title: Genotypic and phenotypic characterization of methicillin-resistant Staphylococcus aureus (MRSA) clones with high-level mupirocin resistance.
abstract: A high proportion of methicillin-resistant Staphylococcus aureus isolates recovered in one year period showed high-level mupirocin-resistance (HLMUPR-MRSA) in our environment (27.2%). HLMUPR-MRSA isolates were mainly collected from skin and soft tissue samples, and diabetes was the main related comorbidity condition. These isolates were more frequently found in vascular surgery. HLMUPR-MRSA was more resistant to aminoglycosides than mupirocin-susceptible MRSA, linked to the presence of bifunctional and/or nucleotidyltransferase enzymes with/without macrolide resistance associated with the msr(A) gene. Most of HLMUPR-MRSA isolates belonged to ST125/t067. Nine IS257-ileS2 amplification patterns (p3 was the most frequent) were observed in HLMUPR-MRSA isolates, suggesting the presence of several mupirocin-resistance-carrying plasmids in our environment and promoting the emergence of mupirocin resistance. The presence of the same IS257-ileS2 amplification pattern p3 in 65% of HLMUPR-MRSA, all of them ST125/t067, suggests a clonal spread in our hospital and community environment which could explain the high prevalence of HLMUPR-MRSA during the study period. An outbreak situation or an increase in mupirocin consumption was not observed.
authors.affiliation: Servicio de Microbiología, Hospital Clínico Universitario Lozano Blesa, San Juan Bosco s/n, 50009, Zaragoza, Spain.
authors.forename: María
authors.initials: M
authors.lastname: González-Domínguez
authors.affiliation: Servicio de Microbiología, Hospital Clínico Universitario Lozano Blesa, San Juan Bosco s/n, 50009, Zaragoza, Spain; Departamento de Microbiología, Facultad de Medicina, Universidad de Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain. Electronic address: cseral@unizar.es.
authors.forename: Cristina
authors.initials: C
authors.lastname: Seral
authors.affiliation: Servicio de Microbiología, Complexo Hospitalario Universitario de Vigo (CHUVI), C/Pizarro, 22, 36204, Vigo Pontevedra, Spain; Unidad de Apoyo a la Investigación, Instituto de Investigación Biomédica de Vigo (IBIV), Spain, Complexo Hospitalario Universitario de Vigo (CHUVI), C/Pizarro, 22, 36204, Vigo Pontevedra, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Potel
authors.affiliation: Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja (CIBIR), C/Piqueras, 98, 26006, Logroño La Rioja, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Sáenz
authors.affiliation: Servicio de Microbiología, Complexo Hospitalario Universitario de Vigo (CHUVI), C/Pizarro, 22, 36204, Vigo Pontevedra, Spain; Unidad de Apoyo a la Investigación, Instituto de Investigación Biomédica de Vigo (IBIV), Spain, Complexo Hospitalario Universitario de Vigo (CHUVI), C/Pizarro, 22, 36204, Vigo Pontevedra, Spain.
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Álvarez
authors.affiliation: Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja (CIBIR), C/Piqueras, 98, 26006, Logroño La Rioja, Spain; Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Avda/Madre de Dios, 51, 26006, Logroño La Rioja, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Torres
authors.affiliation: Servicio de Microbiología, Hospital Clínico Universitario Lozano Blesa, San Juan Bosco s/n, 50009, Zaragoza, Spain; Departamento de Microbiología, Facultad de Medicina, Universidad de Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Castillo
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004251:DNA Transposable Elements; D024881:Drug Resistance, Bacterial; D005260:Female; D005798:Genes, Bacterial; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D016712:Mupirocin / Q000494:pharmacology*; D010957:Plasmids / Q000032:analysis; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D004251:DNA Transposable Elements; D016712:Mupirocin
keywords: Clonal lineages; High-level mupirocin resistance; MRSA; Resistance genes