A variant of the Southern German clone of methicillin-resistant Staphylococcus aureus is predominant in Croatia

Abstract

The aim of the present study was to investigate the antibiotic susceptibility patterns and molecular epidemiology of clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered in 24 hospitals in 20 cities in Croatia from October to December 2004. A total of 1815 consecutive S. aureus isolates were recovered, 248 of which were MRSA. The MRSA isolates were analysed using spa typing, multilocus sequence typing and SCCmec typing. Furthermore, the presence of Panton-Valentine leukocidin (PVL) genes was determined as a genetic marker for community-associated MRSA. The MRSA prevalence was 14%. Ninety-six per cent of the MRSA isolates were resistant to ciprofloxacin, 95% to clindamycin and azithromycin, 94% to gentamicin, and 93% to erythromycin. The majority of the MRSA isolates (78%) was associated with the ST111-MRSA-I clone. In addition, various other endemic MRSA clones were observed, such as the ST247-MRSA-I (4%), the ST45-MRSA-IV (2%), the ST5-MRSA-I (2%), the ST239-MRSA-III (2%), the ST5-MRSA-II (1%), the ST8-MRSA-IV (1%) and the ST5-MRSA-IV (<1%) clones. Furthermore, we observed one PVL-negative ST80-MRSA-IV isolate. Four PVL-positive MRSA isolates were found, associated with ST8-MRSA-IV, ST80-MRSA-IV and ST80-MRSA-I. The ST111-MRSA-I clone was predominant in Croatia. Future surveillance studies of MRSA are important to elucidate whether changes in the clonal distribution of MRSA will occur, and if the minor endemic MRSA clones observed in the present study will replace the ST111-MRSA-I clone on a large scale.

Molecular Characterization and Resistance Profile of Methicillin Resistant Staphylococcus aureus Strains Isolated from Hospitalized Patients in Intensive Care Unit, Tehran-Iran

“…In this study, methicillin resistance was detected in 90.5% S. aureus isolates. The high frequency of MRSA isolates in the present study was in agreement with the findings of the studies in Iran (1), Bolivia (18), and India (19) and is higher than Hungary (20) and Croatia (21). The results of the susceptibility testing showed that all the isolates were susceptible to vancomycin, linezolid, and teicoplanin which is consistent with a previous study in Iran (1) and other studies (16)(17)(18)(19)(20)(21).…”

“…They showed that the most commonly detected antibiotic resistance genes in the MRSA strains were tetK (89.18%), mecA (71.62%), msrA (56.75%), and tetM (54.05%). In accordance with the results of the studies in Italy (35), Croatia (21), and Hungary (20), a high resistance to ciprofloxacin was seen in the current study (63.2%), which could be due to the widespread use of ciprofloxacin in the treatment of MRSA infections, mutation in gyrase or topoisomerase IV enzymes, and efflux pumps (36).…”

“…This finding was inconsistent with the previous reports about the predominance of SCCmec III in most Asian countries (22). In this study, the resistance to antibacterial agents and MDR pattern among isolates with SCCmec type III was more prevalent than that of SCCmec type IV, while the distribution of the virulence factors were vice versa, which is in line with the findings of other studies (16,21).…”

SCCmec and spa Typing of Staphylococcus aureus Strains Isolated from Patients with Urinary Tract Infection: Emergence of spa Types t426 and t021 in Iran

“…According to the literature, MRSA strains are resistant not only to beta-lactams but also to macrolides, lincosides, and aminoglycosides (6,8,18). In the present study, the majority of the MRSA isolates were resistant to ampicillin (100%), ciprofloxacin (94.5%), gentamicin (98.2%), erythromycin (90.9%), tetracyclin (87.3%), and clindamycin (98.2%), which is in line with the findings reported in Iran (8), Croatia (17), and Turkey (19). The rate of resistance to tested antibiotics, with the exception of amikacin among MRSA isolates, was higher than those among MSSA isolates, which is in accordance with the findings reported by Yu et al (20).…”

“…Overall, it is well established that isolation rate of S. aureus in UTI is between 2% and 15% (5). In the present study, MRSA screening showed that 61.1% of the tested isolates were confirmed to be MRSA, which was lower than those reported in previous studies from Iran (8), and higher than those reported in Croatia (17). Moreover, different prevalence rates are reported for MRSA by different researchers.…”