title: Emergence of community-associated methicillin-resistant Staphylococcus aureus in Singapore: a further six cases.
abstract: BACKGROUND
  The clinical features and molecular epidemiology of further cases of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in Singapore are described.
  
  
  METHODS
  Six cases of CA-MRSA infection that occurred between April and October 2004 are described. The bacterial isolates were tested for the presence of Panton-Valentine leukocidin (PVL) genes and typed via pulsedfield gel electrophoresis, staphylococcal chromosomal cassette mec (SCCmec) and multi-locus sequence typing. The results were compared with that of previously-reported local and international CA-MRSA isolates.
  
  
  RESULTS
  There were four cases of cutaneous abscesses and one each of chronic osteomyelitis and endocarditis. CA-MRSA isolates from the last two cases tested negative for PVL genes. Three isolates were identical and related to the Oceanian clone, and one isolate to the predominant Taiwanese clone. The isolate causing osteomyelitis had a novel sequence type.
  
  
  CONCLUSIONS
  CA-MRSA, though uncommon, is being isolated with increasing frequency in Singapore. A predominant clone (ST30- MRSA-IV) seems to be emerging locally.
authors.affiliation: Department of Internal Medicine, Singapore General Hospital, Outram Road, Singapore 169608. liyang_hsu@yahoo.com
authors.forename: L Y
authors.initials: LY
authors.lastname: Hsu
authors.forename: T H
authors.initials: TH
authors.lastname: Koh
authors.forename: T Y
authors.initials: TY
authors.lastname: Tan
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.forename: X X
authors.initials: XX
authors.lastname: Ma
authors.forename: R T
authors.initials: RT
authors.lastname: Lin
authors.forename: B H
authors.initials: BH
authors.lastname: Tan
mesh_terms: D000328:Adult; D001427:Bacterial Toxins; D015373:Bacterial Typing Techniques; D002648:Child; D002876:Chromosomes, Bacterial; D017714:Community-Acquired Infections / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D005098:Exotoxins; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D007956:Leukocidins; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D012846:Singapore; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin