title: Persistence of a major endemic clone of oxacillin-resistant Staphylococcus lugdunensis sequence type 6 at a tertiary medical centre in northern Taiwan.
abstract: OBJECTIVE
  The aim of this study was to investigate the molecular epidemiology and clinical characteristics of a major clone of oxacillin-resistant Staphylococcus lugdunensis in a tertiary hospital.
  
  
  METHODS
  All S. lugdunensis isolated from sterile sites between June 2003 and May 2013 were collected for analysis. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were performed to study their genetic relationships.
  
  
  RESULTS
  A total of 118 S. lugdunensis isolates were analysed by PFGE. Three major PFGE pulsotypes were found: A, H, and L. Most of the pulsotype A isolates were oxacillin-resistant, and SCCmec type V and type VT. Isolates from another major clonal group that consisted primarily of pulsotype L were oxacillin-resistant and SCCmec type II. These 14 SCCmec type II S. lugdunensis isolates demonstrated high PFGE similarity and were obtained in the study hospital over a period of 40 months. Three of these 14 patients had clinically significant bacteraemia, and all three cases were in the intensive care unit. Further MLST analysis of the isolates identified an endemic S. lugdunensis strain of sequence type 6, clonal complex 1.
  
  
  CONCLUSIONS
  This study identified a major endemic clone of S. lugdunensis that is oxacillin-resistant, SCCmec type II, ST6, and capable of long-term persistence in the hospital. Continuous infection control surveillance and monitoring of S. lugdunensis should be considered in endemic areas.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Chun-wen
authors.initials: CW
authors.lastname: Cheng
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, No. 5 Fushing St., Gueishan, Taoyuan County 33375, Taiwan.
authors.forename: Tsui-ping
authors.initials: TP
authors.lastname: Liu
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Chun-fu
authors.initials: CF
authors.lastname: Yeh
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Ming-hsun
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, No. 5 Fushing St., Gueishan, Taoyuan County 33375, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Shih-cheng
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, No. 5 Fushing St., Gueishan, Taoyuan County 33375, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: janglu45@gmail.com.
authors.forename: Jang-jih
authors.initials: JJ
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000382:microbiology; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D010068:Oxacillin / Q000494:pharmacology*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D057787:Staphylococcus lugdunensis / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D013624:Taiwan; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents; D010068:Oxacillin
keywords: Bacteraemia; Clonal spreading; Hospital epidemiology; Nosocomial infection; Staphylococcus lugdunensis