title: Real-time PCR to distinguish livestock-associated (ST398) from non-livestock-associated (methicillin-resistant) Staphylococcus aureus.
abstract: BACKGROUND
  The Netherlands is one of the most densely populated countries in the world, with extensive livestock of pigs. In 2005, the emergence of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) was a fact, with a relatively high MRSA colonisation among pig farmers. These MRSA isolates mostly belonged to sequence type 398 (ST398). Compared to hospital-associated MRSA (HA-MRSA), severe infections due to LA-MRSA and transmission between individuals are still relatively rare. Therefore, LA-MRSA may warrant less stringent containment measures than HA-MRSA in hospital settings.
  
  
  RESULTS
  The aim of this study was to develop a rapid diagnostic tool to distinguish LA-MRSA from non-LA-MRSA in aid of infection control. Here, we show that ST398 strains can be readily detected with real-time polymerase chain reaction (PCR). Analysis of a large panel of related and unrelated microorganisms confirmed that the real-time ST398 PCR (ST398-qPCR) assay does not cross-react with other microorganisms or with non-LA-S. aureus strains. ST398-qPCR analysis of MRSA isolates collected in 2010, 2011 and 2012 at the Jeroen Bosch Hospital (n = 275) showed that an average of 78 % of MRSA belonged to sequence type ST398.
  
  
  CONCLUSIONS
  We conclude that the ST398 real-time PCR is a reliable assay to detect LA-S. aureus and anticipate that the use of this assay can prevent the unnecessary closing of hospital wards, which may lead to substantial savings for the health care system.
authors.affiliation: Laboratory for Molecular Diagnostics, Jeroen Bosch Hospital, P.O. Box 90153, 5200 ME, 's-Hertogenbosch, The Netherlands.
authors.forename: M L J G M
authors.initials: ML
authors.lastname: van Meurs
authors.forename: J J A
authors.initials: JJ
authors.lastname: Schellekens
authors.forename: A J
authors.initials: AJ
authors.lastname: de Neeling
authors.forename: B
authors.initials: B
authors.lastname: Duim
authors.forename: P M
authors.initials: PM
authors.lastname: Schneeberger
authors.forename: M H A
authors.initials: MH
authors.lastname: Hermans
mesh_terms: D000818:Animals; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000175:diagnosis / Q000635:transmission; D003429:Cross Reactions; D004269:DNA, Bacterial / Q000032:analysis; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D009426:Netherlands; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis*; D013552:Swine / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial