title: A field guide to pandemic, epidemic and sporadic clones of methicillin-resistant Staphylococcus aureus.
abstract: In recent years, methicillin-resistant Staphylococcus aureus (MRSA) have become a truly global challenge. In addition to the long-known healthcare-associated clones, novel strains have also emerged outside of the hospital settings, in the community as well as in livestock. The emergence and spread of virulent clones expressing Panton-Valentine leukocidin (PVL) is an additional cause for concern. In order to provide an overview of pandemic, epidemic and sporadic strains, more than 3,000 clinical and veterinary isolates of MRSA mainly from Germany, the United Kingdom, Ireland, France, Malta, Abu Dhabi, Hong Kong, Australia, Trinidad & Tobago as well as some reference strains from the United States have been genotyped by DNA microarray analysis. This technique allowed the assignment of the MRSA isolates to 34 distinct lineages which can be clearly defined based on non-mobile genes. The results were in accordance with data from multilocus sequence typing. More than 100 different strains were distinguished based on affiliation to these lineages, SCCmec type and the presence or absence of PVL. These strains are described here mainly with regard to clinically relevant antimicrobial resistance- and virulence-associated markers, but also in relation to epidemiology and geographic distribution. The findings of the study show a high level of biodiversity among MRSA, especially among strains harbouring SCCmec IV and V elements. The data also indicate a high rate of genetic recombination in MRSA involving SCC elements, bacteriophages or other mobile genetic elements and large-scale chromosomal replacements.
authors.affiliation: Institute for Medical Microbiology and Hygiene, Technical University of Dresden, Dresden, Germany. monecke@rocketmail.com
authors.forename: Stefan
authors.initials: S
authors.lastname: Monecke
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Coombs
authors.forename: Anna C
authors.initials: AC
authors.lastname: Shore
authors.forename: David C
authors.initials: DC
authors.lastname: Coleman
authors.forename: Patrick
authors.initials: P
authors.lastname: Akpaka
authors.forename: Michael
authors.initials: M
authors.lastname: Borg
authors.forename: Henry
authors.initials: H
authors.lastname: Chow
authors.forename: Margaret
authors.initials: M
authors.lastname: Ip
authors.forename: Lutz
authors.initials: L
authors.lastname: Jatzwauk
authors.forename: Daniel
authors.initials: D
authors.lastname: Jonas
authors.forename: Kristina
authors.initials: K
authors.lastname: Kadlec
authors.forename: Angela
authors.initials: A
authors.lastname: Kearns
authors.forename: Frederic
authors.initials: F
authors.lastname: Laurent
authors.forename: Frances G
authors.initials: FG
authors.lastname: O'Brien
authors.forename: Julie
authors.initials: J
authors.lastname: Pearson
authors.forename: Antje
authors.initials: A
authors.lastname: Ruppelt
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwarz
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Scicluna
authors.forename: Peter
authors.initials: P
authors.lastname: Slickers
authors.forename: Hui-Leen
authors.initials: HL
authors.lastname: Tan
authors.forename: Stefan
authors.initials: S
authors.lastname: Weber
authors.forename: Ralf
authors.initials: R
authors.lastname: Ehricht
mesh_terms: D000818:Animals; D002999:Clone Cells; D005798:Genes, Bacterial / Q000235:genetics; D006801:Humans; D020071:Interspersed Repetitive Sequences / Q000235:genetics; D016106:Methicillin Resistance / Q000235:genetics; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D020411:Oligonucleotide Array Sequence Analysis; D058873:Pandemics; D017422:Sequence Analysis, DNA; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D014774:Virulence / Q000235:genetics