title: An epidemiologic survey of methicillin-resistant Staphylococcus aureus by combined use of mec-HVR genotyping and toxin genotyping in a university hospital in Japan.
abstract: OBJECTIVE
  To evaluate the usefulness of an assay using two polymerase chain reaction-based genotyping methods in the practical surveillance of methicillin-resistant Staphylococcus aureus (MRSA).
  
  
  METHODS
  Nosocomial infection and colonization were surveyed monthly in a university hospital in Japan for 20 months. Genotyping with mec-HVR is based on the size of the mec-associated hypervariable region amplified by polymerase chain reaction. Toxin genotyping uses a multiplex polymerase chain reaction method to amplify eight staphylococcal toxin genes.
  
  
  RESULTS
  Eight hundred nine MRSA isolates were classified into 49 genotypes. We observed differing prevalences of genotypes for different hospital wards, and could rapidly demonstrate the similarity of genotype for outbreak isolates. The incidence of genotype D: SEC/TSST1 was significantly higher in isolates causing nosocomial infections (49.5%; 48 of 97) than in nasal isolates (31.4%; 54 of 172) (P = .004), suggesting that this genotype may represent the nosocomial strains.
  
  
  CONCLUSIONS
  The combined use of these two genotyping methods resulted in improved discriminatory ability and should be further investigated.
authors.affiliation: Kagoshima University Hospital, Infection Control Team, Japan.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Nishi
authors.forename: Masao
authors.initials: M
authors.lastname: Yoshinaga
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyanohara
authors.forename: Motoshi
authors.initials: M
authors.lastname: Kawahara
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kawabata
authors.forename: Toshiro
authors.initials: T
authors.lastname: Motoya
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oiso
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kawakami
authors.forename: Shigeko
authors.initials: S
authors.lastname: Kamewari
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Koyama
authors.forename: Naoko
authors.initials: N
authors.lastname: Wakimoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Tokuda
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Manago
authors.forename: Ikuro
authors.initials: I
authors.lastname: Maruyama
mesh_terms: D001427:Bacterial Toxins / Q000235:genetics*; D015373:Bacterial Typing Techniques / Q000379:methods* / Q000592:standards; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D022801:Complementarity Determining Regions / Q000235:genetics; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics*; D016002:Discriminant Analysis; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D004768:Enterotoxins / Q000235:genetics; D005083:Exfoliatins / Q000235:genetics; D005838:Genotype; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D007564:Japan / Q000453:epidemiology; D016106:Methicillin Resistance / Q000235:genetics*; D009666:Nose / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods* / Q000592:standards; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000235:genetics*; D018089:Superantigens
chemical_list: D001427:Bacterial Toxins; D022801:Complementarity Determining Regions; D004269:DNA, Bacterial; D004768:Enterotoxins; D005083:Exfoliatins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal