title: Delineation of the endemic and sporadic methicillin-resistant Staphylococcus aureus clones in a Czech hospital.
abstract: The aim of this study was to define the endemic clones of methicillin-resistant Staphylococcus aureus (MRSA) among strains collected between September, 2001, and February, 2003, at the regional hospital of Nový Jicín, Czech Republic. The isolates were characterized by susceptibility tests, HindIII ribotyping, and pulsed-field gel electrophoresis. Representatives of each clonal type were analyzed by multilocus sequence typing and staphylococcal cassette chromosome mec (SCCmec) typing. The prevalence of the most important macrolide (ermA, ermB, ermC, and msrA) and aminoglycoside (aac6'-aph2", aph3', and ant4') resistance genes was evaluated as well. Our results document the existence of two international MRSA clones: (1) the Iberian clone (ST247:SCCmec IA:PFGE A:ribotype H2), endemic in the hospital and associated to a single multiresistant phenotype; and (2) clone EMRSA-15 (ST22:SCCmec IV:PFGE H-ribotype H7), appearing in the beginning of 2002 and associated with three phenotypes. These two clones could be distinguished by antibiogram, distribution of macrolide and aminoglycoside resistance genes (ermA, aac6'-aph2", ant4' versus ermC and msrA in a few isolates), production of beta-lactamase, and presence of enterotoxin A (in the Iberian clone).
authors.affiliation: National Institute of Public Health, Prague, Czech Republic.
authors.forename: O
authors.initials: O
authors.lastname: Melter
authors.forename: M
authors.initials: M
authors.lastname: Aires de Sousa
authors.forename: K
authors.initials: K
authors.lastname: Laskafeldová
authors.forename: P
authors.initials: P
authors.lastname: Urbásková
authors.forename: M
authors.initials: M
authors.lastname: Wünschová
authors.forename: H
authors.initials: H
authors.lastname: de Lencastre
mesh_terms: D018153:Czech Republic / Q000453:epidemiology; D019353:Endemic Diseases; D004768:Enterotoxins / Q000235:genetics / Q000302:isolation & purification; D005083:Exfoliatins / Q000235:genetics / Q000302:isolation & purification; D006745:Hospital Bed Capacity, 300 to 499; D006801:Humans; D016106:Methicillin Resistance / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D009735:Nursing Homes; D016133:Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*
chemical_list: D004768:Enterotoxins; D005083:Exfoliatins