Molecular pattern and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus isolates at a teaching hospital in Northern Taiwan.
OBJECTIVE
Methicillin-resistant Staphylococcus aureus (MRSA) infection has progressively increased worldwide. Knowledge of the specific epidemiological pattern of isolates at individual hospitals is important.


METHODS
MRSA bacteremia was diagnosed in a total of 68 patients from January 2002 through December 2003, stratified for drug susceptibility and molecular pattern (staphylococcal cassette chromosome mec element [SCCmec] typing and genotypes).


RESULTS
SCCmec-A-positive isolates were found on polymerase chain reaction in 58 patients. The most frequent SCCmec types were III (40 cases) of which less than 5% were susceptible to other beta-lactam antibiotics and most were health care-associated, followed by SCCmec type IV (15 cases), that were demonstrated to be community-acquired. SCCmec type IV MRSA isolates were more likely to be susceptible to ciprofloxacin (93.3%), gentamicin (46.7%) and trimethoprim-sulfamethoxazole (93.3%) than type III isolates. All MRSA isolates were susceptible to glycopeptides and vancomycin (minimum inhibitory concentrations <2 microg/mL). Pulsed-field gel electrophoresis with SmaI digestion was used to fingerprint these isolates. A total of 9 genotypes with 26 type-subtypes were identified. Genotype A was the most frequent (9 subtypes) indicating that it is epidemic in this hospital.


CONCLUSIONS
After analysis, SCCmec typing could be used to predict drug susceptibility. Specific clones of S. aureus are circulating in hospital and communities in Taiwan.
Tai
Pei Wen
PW
Division of Infectious Diseases, Department of Internal Medicine, Cathay-General Hospital, Taipei, Taiwan.
Huang
Cheng Hua
CH
Lin
Qin Dong
QD
Huang
Yang Yang
YY
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods; D005838:Genotype; D006801:Humans; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction / Q000379:methods; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D013624:Taiwan / Q000453:epidemiology
D000900:Anti-Bacterial Agents