title: Characterization of MRSA transmission in an emergency medical center by sequence analysis of the 3'-end region of the coagulase gene.
abstract: The distribution of methicillin-resistant Staphylococcus aureus (MRSA) isolates at the St. Marianna University affiliated emergency medical center (EMC) was studied by sequence analysis of the 3'-end region of the coagulase gene. We collected a total of 42 MRSA isolates, consisting of 20 strains from the hospital environment, 13 strains from the nostrils or fingers of medical staff, and 9 strains from inpatients in the EMC. We compared our results with those from 27 stock strains of known coagulase serotype and 2 strains reported in the literature. All 69 strains tested have four to six tandem repeats in the 3'-end region of the coagulase gene. Among the 42 MRSA isolates collected, the base sequence of the 3'-end region of the coagulase gene was identical in 28 of them (67%). The number of isolates originating from the hospital environment, medical staff, and patients, respectively, that were identical to this representative strain were 18 (90%), 6 (46%), and 4 (44%). Phylogenetic analysis using the DNA sequences of the tandem repeat region demonstrated that almost all strains from the patients formed a concordant cluster with the representative strain from the hospital ward. We also assessed the value of sequence analysis of the 3'-end region of the coagulase gene as an epidemiological marker. Our results indicate that sequence analysis of the 3'-end region of the coagulase gene of MRSA may be a potent epidemiologic typing system.
authors.affiliation: Department of Microbiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 261-8511, Japan kzkane@marianna-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Kanemitsu
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: H
authors.initials: H
authors.lastname: Takemura
authors.forename: M
authors.initials: M
authors.lastname: Kaku
authors.forename: J
authors.initials: J
authors.lastname: Shimada
mesh_terms: D015373:Bacterial Typing Techniques; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D003030:Coagulase / Q000235:genetics*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D004269:DNA, Bacterial / Q000235:genetics; D004587:Electrophoresis, Agar Gel; D004632:Emergency Medical Services; D004866:Equipment Contamination; D005385:Fingers / Q000382:microbiology; D005798:Genes, Bacterial; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D017757:Infectious Disease Transmission, Professional-to-Patient; D007297:Inpatients; D007564:Japan / Q000453:epidemiology; D016106:Methicillin Resistance; D018598:Minisatellite Repeats; D009296:Nasal Cavity / Q000382:microbiology; D010564:Personnel, Hospital; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D012703:Serotyping; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D003030:Coagulase; D004269:DNA, Bacterial