title: Survey of community-associated-methicillin-Resistant Staphylococcus aureus in Slovenia: identification of community-associated and livestock-associated clones.
abstract: The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Slovenia is poorly documented. The aim of this study was to investigate susceptibility patterns, virulence gene profile and clonality among MRSA isolates with positive screened resistance phenotype for CA-MRSA collected from patients in Slovenia, from January 2010 to December 2010. We included only MRSA isolates that were resistant to cefoxitin and oxacillin, and susceptible to at least two of the following four antibiotics: ciprofloxacin, erythromycin, clindamycin or gentamicin (presumptive CA-MRSA). Altogether 151 isolates fulfilled our screening phenotypic definition, 126 MRSA isolates were classified as CA-MRSA and 25 as HA-MRSA. Thirty-six per cent of them were resistant to ciprofloxacin, 24% to clindamycin, 33% to erythromycin and 13% to gentamicin. The mecA gene was detected in 150 isolates, while the mecC gene only in 1 isolate. The MRSA isolates were classified to 19 different clones. The most prevalent sequence types were ST5 (26.4%), ST45 (25.2%), ST22 (10.6%), ST398 (9.9%), ST8 (5.9%), ST7 (4.6%), ST1 (3.9%), ST152/377 (3.3%), ST228 (2.6%) and ST2883 (1.3%). The ST6, ST9, ST30, ST72, ST88, ST111, ST130, ST225 and ST772 were identified sporadically. The Panton-Valentine leukocidin (PVL) gene was detected in 13 (8.6%) isolates that belonged to ST5, ST7, ST8, ST22, ST72, ST88, ST 152/377 and ST772. Our results show high variability of CA-MRSA circulating in Slovenia and also the presence of LA-MRSA clones.
authors.affiliation: National Laboratory for Health, Environment and Food, Department of Medical Microbiology, 2000 Maribor, Slovenia. Electronic address: urska.dermota@nlzoh.si.
authors.forename: U
authors.initials: U
authors.lastname: Dermota
authors.affiliation: Institute of Microbiology and Immunology, University of Ljubljana, Faculty of Medicine, 1000 Ljubljana, Slovenia.
authors.forename: M
authors.initials: M
authors.lastname: Mueller-Premru
authors.affiliation: Institute of Microbiology and Immunology, University of Ljubljana, Faculty of Medicine, 1000 Ljubljana, Slovenia.
authors.forename: N
authors.initials: N
authors.lastname: Švent-Kučina
authors.affiliation: National Laboratory for Health, Environment and Food, Department of Medical Microbiology, 2000 Maribor, Slovenia.
authors.forename: Ž
authors.initials: Ž
authors.lastname: Petrovič
authors.affiliation: National Laboratory for Health, Environment and Food, Department of Medical Microbiology, 2000 Maribor, Slovenia.
authors.forename: H
authors.initials: H
authors.lastname: Ribič
authors.affiliation: National Laboratory for Health, Environment and Food, Department of Medical Microbiology, 2000 Maribor, Slovenia; University of Maribor, Faculty of Medicine, 2000 Maribor, Slovenia.
authors.forename: M
authors.initials: M
authors.lastname: Rupnik
authors.affiliation: National Laboratory for Health, Environment and Food, Department of Medical Microbiology, 2000 Maribor, Slovenia; University of Maribor, Faculty of Medicine, 2000 Maribor, Slovenia.
authors.forename: S
authors.initials: S
authors.lastname: Janežič
authors.affiliation: Institute of Microbiology and Parasitology, University of Ljubljana, Veterinary Faculty, 1000 Ljubljana, Slovenia.
authors.forename: I
authors.initials: I
authors.lastname: Zdovc
authors.affiliation: National Laboratory for Health, Environment and Food, Department of Medical Microbiology, 2000 Maribor, Slovenia.
authors.forename: I
authors.initials: I
authors.lastname: Grmek-Košnik
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D001427:Bacterial Toxins / Q000235:genetics; D002939:Ciprofloxacin / Q000494:pharmacology; D002981:Clindamycin / Q000494:pharmacology; D003001:Cloning, Molecular; D024901:Drug Resistance, Multiple, Bacterial; D004917:Erythromycin / Q000494:pharmacology; D005098:Exotoxins / Q000235:genetics; D005839:Gentamicins / Q000494:pharmacology; D007956:Leukocidins / Q000235:genetics; D058751:Livestock / Q000382:microbiology*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D050296:Microbial Viability; D046915:Penicillin-Binding Proteins / Q000235:genetics / Q000378:metabolism; D017524:Slovenia
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D005098:Exotoxins; D005839:Gentamicins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D046915:Penicillin-Binding Proteins; C487789:mecA protein, Staphylococcus aureus; D002981:Clindamycin; D002939:Ciprofloxacin; D004917:Erythromycin
keywords: CA-MRSA; LA-MRSA; MLST; Slovenia; mecC gene; spa typing