title: Antibiotic susceptibility and molecular epidemiology of Panton-Valentine leukocidin-positive meticillin-resistant Staphylococcus aureus: An international survey.
abstract: The antibiotic susceptibility and molecular epidemiology of Panton-Valentine leukocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA) isolates reported from 17 countries in the Americas, Europe and, Australia-Asia were analysed. Among a total of 3236 non-duplicate isolates, the lowest susceptibility was observed to erythromycin in all regions. Susceptibility to ciprofloxacin showed large variation (25%, 75% and 84% in the Americas, Europe and Australia-Asia, respectively). Two vancomycin-intermediate PVL-positive MRSA isolates were reported, one from Hong Kong and the other from The Netherlands. Resistance to trimethoprim/sulfamethoxazole and linezolid was <1%. Among 1798 MRSA isolates from 13 countries that were tested for the requested 10 non-β-lactam antibiotics, 49.4% were multisusceptible. However, multiresistant isolates (resistant to at least three classes of non-β-lactam antibiotics) were reported from all regions. Sequence type 30 (ST30) was reported worldwide, whereas ST80 and ST93 were exclusive to Europe and Australia, respectively. USA300 and related clones (ST8) are progressively replacing the ST80 clone in several European countries. Eight major clusters were discriminated by multilocus variable-number tandem repeat assay (MLVA), showing a certain geographic specificity. PVL-positive MRSA isolates frequently remain multisusceptible to non-β-lactam agents, but multiresistance is already prevalent in all regions. Surveillance of MRSA susceptibility patterns should be monitored to provide clinicians with the most current information regarding changes in resistance patterns.
authors.affiliation: Hôpitaux Universitaires de Genève, Geneva, Switzerland. Electronic address: mmacedo@cenaque.org.uy.
authors.forename: Marina
authors.initials: M
authors.lastname: Macedo-Viñas
authors.affiliation: Hôpitaux Universitaires de Genève, Geneva, Switzerland; University of Calgary, Calgary, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Conly
authors.affiliation: Hôpitaux Universitaires de Genève, Geneva, Switzerland.
authors.forename: Patrice
authors.initials: P
authors.lastname: Francois
authors.affiliation: Laboratorio Aziendale de Microbiologia e Virologia, Bolzano, Italy.
authors.forename: Richard
authors.initials: R
authors.lastname: Aschbacher
authors.affiliation: Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Blanc
authors.affiliation: Curtin University, Perth, Australia.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Coombs
authors.affiliation: Laiko General Hospital, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Daikos
authors.affiliation: All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Benu
authors.initials: B
authors.lastname: Dhawan
authors.affiliation: National Medicine Institute (NMI), Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Empel
authors.affiliation: National Reference Center for Staphylococci, Lyon, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Etienne
authors.affiliation: Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Agnes Marie Sá
authors.initials: AM
authors.lastname: Figueiredo
authors.affiliation: National Microbiology Laboratory and Canadian Nosocomial Infection Surveillance Program (CNISP), Winnipeg, Canada.
authors.lastname: George Golding Cnisp
authors.affiliation: Shanghai Ruijin Hospital, Shanghai, China.
authors.forename: Lizhong
authors.initials: L
authors.lastname: Han
authors.affiliation: Seoul National University, Bundang Hospital, Seongnam, South Korea.
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
authors.affiliation: University Hospital Münster, Münster, Germany.
authors.forename: Robin
authors.initials: R
authors.lastname: Köck
authors.affiliation: Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Larsen
authors.affiliation: National Reference Centre for Staphylococci and Enterococci, Robert Koch Institute, Wernigerode, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Layer
authors.affiliation: Public Health Laboratory Services Branch Centre for Health Protection, Hong Kong Special Administrative Region.
authors.forename: Janice
authors.initials: J
authors.lastname: Lo
authors.affiliation: Toho University Omori Hospital, Tokyo, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Maeda
authors.affiliation: National Microbiology Laboratory and Canadian Nosocomial Infection Surveillance Program (CNISP), Winnipeg, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Mulvey
authors.affiliation: Instituto Superiore di Sanità, Rome, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pantosti
authors.affiliation: Toho University Omori Hospital, Tokyo, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Saga
authors.affiliation: Hôpitaux Universitaires de Genève, Geneva, Switzerland.
authors.forename: Jacques
authors.initials: J
authors.lastname: Schrenzel
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Simor
authors.affiliation: Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Robert
authors.initials: R
authors.lastname: Skov
authors.affiliation: Laboratory for Microbiology and Infection Control, Breda, The Netherlands.
authors.forename: Miranda
authors.initials: M
authors.lastname: Van Rijen
authors.affiliation: Peking Union Medical College Hospital, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: University Veterinary Hospital, Universiti Putra, Serdang, Malaysia.
authors.forename: Zunita
authors.initials: Z
authors.lastname: Zakaria
authors.affiliation: Hôpitaux Universitaires de Genève, Geneva, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Harbarth
keywords: Antibiotic multiresistance; Meticillin-resistant Staphylococcus aureus; Molecular epidemiology; Panton–Valentine leukocidin