title: Evolution of methicillin-resistant Staphylococcus aureus clones in Latin America.
abstract: OBJECTIVE
  Methicillin-resistant Staphylococcus aureus (MRSA) is a prominent nosocomial bacterial pathogen, associated with significant morbidity and mortality. The global incidence is increasing, and Latin America is no exception. This article reviews MRSA clonal distribution in Latin America and implications for clinical practice.
  
  
  METHODS
  A PubMed literature search (1966-2008) identified 32 articles that characterized MRSA clones in Latin America.
  
  
  RESULTS
  Data from these articles show that since 1990, several epidemic MRSA clones have spread in Latin America. The multidrug-resistant Brazilian clone is widespread, especially in Brazil and Argentina, but more recently clones with susceptibility to a range of antibiotics have been detected in Brazil, whereas in Argentina, as in Chile, Colombia and Paraguay, the multidrug-resistant Cordobes/Chilean clone prevails. In Mexico, the New York/Japan clone is most frequent. Data were not available from every country and, despite the increasing prevalence of community MRSA infections, most were collected from tertiary care centers.
  
  
  CONCLUSIONS
  A variety of epidemic MRSA clones are circulating in Latin America, some of which harbor genes that encode multidrug resistance or enhanced pathogenicity. Continued collection and reporting of epidemiological data is crucial for effective prevention and treatment.
authors.affiliation: Hospital Civil de Guadalajara, Fray Antonio Alcalde, Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Jalisco, Mexico. idfcolima@yahoo.com
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rodríguez-Noriega
authors.forename: Carlos
authors.initials: C
authors.lastname: Seas
authors.forename: Manuel
authors.initials: M
authors.lastname: Guzmán-Blanco
authors.forename: Carlos
authors.initials: C
authors.lastname: Mejía
authors.forename: Carlos
authors.initials: C
authors.lastname: Alvarez
authors.forename: Luis
authors.initials: L
authors.lastname: Bavestrello
authors.forename: Jeannete
authors.initials: J
authors.lastname: Zurita
authors.forename: Jaime
authors.initials: J
authors.lastname: Labarca
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Luna
authors.forename: Mauro J C
authors.initials: MJ
authors.lastname: Salles
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gotuzzo
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D019143:Evolution, Molecular; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance / Q000235:genetics*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin