title: Epidemiological and molecular characteristics of meticillin-resistant Staphylococcus aureus in Turkey: A multicentre study.
abstract: The aim of this study was to investigate the epidemiological and molecular features of clinical meticillin-resistant Staphylococcus aureus (MRSA) isolates in Turkey. MRSA isolates were collected from six regions of Turkey. The mecA and nuc genes were detected by PCR. Antimicrobial susceptibilities were determined by the disk diffusion method. Staphylococcal cassette chromosome mec (SCCmec) and staphylococcal protein A (spa) typing were performed by the sequencing method for 270 randomly selected MRSA isolates. The US Centers for Disease Control and Prevention (CDC) definition was used for epidemiological diagnosis of community-associated MRSA (CA-MRSA). Resistance rates of MRSA to ciprofloxacin, gentamicin, clindamycin, erythromycin, rifampicin, trimethoprim/sulfamethoxazole and tetracycline were 93.4%, 81.2%, 38.5%, 57.8%, 93.9%, 1.1% and 93.1%, respectively. The most frequent SCCmec type was SCCmec III (91.1%). SCCmec type IV was found in 5.2% of the isolates. The most frequent spa type was t030 (81.1%). Five isolates were CA-MRSA if only the epidemiological definition was used (5/725; 0.7%). Two isolates were defined as CA-MRSA both by epidemiological features and SCCmec typing (2/270; 0.7%). Of 14 SCCmec type IV isolates, 12 were not defined as CA-MRSA by epidemiological features. In conclusion, this is the most comprehensive multicentre study in Turkey investigating MRSA using both epidemiological and genotypic features. The CA-MRSA rate is low in Turkey. Combined use of epidemiological and genotypic methods is the most accurate approach for the diagnosis of CA-MRSA.
authors.affiliation: Kocaeli University, Kocaeli, Turkey. Electronic address: devrimdundar@hotmail.com.
authors.forename: Devrim
authors.initials: D
authors.lastname: Dündar
authors.affiliation: Kocaeli University, Kocaeli, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Willke
authors.affiliation: Kocaeli University, Kocaeli, Turkey; Research Center of Experimental Health Sciences, Near East University, Nicosia, North Cyprus, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sayan
authors.affiliation: Kocaeli University, Kocaeli, Turkey.
authors.forename: Meliha Meric
authors.initials: MM
authors.lastname: Koc
authors.affiliation: Ankara University, Ankara, Turkey.
authors.forename: Ozay Arıkan
authors.initials: OA
authors.lastname: Akan
authors.affiliation: Acıbadem Hospital, Kayseri, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Sumerkan
authors.affiliation: Istanbul University, Istanbul, Turkey.
authors.forename: Nese
authors.initials: N
authors.lastname: Saltoglu
authors.affiliation: Çukurova University, Adana, Turkey.
authors.forename: Akgun
authors.initials: A
authors.lastname: Yaman
authors.affiliation: Dicle University, Diyarbakır, Turkey.
authors.forename: Celal
authors.initials: C
authors.lastname: Ayaz
authors.affiliation: Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Iftihar
authors.initials: I
authors.lastname: Koksal
mesh_terms: D003428:Cross Infection; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005798:Genes, Bacterial; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification; D013203:Staphylococcal Infections; D014421:Turkey
keywords: Epidemiology; MRSA; Molecular characteristics