Journal Article

Dissemination of Methicillin-Resistant <i>Staphylococcus aureus</i> USA300 Sequence Type 8 Lineage in Latin America

Jinnethe Reyes, Sandra Rincón, Lorena Díaz, Diana Panesso, Germán A. Contreras, Jeannete Zurita, Carlos Carrillo, Adele Rizzi, Manuel Guzmán, Javier Adachi, Shahreen Chowdhury, Barbara E. Murray and Cesar A. Arias

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 49, issue 12, pages 1861-1877
Published in print December 2009 | ISSN: 1058-4838
Published online December 2009 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/648426
Dissemination of Methicillin-Resistant Staphylococcus aureus USA300 Sequence Type 8 Lineage in Latin America

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Background.Methicillin-resistant Staphylococus aureus (MRSA) is an important nosocomial and community-associated (CA) pathogen. Recently, a variant of the MRSA USA300 clone emerged and disseminated in South America, causing important clinical problems.

Methods.S. aureus isolates were prospectively collected (2006–2008) from 32 tertiary hospitals in Colombia, Ecuador, Peru, and Venezuela. MRSA isolates were subjected to antimicrobial susceptibility testing and pulsed-field gel electrophoresis and were categorized as health care-associated (HA)-like or CA-like clones on the basis of genotypic characteristics and detection of genes encoding Panton-Valentine leukocidin and staphylococcal cassette chromosome (SCC) mec IV. In addition, multilocus sequence typing of representative isolates of each major CA-MRSA pulsotype was performed, and the presence of USA300-associated toxins and the arcA gene was investigated for all isolates categorized as CA-MRSA.

Results.A total of 1570 S. aureus were included; 651 were MRSA (41%)—with the highest rate of MRSA isolation in Peru (62%) and the lowest in Venezuela (26%)—and 71%, 27%, and 2% were classified as HA-like, CA-like, and non-CA/HA-like clones, respectively. Only 9 MRSA isolates were confirmed to have reduced susceptibility to glycopeptides (glycopeptide-intermediate S. aureus phenotype). The most common pulsotype (designated ComA) among the CA-like MRSA strains was found in 96% of isolates, with the majority (81%) having a ⩽6-band difference with the USA300-0114 strain. Representative isolates of this clone were sequence type 8; however, unlike the USA300-0114 strain, they harbored a different SCCmec IV subtype and lacked arcA (an indicator of the arginine catabolic mobile element).

Conclusion.A variant CA-MRSA USA300 clone has become established in South America and, in some countries, is endemic in hospital settings.

Journal Article.  4853 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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