title: Spread of a single multiresistant methicillin-resistant Staphylococcus aureus clone carrying a variant of staphylococcal cassette chromosome mec type III isolated in a university hospital.
abstract: The purpose of the study was the molecular characterization of methicillin-resistant Staphylococcus aureus (MRSA) isolates cultured from patients treated in seven wards of a university hospital in Lublin, Poland, over a 14-month period. Eleven nosocomial MRSA isolates were analyzed. Phenotypic identification of the isolates as MRSA was confirmed by the detection of the nuc and mecA genes using a multiplex PCR assay. The MRSA isolates were further characterized by pulsed-field gel electrophoresis, 16S-23S rRNA spacer length polymorphism analysis, and the simplex and multiplex SCCmec PCR assays. The MRSA isolates were found to be multiresistant: in addition to resistance to beta-lactam agents, they demonstrated resistance to ciprofloxacin, tetracycline, erythromycin, and gentamicin. The MRSA isolates were genetically identical and shared common pulsed-field gel electrophoresis profiles and 16S-23S rRNA spacer length polymorphism profiles. The PCR-based method revealed that the profile of the Lublin clone was identical to that of the Brazilian pandemic MRSA isolates. By SCCmec typing, all MRSA isolates harbored the C variant of the SCCmec type III that differed from the typical SCCmec type III pattern by the lack of locus F (414 bp). The results of this study indicate the spread of a single, multiresistant, MRSA clone in various wards of a university hospital over a 14-month period. The SCCmec structure harbored by the Lublin clone has previously been identified among Polish MRSA isolates representing the HoMRSA-Pol1 clone. The data from this study indicate that the Lublin MRSA clone is most probably genetically related to the HoMRSA-Pol1 clone. Moreover, this latter clone belongs to ST239, the same sequence type as the Hungarian and Brazilian pandemic MRSA isolates.
authors.affiliation: Department of Clinical Microbiology, Medical University of Lublin, Lublin, Poland. agola7@wp.pl
authors.forename: A
authors.initials: A
authors.lastname: Szczepanik
authors.forename: M
authors.initials: M
authors.lastname: Kozioł-Montewka
authors.forename: Z
authors.initials: Z
authors.lastname: Al-Doori
authors.forename: D
authors.initials: D
authors.lastname: Morrison
authors.forename: D
authors.initials: D
authors.lastname: Kaczor
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D018432:Drug Resistance, Multiple / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D004720:Endonucleases / Q000235:genetics*; D006785:Hospitals, University; D006801:Humans; D016106:Methicillin Resistance / Q000187:drug effects / Q000235:genetics; D008836:Micrococcal Nuclease / Q000235:genetics*; D046915:Penicillin-Binding Proteins; D011044:Poland / Q000453:epidemiology; D012336:RNA, Ribosomal, 16S; D013203:Staphylococcal Infections / Q000235:genetics*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics* / Q000472:pathogenicity
chemical_list: D001426:Bacterial Proteins; D046915:Penicillin-Binding Proteins; D012336:RNA, Ribosomal, 16S; C487789:mecA protein, Staphylococcus aureus; C074002:nuc protein, staphylococcus; D004720:Endonucleases; D008836:Micrococcal Nuclease