Molecular and epidemiological evidence for spread of multiresistant methicillin-susceptible Staphylococcus aureus strains in hospitals.
The excision of the staphylococcal chromosomal cassette mec (SCCmec) from methicillin-resistant Staphylococcus aureus (MRSA) strains results in methicillin-susceptible S. aureus (MSSA) strains. In order to determine the proportion and diversity of multidrug-resistant MSSA (MR-MSSA) strains derived from MRSA strains, 247 mecA-negative isolates recovered in 60 French hospitals between 2002 and 2004 were characterized. The spa types of all strains were determined, and a subset of the strains (n = 30) was further genotyped by multilocus sequence typing. The IDI-MRSA assay was used to test the isolates for the presence of the SCCmec element, which was detected in 68% of all isolates analyzed. Molecular analysis of the samples suggested that 92% of the MR-MSSA isolates were derived from MRSA clones of diverse genetic backgrounds, of which the clone of sequence type 8 and SCCmec type IV(A) accounted for most of the samples. High variations in incidence data and differences in the molecular characteristics of the isolates from one hospital to another indicate that the emergence of MR-MSSA resulted from independent SCCmec excisions from epidemic MRSA isolates, as well as the diffusion of methicillin-susceptible strains after the loss of SCCmec. MR-MSSA could constitute a useful model for the study of the respective genetic and environmental factors involved in the dissemination of S. aureus in hospitals.
Donnio
Pierre-Yves
PY
Département de Bactériologie-Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire, 35033 Rennes, France. pierre-yves.donnio@chu-rennes.fr
Février
Frédéric
F
Bifani
Pablo
P
Dehem
Marie
M
Kervégant
Christèle
C
Wilhelm
Nathalie
N
Gautier-Lerestif
Anne-Lise
AL
Lafforgue
Nathalie
N
Cormier
Michel
M
Le Coustumier
Alain
A
D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005602:France / Q000453:epidemiology; D005798:Genes, Bacterial / Q000235:genetics; D005843:Geography; D006801:Humans; D008712:Methicillin / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D008957:Models, Genetic; D017720:Molecular Epidemiology; D046915:Penicillin-Binding Proteins; D016133:Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects* / Q000235:genetics*
D001426:Bacterial Proteins; D046915:Penicillin-Binding Proteins; C487789:mecA protein, Staphylococcus aureus; D008712:Methicillin
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