In only a few instances has the clonal composition of Staphylococcus aureus collections that include methicillinsusceptible S. aureus (MSSA) been extensively characterized. In order to investigate the clonal composition of MSSA and methicillin-resistant S. aureus (MRSA) and examine whether the infections diagnosed at our hospital were related to internationally distributed S. aureus lineages, we collected 89 clinical S. aureus isolates from patients at a public university hospital in Rio de Janeiro, Brazil, from September 1999 to June 2000. All S. aureus isolates were genotyped by pulsed-field gel electrophoresis and multilocus restriction fragment typing (MLRFT), and a subset (n ؍ 17) was further characterized by multilocus sequence typing (MLST). The 34 MRSA isolates were additionally characterized by SCCmec typing. The MSSA population (n ؍ 55) was grouped into 18 restriction fragment types (RFTs); of these, five RFTs accounted for 67% (37) of the MSSA isolates. MRSA isolates were clustered into only three RFTs (P ؍ 0.02). The majority of MSSA RFTs were related to sequence type 30 (ST30) (12 isolates, 22%), ST1, ST188, and ST432 (6 isolates, 11% each). The predominant MRSA RFT comprised 31 (91%) of 34 isolates; four randomly selected isolates of this RFT were ST239, the previously described widely disseminated Brazilian clone. However, a fifth isolate belonging to this RFT was the ST644, a new single locus variant of ST239. By applying MLRFT and MLST, we found evidence for a clonal structure in MSSA isolates and detected the dissemination of MSSA clonal complexes 1, 5, 8, 30, and 45.
After mupirocin use decreased, the ileS-2 encoding plasmid persisted in only a few Brazilian clone isolates. Our data on mupirocin-resistant MRSA incidence and mupirocin use strongly suggested that restricted use was related to decreased rates of mupirocin resistance at our hospital.
In the present study, 37 group A Streptococcus (GAS) strains belonging to 13 new emm sequence types identified among GAS strains randomly isolated in Brazil were characterized by using phenotypic and genotypic methods. The new types were designated st204, st211, st213, st809, st833, st854, st2904, st2911, st2917, st2926, st3757, st3765, and st6735. All isolates were susceptible to the antimicrobial agents tested, except to tetracycline. They all carried the speB gene, and 94.6% produced detectable SpeB. Most strains belonging to a given emm type had similar or highly related pulsed-field gel electrophoresis profiles that were distinct from profiles of strains of another type. The other characteristics were variable from isolate to isolate, although some associations were consistently found within some emm types. Unlike the other isolates, all type st213 isolates were speA positive and produced SpeA. Strains belonging to st3765 were T6 and opacity factor (OF) negative. Individual isolates within OF-positive emm types were associated with unique sof gene sequence types, while OF-negative isolates were sof negative by PCR. This report provides information on new emm sequence types first detected in GAS isolates from a geographic area not extensively surveyed. Such data can contribute to a better understanding of the local and global dynamics of GAS populations and of the epidemiological aspects of GAS infections occurring in tropical regions.Streptococcus pyogenes, frequently referred to as group A Streptococcus (GAS), is a significant cause of human morbidity worldwide, and it is associated with a variety of mild and severe diseases that may occur either in areas where the diseases are endemic or as epidemics (10). Most of the knowledge that has been accumulated concerning GAS epidemiology is based upon serologic M and T typing. However, many GAS isolates are nontypeable due to the lack of appropriate type-specific antisera or possibly due to loss of antigen expression under cultivation. In recent years, DNA sequencing-based methods for characterizing GAS strains have been used, including sequence analysis of emm gene-specific PCR products (emm typing) (1, 2). This methodology has allowed the recognition of several previously unknown GAS types in different geographic areas, demonstrating the usefulness of emm typing for detecting genetic diversity among GAS isolates and for tracing GAS infections (1, 2, 5). A complementary molecular methodology (sof typing) is also based upon sequence analysis of a hypervariable virulence gene (3).In the present study, we describe the characteristics of GAS isolates belonging to new emm types identified among strains recovered from patients living in Brazil. These strains were further characterized through phenotypic tests (T-protein typing, detection of opacity factor [OF], antimicrobial susceptibility, and production of streptococcal pyrogenic exotoxin A [SpeA] and SpeB) and additional genotypic tests (the presence of speA, speB, speC, and sof gene PCR products, sof sequence typ...
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