title: Detection of diverse genotypes of Methicillin-resistantStaphylococcus aureusfrom hospital personnel and the environment in Armenia.
abstract: BACKGROUND
  Methicillin-resistantStaphylococcus aureus(MRSA) is a public health concern internationally. Studies examining a range of cohorts have been reported from various regions of the world, but little is known about the molecular epidemiology of MRSA in Armenia.
  
  
  METHODS
  Between May and September 2013, twenty isolates of methicillin-resistantStaphylococcus aureus(MRSA;mecApositive) were recovered from hospital personnel (n= 10; 9 females, 1 male) and environmental sites (n= 10) in the maternity ward of one of the teaching hospitals in Armenia.
  
  
  RESULTS
  Multi-locus sequence type clonal complex (MLST-CC) assignments inferred fromspatyping data revealed the majority belonged to 3 pandemic lineages of MRSA including: t008-CC8-SCCmecV (n= 10; 7 from personnel); t021-CC30-SCCmecIV (n= 5; all environmental); and t1523-CC45 (n= 2; 1 from personnel), one harboured SCCmecV the other was SCCmecnon-typable. The remainder identified as belonging to genotype t364-CC182, both of which harboured a novel SCCmeccassette withkdp,rif5,ccrB2andccrCdetected by PCR (both from personnel); and t325-CC88-SCCmecIV (n= 1; environmental). All MRSA were negative for the Panton-Valentine Leukocidin (PVL) locus and three CC8 strains were positive for the arginine catabolic element (ACME).
  
  
  CONCLUSIONS
  In this small study, we report for the first time of the occurrence of diverse MRSA genotypes belonging to both pandemic and more sporadic international clones in Armenia harbouring the smaller SCCmectypes and/or ACME, both of which have been associated with strain fitness. Further surveillance is warranted to better understand the prevalence, clinical and molecular epidemiology of MRSA throughout Armenia.
authors.affiliation: Queen Mary University of London, School of Biological and Chemical Sciences, Mile End Road, London, E1 4NS UK.|School of Health, Sport and Bioscience, University of East London, Water Lane, London, E15 4LZ UK.
authors.forename: Hermine V
authors.initials: HV
authors.lastname: Mkrtchyan
authors.affiliation: Queen Mary University of London, School of Biological and Chemical Sciences, Mile End Road, London, E1 4NS UK.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, National Infection Service, Colindale, London, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Yacoub
authors.affiliation: Yerevan State Medical University, Yerevan, Armenia.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Ter-Stepanyan
authors.affiliation: Yerevan State Medical University, Yerevan, Armenia.
authors.forename: Hayk D
authors.initials: HD
authors.lastname: Karapetyan
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, National Infection Service, Colindale, London, UK.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Kearns
authors.affiliation: Queen Mary University of London, School of Biological and Chemical Sciences, Mile End Road, London, E1 4NS UK.
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Cutler
authors.affiliation: Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, National Infection Service, Colindale, London, UK.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pichon
authors.affiliation: Yerevan State Medical University, Yerevan, Armenia.
authors.forename: Armen Dz
authors.initials: AD
authors.lastname: Hambardzumyan
keywords: ACME; MRSA; Maternity ward; Pandemic; SCCmec