title: Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus strains isolated in a multicenter study of nursing home residents in Croatia.
abstract: BACKGROUND
  Residents of nursing homes (NHs) are often hospitalized and could present a potential reservoir for methicillin-resistant Staphylococcus aureus (MRSA). The aim of the study was to determine the prevalence for MRSA carriage in residents and staff in Croatian NHs and to characterize MRSA strains using genotyping techniques.
  
  
  METHODS
  A cross-sectional study was performed among 877 residents and staff of 7 NHs representing 3 major Croatian regions. Nasal swabs from residents and staff and other samples from residents with invasive devices were obtained. Identified isolates were submitted to susceptibility testing and genotyping with SCCmec typing, S aureus protein A (spa) locus typing, and pulsed-field gel electrophoresis (PFGE).
  
  
  RESULTS
  The overall prevalence of MRSA colonization was 7.1% (95 confidence interval, 5.4%-8.8%), ranging from 0% to 28.8%. Four MRSA isolates were found in NH staff. All MRSA isolates were negative for Panton-Valentine leukocidin-encoding genes. SCCmec type II was found in 32 MRSA strains; SCCmec IV, in 27 strains; SCCmec I, in 3 strains. The predominant spa type was t008, found in 49 strains; PFGE analysis revealed 2 major clonal groups.
  
  
  CONCLUSIONS
  MRSA strains were found to be colonizing residents and staff of 7 NHs in Croatia. Our study demonstrates the spread of 2 clones within and among Croatian NHs. The data presented here provide an important baseline for future surveillance of MRSA in NH.
authors.affiliation: University Hospital Center Zagreb, Department of Clinical and Molecular Microbiology, Zagreb; University of Zagreb School of Medicine, Department of Microbiology and Parasitology, Zagreb. Electronic address: abudimir@kbc-zagreb.hr.
authors.forename: Ana
authors.initials: A
authors.lastname: Budimir
authors.affiliation: Public Health Institute of Međimurje County, Department of Microbiology, Čakovec.
authors.forename: Marina
authors.initials: M
authors.lastname: Payerl Pal
authors.affiliation: University Hospital Center Zagreb, Department of Clinical and Molecular Microbiology, Zagreb.
authors.forename: Zrinka
authors.initials: Z
authors.lastname: Bošnjak
authors.affiliation: University Hospital Center Zagreb, Department of Clinical and Molecular Microbiology, Zagreb; University of Zagreb School of Medicine, Department of Microbiology and Parasitology, Zagreb.
authors.forename: Ivana
authors.initials: I
authors.lastname: Mareković
authors.affiliation: Institute Public Health Osijek Baranja County, Department of Microbiology, Osijek.
authors.forename: Dubravka
authors.initials: D
authors.lastname: Vuković
authors.affiliation: Institute Public Health Osijek Baranja County, Department of Microbiology, Osijek.
authors.forename: Ivana
authors.initials: I
authors.lastname: Roksandić Križan
authors.affiliation: Institute Public Health Osijek Baranja County, Department of Microbiology, Osijek.
authors.forename: Josip
authors.initials: J
authors.lastname: Milas
authors.affiliation: University Hospital Center Zagreb, Department of Clinical and Molecular Microbiology, Zagreb; University of Zagreb School of Medicine, Department of Microbiology and Parasitology, Zagreb.
authors.forename: Vanda
authors.initials: V
authors.lastname: Plečko
authors.affiliation: University of Zagreb School of Medicine, Department of Microbiology and Parasitology, Zagreb.
authors.forename: Smilja
authors.initials: S
authors.lastname: Kalenić
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D017523:Croatia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000235:genetics; D005838:Genotype; D006282:Health Personnel; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058889:Molecular Typing; D009297:Nasal Mucosa / Q000382:microbiology; D009735:Nursing Homes; D010361:Patients; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013205:Staphylococcal Protein A / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D013205:Staphylococcal Protein A
keywords: Colonization; Cross sectional; Study; Typing