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Journal of Clinical Microbiology, October 2005, p. 5069-5073, Vol. 43, No. 10
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.10.5069-5073.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Contemporary Methicillin-Resistant Staphylococcus aureus Clones in Hong Kong

Margaret Ip,^1* R. W. H. Yung,^2, T. K. Ng,³ W. K. Luk,⁴ Cindy Tse,^3, Philip Hung,¹ Mark Enright,^5,¶ and Donald J. Lyon^1,

The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong,¹ Pamela Youde Nethersole Eastern Hospital, Hong Kong,² Princess Margaret Hospital, Kowloon, Hong Kong,³ Tseung Kwan O Hospital, Hong Kong,⁴ Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom⁵

Received 19 May 2005/ Returned for modification 29 June 2005/ Accepted 7 July 2005

Two hundred nonduplicate methicillin-resistant Staphylococcus aureus (MRSA) isolates causing bacteremia in patients in four major Hong Kong hospitals during the period 2000 to 2001 were characterized by antibiogram, pulsed-field gel electrophoresis (PFGE) using SmaI restriction enzymes, and determination of staphylococcal cassette chromosome mec (SCCmec) types. Nine PFGE types, A to I, were obtained. PFGE type A constituted 50% (99/200) of all isolates and was present in isolates from all four hospitals. PFGE types A to E, had previously been identified as the major types at one of the hospitals from 1988 to 2000. The majority had a resistance profile to tetracycline (T), erythromycin (E), clindamycin (D), gentamicin (G), tobramycin (To), and ciprofloxacin (Ci), and belonged to SCCmec type III; and representatives belonged to clonal complex 239 (CC239) (MRSA with SCCmec type III and sequence type 239, designated ST239-MRSA-III). PFGE types F to I were new patterns that had not been previously identified in isolates from Hong Kong. PFGE type F constituted 18% (35/200) of MRSAs, had resistance profile TEGToCi, and belonged to CC5 (ST5-MRSA-II). PFGE type G included 13% (26/200) of MRSAs, had resistance profile TECi, and belonged to CC45 with SCCmec type I or II. PFGE type H had characteristics similar to those of CC239, while PFGE type I included three isolates, two of which expressed resistance to oxacillin and fusidic acid only. Two of these strains had SCCmec IVa and carried sequence type 389, with a multilocus sequence typing allelic profile of 3-35-19-2-20-26-39. Contemporary MRSAs causing bacteremia in Hong Kong hospitals belong to three clonal complexes (CC5, CC45, and CC239). The most prevalent MRSA clone in Hong Kong belongs to CC239, with PFGE types A to E and H, SCCmec type III, ST239, and a resistance profile of TEDGToCi.

Present address: Infection Control Branch, Center for Health Protection (CPHL), Hong Kong.

Present address: Kwong Wah Hospital, Hong Kong, Hong Kong.

^¶ Present address: Imperial College London, Old Medical School Bldg., St. Mary’s Hospital, London, England, United Kingdom.

Present address: Surrey and Sussex Healthcare NHS Trust, Surrey, England, United Kingdom.

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