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Journal of Clinical Microbiology, April 2000, p. 1347-1351, Vol. 38, No. 4
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Comparison of Protein A Gene Sequencing with Pulsed-Field Gel Electrophoresis and Epidemiologic Data for Molecular Typing of Methicillin-Resistant Staphylococcus aureus

Yi-Wei Tang,1,* Michael G. Waddington,2 Douglas H. Smith,3 Janice M. Manahan,4 Peggy C. Kohner,4 Leanne M. Highsmith,2 Haijing Li,1 Franklin R. Cockerill III,4 Rodney L. Thompson,4 Stacy O. Montgomery,5 and David H. Persing6

Vanderbilt University School of Medicine, Nashville, Tennessee 372321; MIDI Labs, Inc., Newark, Delaware 197092; Hewlett-Packard, Palo Alto, California 943043; Mayo Clinic, Rochester, Minnesota 559054; Perkin-Elmer Biosystems, Foster City, California 944045; and Corixa Corporation and the Infectious Disease Research Institute, Seattle, Washington 981046

Received 1 September 1999/Returned for modification 22 November 1999/Accepted 7 January 2000

The epidemiologic relatedness of methicillin-resistant Staphylococcus aureus (MRSA) isolates is currently determined by analysis of chromosomal DNA restriction patterns by pulsed-field gel electrophoresis (PFGE). We have evaluated an alternative typing system (MicroSeq StaphTrack Kit; Perkin-Elmer Biosystems) based on the sequence analysis of the chromosomally encoded polymorphic repeat X region of the S. aureus protein A (spa) gene. A total of 69 clinical MRSA isolates were divided into 18 groups according to the number and nucleotide sequences of the spa repeats. Molecular typing results obtained both by spa sequencing and from the PFGE patterns were concordant except for one group, which contained 20 isolates recovered over a 2-year period from hospitalized patients at the Mayo Clinic. Although the spa typing patterns were indistinguishable for those isolates, PFGE analysis yielded seven related but distinguishable patterns. Further coagulase gene sequence analysis subtyped those 20 strains into four groups which followed distinct temporal and geographic distributions. During a 2-year epidemic period there were up to 7 fragment changes in PFGE patterns among epidemiologically related isolates, suggesting that PFGE may be unsuitable for long-term typing of strains involved in epidemics. Although more limited than PFGE in discriminatory power, spa sequencing analysis could be used as a screening method for typing of MRSA strains because of the shorter turnaround time, ease of use, and the inherent advantages of sequence analysis, storage, and sharing of information.

* Corresponding author. Mailing address: A3310 MCN, Division of Infectious Diseases, Vanderbilt University Medical Center, 1161 21st Ave., S., Nashville, TN 37232-2605. Phone: (615) 322-2035. Fax: (615) 343-6160. E-mail: yiwei.tang{at}vanderbilt.edu.

Journal of Clinical Microbiology, April 2000, p. 1347-1351, Vol. 38, No. 4
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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