Cross-Border Dissemination of Methicillin-ResistantStaphylococcus aureus, Euregio Meuse-Rhin Region

Abstract

MRSA clones were associated with hospital-associated clonal complexes and with Panton-Valentine leukocidin–positive community-associated MRSA.

Population Structure of Staphylococcus aureus Strains Isolated from Intensive Care Unit Patients in The Netherlands over an 11-Year Period (1996 to 2006)

“…Four MRSA isolates were associated with ST8-MRSA-IV (UK MRSA-2/-6), which was earlier found in Dutch hospitals and in multiple countries worldwide (9,50). Two MRSA isolates were associated with ST5-MRSA-II (New York/Japan clone), which was identified as the dominant MRSA in hospitals in New York and Japan (9) and was recently observed to be a dominant clone in the hospitals in The Netherlands as well (8). The other MRSA isolate was associated with ST228-MRSA-I (southern Germany clone) (9).…”

“…The prevalence of MLST CC8, CC15, and CC45 fluctuated over time. The change in prevalence might be due to import from abroad or from cross-border healthcare (8,52), but further studies to confirm this hypothesis are needed.…”

Overview of molecular typing methods for outbreak detection and epidemiological surveillance

“…In the spa sequence typing method, each identified repeat is associated to a code and a spa-type is deduced from the order of specific repeats. Although spa-typing has a lower discriminatory ability than PFGE [45,46], its cost-effectiveness, ease of use, speed, excellent reproducibility, appropriate in vivo and in vitro stability, standardised international nomenclature, high-throughput by using the StaphType software, and full portability of data via the Ridom database (http:// spaserver.ridom.de) makes this method the currently most useful instrument for characterising S. aureus isolates at the local, national and international levels [47][48][49][50][51][52]. Importantly, this approach ensures strict criteria for internal and external quality assurance of data submitted to the database that is curated by SeqNet.org [50,53].…”

The current role of pulsed-field gel electrophoresis in methicillin-resistantStaphylococcus aureus(MRSA) typing and the retrospective identification of outbreaks

“…As published in 2009, the 'Rhine-Hesse' clone and the 'Berlin' clone are common in the Western German parts of the Euregio Meuse-Rhin (EMR) region, while -in addition to these clones -a higher clonal diversity was detected on the Dutch side. The predominant clonal complexes in the EMR region are CC5, CC8, CC30, and CC45 [29]. Another study identified the 'Barnim' clone as one of the predominant clones in the Dutch-German border area [30].…”