbiology, University of Dublin, Trinity College, St. James's Hospital, James's St., Dublin 8, Ireland; Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental School and Hospital, University of Dublin, Trinity College, Dublin 2, Ireland. | | Source | J Clin Microbiol 2007 Jun 20. | | Abstract | Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) encoding pvl is an emerging problem worldwide. CA-MRSA tend to harbor staphylococcal cassette chromosome mec (SCCmec) type IV, to be non-multi-antibiotic resistant and to have different genotypes from local hospital-acquired MRSA (HA-MRSA). However, in Ireland, 80% of HA-MRSA have the non-multi-antibiotic resistant genotype ST22-MRSA-IV. This study investigated MRSA from Ireland (CA-, healthcare-associated- and HA-MRSA) for carriage of pvl, and determined the genotypic characteristics of all pvl-positive isolates identified. All 1,389 MRSA isolates were investigated by antibiogram-resistogram typing and SmaI DNA macrorestriction analysis. pvl-positive isolates were further characterized by multilocus sequence typing, SCCmec, agr and toxin gene typing. Twenty-five (1.8%) MRSA isolates belonging to six genotypes (ST30, ST8, ST22, ST80, ST5, ST154) harbored pvl. Nineteen of these (76%) were community-acquired but a prospective study of MRSA from 401 patients showed that only 6.7% of patients with CA-MRSA (2/30) yielded pvl-positive isolates. Thus pvl cannot be used as a sole marker for CA-MRSA. Fifty-two percent of pvl-positive MRSA isolates were recovered from patients with skin and soft tissue infections. Thirty-six percent were from patients of non-Irish ethnic origin reflecting the increasing heterogeneity of the Irish population due to immigration. All 25 pvl-positive isolates carried SCCmec type IV; 14 (56%) harbored SCCmec IV.1 or IV.3. The remaining 11 isolates could not be subtyped. This study demonstrates that pvl is not a reliable marker for CA-MRSA in Ireland and reveals the emergence and importation of diverse genotypes of pvl-positive MRSA in Ireland. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 17581935 |
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