title: High Prevalence and Resistance Patterns of Community-Associated Methicillin-Resistant Staphylococcus Aureus in the Pomoravlje Region, Serbia.
abstract: With a view to estimating the prevalence and resistance patterns of CA-MRSA in one region of Serbia, we performed an analysis of MRSA isolates from healthy people and hospitalised patients. The detection of CA-MRSA was carried out by SCCmec typing. In MRSA isolates from hospitalised patients SCCmec types IV and V were found in 76% of the strains. Similar percentage (80%) of CA-MRSA genotypes was present in healthy people. SCCmec type V harbouring MRSA was the most successful clone. Higher prevalence of type V in hospitalised patients to that in healthy people (70% vs 54%) may indicate nosocomial transmissions in at least some hospital units. All MRSA strains from hospitalised patients were resistant to one or more non-β-lactam antibiotics while 52% were multi-resistant. In isolates from healthy people, 16% were sensitive to all non-β-lactam antibiotics and 40% were multi-resistant. Similar percentage of multi-resistant CA- and HA-genotypes occurred in a particular environment (53% vs 50% in hospitalised patients, and 37.5% vs 37.5% in healthy people) indicating selective pressure of antibiotics as a leading force conferring antibiotic resistance. High prevalence of CA-MRSA and high resistance rate both in hospitals and the community suggest that this pathogen has been present in the Pomoravlje Region, central Serbia for years.
authors.affiliation: Institute of Epidemiology, Military Medical Academy , Crnotravska 17, Belgrade , Serbia.
authors.forename: Zorica
authors.initials: Z
authors.lastname: Lepsanovic
authors.affiliation: Centre for Clinical Microbiology, Public Health Institute , Miodraga Novakovica 78, Cuprija , Serbia.
authors.forename: Ljiljana Petrovic
authors.initials: LP
authors.lastname: Jeremic
authors.affiliation: Institute of Epidemiology, Military Medical Academy , Crnotravska 17, Belgrade , Serbia.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Lazic
authors.affiliation: Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade , Dr Subotica 1, Belgrade , Serbia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Cirkovic
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008712:Methicillin / Q000494:pharmacology*; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D055771:Serbia / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin
keywords: CA-MRSA; SCCmec typing; healthy people; hospitalised patients; resistance patterns