title: MRSA SCCmec epidemiology in Israel: development and implementation of an MRSA SCCmec typing strategy.
abstract: Staphylococcal cassette chromosome mec (SCCmec) typing is essential for investigating the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA). Published assays were often found to be limited in their ability to characterize isolates that were not collected locally. We aimed to develop, test, and implement a molecular method which would enable the SCCmec classification of a large collection of MRSA isolates in a routine clinical laboratory. A multistep working algorithm consisting of two main steps and four additional supplementary steps was developed, using previously reported primers. A total of 1,008 isolates obtained locally, by both clinical and screening cultures, were tested. The majority of isolates (82.54%) could be classified using two main reactions. Overall, our MRSA SCCmec typing strategy was able to classify 917/1,008 (90.97%) of the MRSA isolates. The most predominant was type II SCCmec (41%); a high prevalence of type V SCCmec (16.37%) was also found. PVL gene carriage was found among two type IV SCCmec isolates only. We present a logistically feasible, multistep, MRSA SCCmec typing algorithm which can be used to type a large collection of MRSA isolates. The distinctly higher prevalence of SCCmec type V might reflect a unique MRSA distribution pattern in Israel.
authors.affiliation: Infectious Diseases Unit, Meir Medical Center, Kfar Saba, Israel. dr.danny.alon@gmail.com
authors.forename: D
authors.initials: D
authors.lastname: Alon
authors.forename: F
authors.initials: F
authors.lastname: Abd-Elkadir
authors.forename: M
authors.initials: M
authors.lastname: Chowers
authors.forename: Y
authors.initials: Y
authors.lastname: Paitan
mesh_terms: D015373:Bacterial Typing Techniques / Q000379:methods*; D002876:Chromosomes, Bacterial / Q000235:genetics*; D004269:DNA, Bacterial / Q000235:genetics; D005240:Feasibility Studies; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology*
chemical_list: D004269:DNA, Bacterial