Article Figures & Data
Figures
- FIG 1
Flowcharts. (Top) Human isolates. MUO is MRSA without known risk factors as described by the Dutch national guideline. MKO is MRSA with known risk factors as described by the Dutch national guideline. MKO CC398 represents a pig or veal calf farmer, a person with direct contact to pigs and/or veal calves and/or who lives on a pig or veal calf farm, or a broiler chicken handler. (Bottom) Animal isolates. RIVM, the National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
- FIG 2
Selected spa types for human and animal groups. MKO, MRSA of known origin (known risk factors described in the Dutch MRSA guideline); MSSA, methicillin-susceptible Staphylococcus aureus; MUO, MRSA of unknown origin (unknown risk factors not described in the Dutch MRSA guideline). The outbreak isolate was described by Wulf et al. (9).
- FIG 3
Results of β-hemolysin screening, PCR typing, and susceptibility testing. Isolates were clustered transversally, using the Jaccard coefficient, on the presence of MGEs, β-hemolysin expression, and susceptibility to tetracycline and trimethoprim-sulfamethoxazole. The dendrogram was created based on UPGMA with Jaccard similarity. The epidemiological subtypes in humans are MKO (MRSA of known origin: MRSA with known risk factors for acquisition) and MUO (MRSA of unknown origin: MRSA with unknown risk factors for acquisition). MUO 2007 are MUO isolates according to the 2007 guideline definition but no longer included under the 2012 guideline definition. MUO 2012 are MUO isolates according to the current guideline of December 2012. Outbreak represents an isolate involved from a MRSA CC398 outbreak in a Dutch hospital as described by Wulf et al. (9). Mobile genetic elements: chp (gene encoding chemotaxis-inhibiting protein [CHIPS], which is found in the φ3 bacteriophage that contains the immune evasion complex [IEC] that chp is sometimes part of); scn (gene encoding staphylococcal complement inhibitor [SCIN], which is found in the φ3 bacteriophage that contains the IEC that scn is sometimes part of); φ3 int (integrase gene of bacteriophage 3); φ6 int (integrase gene of bacteriophage 6); φ7 int (integrase gene of bacteriophage 7); rep7 (replication protein 7); rep27 (replication protein 27); and cadDX (operon of gene cadX [cad operon regulatory protein], which encodes resistance against the heavy metal cadmium). Antimicrobial susceptibility: tetracycline susceptibility testing; Trim./sulfa., trimethoprim-sulfamethoxazole susceptibility testing.
Additional Files
Supplemental material
- Supplemental file 1 -
Table S1 (MRSA guideline risk categories)
PDF, 14K
- Supplemental file 2 -
Table S2 (Risk factors added to questionnaire after literature search)
PDF, 79K
- Supplemental file 3 -
Table S3 (Primers for mobile genetic elements)
PDF, 38K
- Supplemental file 4 -
Table S4 (PCR programs)
PDF, 69K
- Supplemental file 1 -
