title: Changes in staphylococcal cassette chromosome type and antibiotic resistance profile in methicillin-resistant Staphylococcus aureus isolates from a French hospital over an 11 year period.
abstract: BACKGROUND
  In this study, we investigated the relationship between changes in antibiotic resistance and distribution of staphylococcal cassette chromosome (SCC) types amongst methicillin-resistant Staphylococcus aureus (MRSA) isolates expressing the most frequently encountered profiles of antibiotic resistance over an 11 year period in the University Hospital of Rennes, France.
  
  
  METHODS
  Antibiotic susceptibilities were determined by agar diffusion. SCC typing was performed using PCR. PFGE demonstrated that isolates were phylogenetically related.
  
  
  RESULTS
  Fourteen profiles of antibiotic resistance were defined among MRSA isolates. For each resistance profile, only one SCC type was associated: four patterns corresponded to SCC type I or IA, nine to SCC type IV or IVA, and none to types II and III. One was not typed. PFGE indicated that isolates with SCC type I or IA belong to a single genetic lineage, which also includes most of the epidemic isolates, which carry SCC type IVA. In contrast to type I or IA, isolates with SCC type IV or IVA were found to be associated with several different PFGE clusters, although not all of these represent epidemic isolates.
  
  
  CONCLUSIONS
  During the course of the study, the spectrum of antibiotic resistance in MRSA isolates decreased. This occurred due to the emergence of strains with SCC type IV or IVA, which are susceptible to more antibiotics than type I or IA strains. The greater prevalence of such isolates could not be linked conclusively to the presence of SCC type IV or IVA, or to one particular PFGE cluster.
authors.affiliation: Laboratoire de Bactériologie-Virologie and Laboratoire de Parasitologie, Centre Hospitalier Universitaire, 35033 Rennes cedex 9, France. pierre-yves.donnio@chu-rennes.fr
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Donnio
authors.forename: Laure
authors.initials: L
authors.lastname: Preney
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Gautier-Lerestif
authors.forename: Jean-Loup
authors.initials: JL
authors.lastname: Avril
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lafforgue
mesh_terms: D002876:Chromosomes, Bacterial / Q000235:genetics*; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005602:France; D006801:Humans; D016106:Methicillin Resistance; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000382:microbiology*; D013210:Staphylococcus / Q000187:drug effects* / Q000235:genetics*; D013211:Staphylococcus aureus / Q000187:drug effects*