title: Rapid geographic spread of a methicillin-resistant Staphylococcus aureus strain.
abstract: In May 1993, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) was identified at our tertiary care teaching center. The epidemic MRSA strain was transmitted efficiently in the hospital environment. Subsequent investigations indicated that the strain had been introduced into western Canada by a patient who had recently been hospitalized for 3 months in the Punjab, India, and had been admitted to a hospital in rural British Columbia shortly after his arrival in Canada. Transfer of the patient to a hospital in Vancouver and subsequent transfer of a colonized patient contact to a hospital in Winnipeg, Manitoba, resulted in major outbreaks of MRSA at these two large tertiary care centers within 6 weeks of the arrival of the index case in Canada. Epidemiological typing of the S. aureus coagulase gene with use of a polymerase chain reaction method and pulsed-field gel electrophoresis documented clonality of this strain. These outbreaks again illustrate both the propensity of certain strains of S. aureus to produce epidemic disease, including rapid spread within the institutional setting, and the global nature of problems with antimicrobial resistance.
authors.affiliation: MDS-Metro-McNair Clinical Laboratories, Burnaby, British Columbia, Canada.
authors.forename: R S
authors.initials: RS
authors.lastname: Roman
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Walker
authors.forename: S
authors.initials: S
authors.lastname: Byrne
authors.forename: K
authors.initials: K
authors.lastname: Ramotar
authors.forename: B
authors.initials: B
authors.lastname: Dyck
authors.forename: A
authors.initials: A
authors.lastname: Kabani
authors.forename: L E
authors.initials: LE
authors.lastname: Nicolle
mesh_terms: D015373:Bacterial Typing Techniques; D001483:Base Sequence; D001955:British Columbia / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D017931:DNA Primers / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control; D008350:Manitoba / Q000453:epidemiology; D016106:Methicillin Resistance / Q000235:genetics; D017720:Molecular Epidemiology; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D017931:DNA Primers; D004269:DNA, Bacterial