title: Usefulness of mec-associated direct repeat unit (dru) typing in the epidemiological analysis of highly clonal methicillin-resistant Staphylococcus aureus in Scotland.
abstract: The incidence of the epidemic methicillin-resistant Staphylococcus aureus (EMRSA) strains EMRSA-15 and EMRSA-16 in Scotland has increased dramatically, now accounting for c. 70% and c. 20% of isolates, respectively. Epidemiological tracking of these EMRSA strains is difficult, as c. 50% of EMRSA-15 and c. 35% of EMRSA-16 isolates are indistinguishable using pulsed-field gel electrophoresis (PFGE) and other typing methods. The usefulness of mec-associated direct repeat unit (dru) sequence analysis as a more sensitive approach to tracking the persistence and spread of these 'clonal' EMRSA strains in Scotland was evaluated. Analysis of 47 EMRSA-15 and 57 EMRSA-16 isolates (including two separately cultured isolates of the Harmony collection type strain) obtained from 22 hospital laboratories over an 8-year period (1997-2005) revealed 13 and 12 different dru types, respectively. Whereas some types appeared to be endemic in multiple hospitals, subtypes that may represent specific strain movement among hospitals in a given geographical region were identified in other instances. These results suggest that mec-associated dru typing may have potential for identifying and tracking specific subtypes of otherwise indistinguishable epidemic MRSA isolates such as those in Scotland.
authors.affiliation: Department of Medical Microbiology and Immunology, Creighton University School of Medicine, Omaha, NE 68178, USA. rgoeri@creighton.edu
authors.forename: R V
authors.initials: RV
authors.lastname: Goering
authors.forename: D
authors.initials: D
authors.lastname: Morrison
authors.forename: Z
authors.initials: Z
authors.lastname: Al-Doori
authors.forename: G F S
authors.initials: GF
authors.lastname: Edwards
authors.forename: C G
authors.initials: CG
authors.lastname: Gemmell
mesh_terms: D015373:Bacterial Typing Techniques; D001483:Base Sequence; D004269:DNA, Bacterial / Q000235:genetics*; D005838:Genotype; D006801:Humans; D016106:Methicillin Resistance; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D012091:Repetitive Sequences, Nucleic Acid; D012606:Scotland / Q000453:epidemiology; D016415:Sequence Alignment; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification* / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D004269:DNA, Bacterial