title: Molecular pattern and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus isolates at a teaching hospital in Northern Taiwan.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Cathay-General Hospital, Taipei, Taiwan.
authors.forename: Pei Wen
authors.initials: PW
authors.lastname: Tai
authors.forename: Cheng Hua
authors.initials: CH
authors.lastname: Huang
authors.forename: Qin Dong
authors.initials: QD
authors.lastname: Lin
authors.forename: Yang Yang
authors.initials: YY
authors.lastname: Huang
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents