title: Staphylococcus aureus spa type t437: identification of the most dominant community-associated clone from Asia across Europe.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) belonging to the multilocus sequence type clonal complex 59 (MLST CC59) is the predominant community-associated MRSA clone in Asia. This clone, which is primarily linked with the spa type t437, has so far only been reported in low numbers among large epidemiological studies in Europe. Nevertheless, the overall numbers identified in some Northern European reference laboratories have increased during the past decade. To determine whether the S. aureus t437 clone is present in other European countries, and to assess its genetic diversity across Europe, we analysed 147 S. aureus t437 isolates from 11 European countries collected over a period of 11 years using multiple locus variable number tandem repeat fingerprinting/analysis (MLVF/MLVA) and MLST. Additionally 16 S. aureus t437 isolates from healthy carriers and patients from China were included. Most isolates were shown to be monophyletic with 98% of the isolates belonging to the single MLVA complex 621, to which nearly all included isolates from China also belonged. More importantly, all MLST-typed isolates belonged to CC59. Our study implies that the European S. aureus t437 population represents a genetically tight cluster, irrespective of the year, country and site of isolation. This underpins the view that S. aureus CC59 has been introduced into several European countries, not being restricted to particular geographical regions or specific host environments. The European S. aureus t437 isolates thus bear the general hallmarks of a high-risk clone.
authors: Department of Medical Microbiology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors: C
authors: C
authors: Glasner
authors: Bacterial Surveillance and Response, Center for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
authors: G
authors: G
authors: Pluister
authors: Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark; Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: H
authors: H
authors: Westh
authors: Department of Medical Microbiology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors: J P
authors: JP
authors: Arends
authors: Department of Molecular Microbiology National Medicines Institute, Warsaw, Poland.
authors: J
authors: J
authors: Empel
authors: Department of Microbiology, Scottish MRSA Reference Laboratory, Glasgow, United Kingdom.
authors: E
authors: E
authors: Giles
authors: Centre National de Référence des Staphylocoques, Université de Lyon, INSERM U851, Lyon, France.
authors: F
authors: F
authors: Laurent
authors: National Reference Centre for Staphylococci and Enterococci, Division Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode, Germany.
authors: F
authors: F
authors: Layer
authors: Department of Medical Microbiology, MRSA Reference Laboratory, St. Olavs Hospital, Trondheim University Hospital, Norway.
authors: L
authors: L
authors: Marstein
authors: Department of Laboratory Services, County Hospital Ryhov, Jönköping, Sweden.
authors: A
authors: A
authors: Matussek
authors: Institute for Hygiene University Hospital Münster, Münster, Germany.
authors: A
authors: A
authors: Mellmann
authors: Servicio de Bacteriología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
authors: M
authors: M
authors: Pérez-Vásquez
authors: Department of Phage Typing and Molecular Epidemiology, National Center for Epidemiology, Budapest, Hungary.
authors: E
authors: E
authors: Ungvári
authors: State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors: X
authors: X
authors: Yan
authors: National Institute of Public Health, Prague, Czech Republic.
authors: H
authors: H
authors: Žemličková
authors: Department of Medical Microbiology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors: H
authors: H
authors: Grundmann
authors: Department of Medical Microbiology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands. Electronic address: j.m.van.dijl01@umcg.nl.
authors: J M
authors: JM
authors: van Dijl
mesh_terms: D001208:Asia / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D018598:Minisatellite Repeats; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology
keywords: Asia; CC59; Europe; MRSA; Staphylococcus aureus; community-associated; identification; spa type t437