title: Methicillin-resistant Staphylococcus aureus in hospitalized patients from the Bolivian Chaco.
abstract: OBJECTIVE
  Information is lacking on the methicillin-resistant Staphylococcus aureus (MRSA) clonal lineages circulating in Bolivia. We investigated the prevalence and molecular epidemiology of S. aureus colonization in hospitalized patients from the Bolivian Chaco, and compared their features with those of the few clinical isolates available from that setting.
  
  
  METHODS
  S. aureus nasal/inguinal colonization was investigated in 280 inpatients from eight hospitals in two point prevalence surveys (2012, n=90; 2013, n=190). Molecular characterization included genotyping (spa typing, multilocus sequence typing, and pulsed-field gel electrophoresis), detection of virulence genes, and SCCmec typing.
  
  
  RESULTS
  Forty-one inpatients (14.6%) were S. aureus nasal/inguinal carriers, of whom five were colonized by MRSA (1.8%). MRSA isolates mostly belonged to spa-type t701, harboured SCCmec IVc, and were negative for Panton-Valentine leukocidin (PVL) genes. However, a USA300-related isolate was also detected, which showed the characteristics of the USA300 Latin American variant (USA300-LV; i.e., ST8, spa-type t008, SCCmec IVc, presence of PVL genes, absence of arcA). Notably, all the available MRSA clinical isolates (n=5, collected during 2011-2013) were also identified as USA300-LV.
  
  
  CONCLUSIONS
  Overall, MRSA colonization in inpatients from the Bolivian Chaco was low. However, USA300-LV-related isolates were detected in colonization and infections, emphasizing the importance of implementing control measures to limit their further dissemination in this resource-limited area.
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Ospedale di Careggi, Largo Brambilla 3, 50134 Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy. Electronic address: alessandro.bartoloni@unifi.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bartoloni
authors.affiliation: Dipartimento di Biotecnologie Mediche, Università di Siena, Siena, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Riccobono
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Ospedale di Careggi, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: Donata
authors.initials: D
authors.lastname: Magnelli
authors.affiliation: Hospital Basico Villa Montes, Villa Montes, Bolivia.
authors.forename: Ana Liz
authors.initials: AL
authors.lastname: Villagran
authors.affiliation: Dipartimento di Biotecnologie Mediche, Università di Siena, Siena, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Di Maggio
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Ospedale di Careggi, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: Antonia
authors.initials: A
authors.lastname: Mantella
authors.affiliation: Dipartimento di Biotecnologie Mediche, Università di Siena, Siena, Italy.
authors.forename: Samanta
authors.initials: S
authors.lastname: Sennati
authors.affiliation: Instituto Nacional de Laboratorios de Salud "Dr. Nestor Morales Villazón" (INLASA), La Paz, Bolivia.
authors.forename: Carmen
authors.initials: C
authors.lastname: Revollo
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Ospedale di Careggi, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: Marianne
authors.initials: M
authors.lastname: Strohmeyer
authors.affiliation: Dipartimento di Biotecnologie Mediche, Università di Siena, Siena, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Giani
authors.affiliation: Dipartimento di Biotecnologie Mediche, Università di Siena, Siena, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pallecchi
authors.affiliation: Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Ospedale di Careggi, Largo Brambilla 3, 50134 Firenze, Italy; Dipartimento di Biotecnologie Mediche, Università di Siena, Siena, Italy; SOD Microbiologia e Virologia, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy. Electronic address: gianni.rossolini@gmail.com.
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Rossolini
mesh_terms: D001838:Bolivia; D006760:Hospitalization; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification
keywords: Bolivia; Carriage; Infection; Latin America; MRSA; USA300-LV