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Journal of Clinical Microbiology, May 2009, p. 1344-1351, Vol. 47, No. 5
0095-1137/09/$08.00+0     doi:10.1128/JCM.02264-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Characterization of Methicillin-Resistant Staphylococcus aureus Isolates Collected in 2005 and 2006 from Patients with Invasive Disease: a Population-Based Analysis{triangledown}

Brandi Limbago,1* Gregory E. Fosheim,1 Valerie Schoonover,1 Christina E. Crane,1 Joelle Nadle,2 Susan Petit,3 David Heltzel,4 Susan M. Ray,5 Lee H. Harrison,6 Ruth Lynfield,7 Ghinwa Dumyati,8 John M. Townes,9 William Schaffner,10 Yi Mu,1 Scott K. Fridkin,1 for the Active Bacterial Core surveillance (ABCs) MRSA Investigators

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia,1 California Emerging Infections Program, Oakland, California,2 Connecticut Department of Health, Hartford, Connecticut,3 Colorado Emerging Infections Program, Denver, Colorado,4 Emory University School of Medicine and Georgia Emerging Infections Program, Atlanta, Georgia,5 Maryland Emerging Infections Program and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,6 Minnesota Department of Health, Minneapolis, Minnesota,7 University of Rochester, Rochester, New York,8 Oregon Health & Science University, Portland, Oregon,9 Vanderbilt University School of Medicine, Nashville, Tennessee,10

Received 25 November 2008/ Returned for modification 13 February 2009/ Accepted 16 March 2009

This study characterizes 1,984 methicillin-resistant Staphylococcus aureus (MRSA) isolates collected in 2005 and 2006 from normally sterile sites in patients with invasive MRSA infection. These isolates represent a convenience sample of all invasive MRSA cases reported as part of the Active Bacterial Core surveillance system in eight states in the United States. The majority of isolates were from blood (83.8%), joints (4.1%), and bone (4.2%). Isolates were characterized by pulsed-field gel electrophoresis (PFGE); SCCmec typing; susceptibility to 15 antimicrobial agents; and PCR analysis of staphylococcal enterotoxin A (SEA) to SEH, toxic shock syndrome toxin 1, and Panton-Valentine leukocidin. Thirteen established PFGE types were recognized among these isolates, although USA100 and USA300 predominated, accounting for 53.2% and 31.4% of the isolates, respectively. As expected, isolates from hospital onset cases were predominantly USA100, whereas those from community-associated cases were predominantly USA300. USA100 isolates were diverse (Simpson's discriminatory index [DI] = 0.924); generally positive only for enterotoxin D (74.5%); and resistant to clindamycin (98.6%), erythromycin (99.0%), and levofloxacin (99.6%), in addition to β-lactam agents. USA300 isolates were less diverse (DI = 0.566), positive for Panton-Valentine leukocidin (96.3%), and resistant to erythromycin (94.1%) and, less commonly, levofloxacin (54.6%), in addition to β-lactam agents. This collection provides a reference collection of MRSA isolates associated with invasive disease, collected in 2005 and 2006 in the United States, for future comparison and ongoing studies.

* Corresponding author. Mailing address: 1600 Clifton Rd. NE, MS C-16, Atlanta, GA 30333. Phone: (404) 639-2162. Fax: (404) 639-3822. E-mail: BBL7{at}cdc.gov

{triangledown} Published ahead of print on 25 March 2009.

Journal of Clinical Microbiology, May 2009, p. 1344-1351, Vol. 47, No. 5
0095-1137/09/$08.00+0     doi:10.1128/JCM.02264-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Tenover, F. C., Gay, E. A., Frye, S., Eells, S. J., Healy, M., McGowan, J. E. Jr. (2009). Comparison of Typing Results Obtained for Methicillin-Resistant Staphylococcus aureus Isolates with the DiversiLab System and Pulsed-Field Gel Electrophoresis. J. Clin. Microbiol. 47: 2452-2457 [Abstract] [Full Text]  


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