Abstract
In Copenhagen, methicillin-resistant Staphylococcus aureus (MRSA) accounted for <15 isolates per year during 1980-2002. However, since 2003 an epidemic increase has been observed, with 33 MRSA cases in 2003 and 110 in 2004. We analyzed these 143 cases epidemiologically and characterized isolates by pulsed-field gel electrophoresis, Staphylococcus protein A (spa) typing, multilocus sequence typing, staphylococcal chromosome cassette (SCC) mec typing, and detection of Panton-Valentine leukocidin (PVL) genes. Seventy-one percent of cases were community-onset MRSA (CO-MRSA); of these, 36% had no identified risk factors. We identified 29 spa types (t) and 16 sequence types (STs) belonging to 8 clonal complexes and 3 ST singletons. The most common clonal types were t024/ST8-IV, t019/ST30-IV, t044/ST80-IV, and t008/ST8-IV (USA300). A total of 86% of isolates harbored SCCmec IV, and 44% had PVL. Skin and soft tissue infections dominated. CO-MRSA with diverse genetic backgrounds is rapidly emerging in a low MRSA prevalence area.
Highlights
Crease in CO-methicillin-resistant Staphylococcus aureus (MRSA) has mostly been attributed to the PVLpositive ST80 clone [3,8]
Pulsed-field gel electrophoresis (PFGE) clusters were identified on an UPGMA dendrogram based on Dice coefficients, where optimization and band position tolerance were set at 1% and 2%, respectively
Background and SCCmec cassettes) found among MRSA isolates from a low-prevalence area is of global public health concern
Summary
Crease in CO-MRSA has mostly been attributed to the PVLpositive ST80 clone [3,8]. MRSA has been isolated from
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