title: Molecular picture of community- and healthcare-associated methicillin-resistant Staphylococcus aureus circulating in a teaching hospital in Milan.
abstract: The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) has dramatically changed over the past 10 y with the emergence of community-associated MRSA (CA-MRSA). Recent studies have reported a frequent association of these strains with hospital outbreaks, and an incidence varying over time and by region. In order to evaluate the MRSA lineages circulating in our area of Italy, we performed a molecular characterization of CA-MRSA isolates prospectively collected from April 2006 to July 2007 at the San Paolo Hospital of Milan. We investigated the protein A-encoding gene (spa-typing), the staphylococcal chromosomal cassette SCCmec, the presence of Panton-Valentine leukocidin (PVL), and 3 adhesin genes. Twenty-five CA-MRSA isolates cultured from 25 patients were collected; an equal number of healthcare-associated (HA)-MRSA strains, from 25 patients hospitalized in various wards, were collected for comparison purposes. SCCmec type IV emerged as the most frequent genotype in both CA- and HA-MRSA. Seventeen different spa types were identified: t515 was the most common (36%), followed by t008 (20%). We detected 3 PVL-positive strains, only among the CA-MRSA. On the whole, our local MRSA epidemiology appears to be heterogeneous, with a predominant t515 spa type, only recently considered to belong to clonal EMRSA-15.
authors.affiliation: Department of Public Health-Microbiology-Virology, Università degli Studi di Milano, Milan, Italy. Elisa.borghi@unimi.it
authors.forename: Elisa
authors.initials: E
authors.lastname: Borghi
authors.forename: Marinella
authors.initials: M
authors.lastname: Cainarca
authors.forename: Rita
authors.initials: R
authors.lastname: Sciota
authors.forename: Caterina
authors.initials: C
authors.lastname: Biassoni
authors.forename: Giulia
authors.initials: G
authors.lastname: Morace
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques; D002648:Child; D016000:Cluster Analysis; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D005838:Genotype; D006784:Hospitals, Teaching; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D008875:Middle Aged; D017720:Molecular Epidemiology; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D037521:Virulence Factors