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Journal of Clinical Microbiology, August 2007, p. 2654-2661, Vol. 45, No. 8
0095-1137/07/$08.00+0     doi:10.1128/JCM.02579-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Sporadic "Transitional" Community-Associated Methicillin-Resistant Staphylococcus aureus Strains from Health Care Facilities in the United States{triangledown}

Jennifer M. Brady,1 Mary E. Stemper,1,3 Ashley Weigel,1 Po-Huang Chyou,2 Kurt D. Reed,1,3 and Sanjay K. Shukla1*

Molecular Microbiology Laboratory,1 Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin,2 Marshfield Laboratories, Marshfield, Wisconsin3

Received 22 December 2006/ Returned for modification 19 March 2007/ Accepted 3 June 2007

We describe phenotypic and genotypic traits of a group of methicillin-resistant Staphylococcus aureus (MRSA) clones that are either remnants of unsuccessful community-associated MRSA (CA-MRSA) clones or represent a transitional state with some yet-to-be-acquired characteristics of CA-MRSA. These rare strains (n = 20) were identified during a 10-year period (1990-1999) from 13 unrelated health care facilities in Wisconsin. The isolates were recovered from patients in nosocomial or long-term chronic care facilities (60%) and outpatient settings (40%). Sixty percent (n = 12) of the isolates were recovered from skin and soft tissue infections, whereas the remaining isolates (n = 8) were from invasive infections. Ninety percent of isolates were susceptible to all antibiotic classes tested or resistant to erythromycin and clindamycin. Pulsed-field gel electrophoresis, multilocus sequence typing, and spa typing clustered these isolates into 8, 8, and 14 clonal groups, respectively. Eight plasmid profiles were represented in these strains. All four agr types were represented, with type IV being predominant (40%). All strains harbored subtypes of type IV staphylococcal cassette chromosome mec but lacked genes for the virulence factor Panton-Valentine leukocidin (PVL). The strains harbored one or more of the following toxin genes: sea, seb, sec, sed, see, seh, sej, sek, sel, seg, sei, sem, sen, and seo. Individual clonal groups maintained the same set of enterotoxin genes even though they were isolated over extended time periods, suggesting significant genomic stability. The potential role of PVL-carrying phages and plasmids in the success of CA-MRSA clones has been discussed.

* Corresponding author. Mailing address: Molecular Microbiology Laboratory, Marshfield Clinic Research Foundation, 1000 North Oak Avenue, Marshfield, WI 54449. Phone: (715) 389-5363. Fax: (715) 389-3808. E-mail: shukla.sanjay{at}mcrf.mfldclin.edu

{triangledown} Published ahead of print on 13 May 2007.

Journal of Clinical Microbiology, August 2007, p. 2654-2661, Vol. 45, No. 8
0095-1137/07/$08.00+0     doi:10.1128/JCM.02579-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • El Garch, F., Hallin, M., De Mendonca, R., Denis, O., Lefort, A., Struelens, M. J. (2009). StaphVar-DNA microarray analysis of accessory genome elements of community-acquired methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother 63: 877-885 [Abstract] [Full Text]  


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