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Molecular analysis and susceptibility patterns of meticillin-resistant Staphylococcus aureus (MRSA) strains circulating in the community in the Ligurian area, a northern region of Italy: emergence of USA300 and EMRSA-15 clones.
Int J Antimicrob Agents. 2009 Nov; 34(5):424-8.IJ

Abstract

For many years meticillin-resistant Staphylococcus aureus (MRSA) has been considered a typical nosocomial pathogen. Recently, MRSA has emerged as a frequent cause of infections in the community. A multicentre surveillance study was carried out in the Ligurian area of Italy to evaluate the incidence, molecular nature and susceptibility patterns of MRSA strains circulating among outpatients. The genetic background of MRSA strains was analysed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Determination of antimicrobial susceptibility patterns, staphylococcal cassette chromosome mec (SCCmec) type, accessory gene regulator (agr) group and Panton-Valentine leukocidin (PVL) production was also performed. In total, 12 (6.4%) of 188 S. aureus isolates collected during 2006-2007 were found to be MRSA by phenotypic and genotypic methods. Analysis of isolates by PFGE showed that the majority of strains (11/12) belonged to two well-known international clones (EMRSA-15 and USA300) and their variations. High variability regarding SCCmec IV subtypes, susceptibility patterns and PVL toxin production were found among members of the USA300 clonal group, even when displaying the same PFGE profiles. The remaining MRSA strain belonged to sequence type (ST) 8, agr group I and carried SCCmec type I. Both community-associated MRSA and healthcare-associated MRSA epidemic international clones circulate among outpatients in our region. It is alarming that members of the most represented clonal group in our collection (USA300) can acquire multiresistance as well as PVL genes. Infection control measures in our area should be improved to avoid the selection of microorganisms displaying both traits simultaneously as well as the spread of these epidemic international clones.

Authors+Show Affiliations

Sezione di Microbiologia del DISCMIT, University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy. anna.marchese@unige.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19651493

Citation

Marchese, Anna, et al. "Molecular Analysis and Susceptibility Patterns of Meticillin-resistant Staphylococcus Aureus (MRSA) Strains Circulating in the Community in the Ligurian Area, a Northern Region of Italy: Emergence of USA300 and EMRSA-15 Clones." International Journal of Antimicrobial Agents, vol. 34, no. 5, 2009, pp. 424-8.
Marchese A, Gualco L, Maioli E, et al. Molecular analysis and susceptibility patterns of meticillin-resistant Staphylococcus aureus (MRSA) strains circulating in the community in the Ligurian area, a northern region of Italy: emergence of USA300 and EMRSA-15 clones. Int J Antimicrob Agents. 2009;34(5):424-8.
Marchese, A., Gualco, L., Maioli, E., & Debbia, E. (2009). Molecular analysis and susceptibility patterns of meticillin-resistant Staphylococcus aureus (MRSA) strains circulating in the community in the Ligurian area, a northern region of Italy: emergence of USA300 and EMRSA-15 clones. International Journal of Antimicrobial Agents, 34(5), 424-8. https://doi.org/10.1016/j.ijantimicag.2009.06.016
Marchese A, et al. Molecular Analysis and Susceptibility Patterns of Meticillin-resistant Staphylococcus Aureus (MRSA) Strains Circulating in the Community in the Ligurian Area, a Northern Region of Italy: Emergence of USA300 and EMRSA-15 Clones. Int J Antimicrob Agents. 2009;34(5):424-8. PubMed PMID: 19651493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular analysis and susceptibility patterns of meticillin-resistant Staphylococcus aureus (MRSA) strains circulating in the community in the Ligurian area, a northern region of Italy: emergence of USA300 and EMRSA-15 clones. AU - Marchese,Anna, AU - Gualco,Laura, AU - Maioli,Elisabetta, AU - Debbia,Eugenio, Y1 - 2009/08/03/ PY - 2009/03/31/received PY - 2009/06/09/accepted PY - 2009/8/5/entrez PY - 2009/8/5/pubmed PY - 2009/11/7/medline SP - 424 EP - 8 JF - International journal of antimicrobial agents JO - Int J Antimicrob Agents VL - 34 IS - 5 N2 - For many years meticillin-resistant Staphylococcus aureus (MRSA) has been considered a typical nosocomial pathogen. Recently, MRSA has emerged as a frequent cause of infections in the community. A multicentre surveillance study was carried out in the Ligurian area of Italy to evaluate the incidence, molecular nature and susceptibility patterns of MRSA strains circulating among outpatients. The genetic background of MRSA strains was analysed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Determination of antimicrobial susceptibility patterns, staphylococcal cassette chromosome mec (SCCmec) type, accessory gene regulator (agr) group and Panton-Valentine leukocidin (PVL) production was also performed. In total, 12 (6.4%) of 188 S. aureus isolates collected during 2006-2007 were found to be MRSA by phenotypic and genotypic methods. Analysis of isolates by PFGE showed that the majority of strains (11/12) belonged to two well-known international clones (EMRSA-15 and USA300) and their variations. High variability regarding SCCmec IV subtypes, susceptibility patterns and PVL toxin production were found among members of the USA300 clonal group, even when displaying the same PFGE profiles. The remaining MRSA strain belonged to sequence type (ST) 8, agr group I and carried SCCmec type I. Both community-associated MRSA and healthcare-associated MRSA epidemic international clones circulate among outpatients in our region. It is alarming that members of the most represented clonal group in our collection (USA300) can acquire multiresistance as well as PVL genes. Infection control measures in our area should be improved to avoid the selection of microorganisms displaying both traits simultaneously as well as the spread of these epidemic international clones. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/19651493/Molecular_analysis_and_susceptibility_patterns_of_meticillin_resistant_Staphylococcus_aureus__MRSA__strains_circulating_in_the_community_in_the_Ligurian_area_a_northern_region_of_Italy:_emergence_of_USA300_and_EMRSA_15_clones_ DB - PRIME DP - Unbound Medicine ER -