RRML - Molecular epidemiology and virulence factors of methicillin-resistant Staphylococcus aureus strains in a Romanian university hospital

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Nr. 20(4)/2012

Molecular epidemiology and virulence factors of methicillin-resistant Staphylococcus aureus strains in a Romanian university hospital

Edit Székely, Adrian Man, Anca Mare, Krisztina E. Vas, Szabolcs Molnár, Doina Bilca, János Szederjesi, Felicia Toma, Lilla Lőrinczi

Abstract:

The aim of the present study was to analyze the clonal relations and virulence profile of clinically relevant MRSA strains collected during one year from patients admitted to clinical wards with high risk for nosocomial infections in a university hospital. One hundred and twenty two MRSA strains isolated from patients admitted to surgical and intensive care units during 2010 were analyzed. Molecular characterization was performed using PFGE (pulsed-field gel electrophoresis), determining spa polymorphism and SCCmec type. The presence of genes encoding for virulence factors was assessed. We have identified 25 distinct pulsotypes clustering into 4 major clonal groups. Group A comprised 82% of MRSA strains (n=100), corresponding to spa type t030. These strains harboured SCCmec type III and were positive for enterotoxin A genes. Fifteen percent of the strains (n=18) belonged to group B representing spa types t127, t015 and t321, carrying SCCmec type IV and genes encoding for diverse enterotoxins. Groups C and D were represented by one strain each, belonging to spa type t044 and t582, respectively. These strains were positive for genes encoding for Panton-Valentine leukocidin (PVL), enterotoxin G and toxic shock syndrome toxin. Two strains were non-typeable by PFGE, these belonged to spa type t034, characteristic to livestock-associated MRSA (LA-MRSA) strains. The majority of MRSA strains were clonally related. Supported by epidemiological data, our findings point to the intrahospital origin of these strains. Community-associated MRSA strains (SCCmec type IV) were sporadically involved in infections. Strains with multiple virulence factors and new, emerging strains (LA-MRSA) were detected.

Keywords: molecular typing,PFGE,nosocomial infections,community-onset infections

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Székely E, Man A, Mare A, Vas KE, Molnár S, Bilca D, et al. Molecular epidemiology and virulence factors of methicillin-resistant Staphylococcus aureus strains in a Romanian university hospital. Rev Romana Med Lab. 2012;20(4):371-82