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Title: A field guide to pandemic, epidemic and sporadic clones of methicillin-resistant Staphylococcus aureus
Authors: Monecke, Stefan
Coombs, Geoffrey
Shore, Anna C.
Coleman, David C.
Akpaka, Patrick
Borg, Michael Angelo
Chow, Henry
Ip, Margaret
Jatzwauk, Lutz
Jonas, Daniel
Kadlec, Kristina
Kearns, Angela
Laurent, Frederic
O'Brien, Frances G.
Pearson, Julie
Ruppelt, Antje
Schwarz, Stefan
Scicluna, Elizabeth
Slickers, Peter
Tan, Hui-Leen
Weber, Stefan
Ehricht, Ralf
Keywords: Staphylococcus aureus
Staphylococcus aureus infections -- Epidemiology
Staphylococcus aureus infections -- Pathogenesis
Methicillin-resistant staphylococcus aureus
Issue Date: 2011
Publisher: PLOS
Citation: Monecke, S., Coombs, G., Shore, A. C., Coleman, D. C., Akpaka, P., Borg, M. A.,...Ehricht, R. (2011). A field guide to pandemic, epidemic and sporadic clones of methicillin-resistant Staphylococcus aureus. PloS one, 6(4), e17936.
Abstract: In recent years, methicillin-resistant Staphylococcus aureus (MRSA) have become a truly global challenge. In addition to the long-known healthcare-associated clones, novel strains have also emerged outside of the hospital settings, in the community as well as in livestock. The emergence and spread of virulent clones expressing Panton-Valentine leukocidin (PVL) is an additional cause for concern. In order to provide an overview of pandemic, epidemic and sporadic strains, more than 3,000 clinical and veterinary isolates of MRSA mainly from Germany, the United Kingdom, Ireland, France, Malta, Abu Dhabi, Hong Kong, Australia, Trinidad & Tobago as well as some reference strains from the United States have been genotyped by DNA microarray analysis. This technique allowed the assignment of the MRSA isolates to 34 distinct lineages which can be clearly defined based on non-mobile genes. The results were in accordance with data from multilocus sequence typing. More than 100 different strains were distinguished based on affiliation to these lineages, SCCmec type and the presence or absence of PVL. These strains are described here mainly with regard to clinically relevant antimicrobial resistance- and virulence-associated markers, but also in relation to epidemiology and geographic distribution. The findings of the study show a high level of biodiversity among MRSA, especially among strains harbouring SCCmec IV and V elements. The data also indicate a high rate of genetic recombination in MRSA involving SCC elements, bacteriophages or other mobile genetic elements and large-scale chromosomal replacements.
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