title: Changes in the epidemiology of meticillin-resistant Staphylococcus aureus associated with the emergence of EMRSA-16 at a university hospital.
abstract: This study investigated the molecular epidemiology of meticillin-resistant Staphylococcus aureus (MRSA) in the University Hospital of the Canary Islands (HUC) in order to evaluate epidemiological changes over a six-year period. Clinical and epidemiological data were collected between May 2000 and December 2003, and isolates were subjected to pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST), SCCmec typing and spa typing. Since 2000, the rate of MRSA infections has increased at the HUC, coinciding with the emergence and spread of the EMRSA-16 clone (ST36-MRSA-II) and replacement of the Iberian clone (ST247-MRSA-I). Genotypic changes were associated with changes in the epidemiological profile. The mean age and proportion of patients over 60 years old (P=0.01) and the proportion of respiratory infections (P=0.001) increased significantly. Gentamicin and tetracycline susceptibility of MRSA isolates increased (P<0.001) following the emergence of EMRSA-16. Combining PFGE, SCCmec and MLST has been instrumental in understanding these changes and defining the clones circulating in the HUC patient population.
authors.affiliation: Infection Control and Microbiology Department, Hospital Universitario de Canarias, La Laguna, Tenerife, Canary Islands, Spain. carlotamontesin@terra.es
authors.forename: I
authors.initials: I
authors.lastname: Montesinos
authors.forename: T
authors.initials: T
authors.lastname: Delgado
authors.forename: D
authors.initials: D
authors.lastname: Riverol
authors.forename: E
authors.initials: E
authors.lastname: Salido
authors.forename: M A
authors.initials: MA
authors.lastname: Miguel
authors.forename: A
authors.initials: A
authors.lastname: Jimenez
authors.forename: A
authors.initials: A
authors.lastname: Sierra
mesh_terms: D000367:Age Factors; D000368:Aged; D015373:Bacterial Typing Techniques / Q000379:methods*; D003428:Cross Infection / Q000453:epidemiology* / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D016106:Methicillin Resistance / Q000187:drug effects* / Q000235:genetics; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D017720:Molecular Epidemiology / Q000379:methods; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification