Different Clonal Complexes of Methicillin-Resistant Staphylococcus aureus Are Disseminated in the Euregio Meuse-Rhine Region

Abstract

The Euregio Meuse-Rhine (EMR) is formed by the border regions of Belgium, Germany, and The Netherlands. Cross-border health care requires infection control measures, in particular since the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) differs among the three countries. To investigate the dissemination of MRSA in the EMR, 152 MRSA isolates were characterized by pulsed-field gel electrophoresis (PFGE), SCCmec typing, and multilocus sequence typing. PFGE revealed major clonal groups A, G, L, and Q, suggesting dissemination of MRSA in the EMR. Group A harbored mainly SCCmec type III and sequence types (STs) 239 and 241. The majority of the strains from group G harbored SCCmec type I and ST8 and ST247, whereas most strains from group L carried either SCCmec type IV or type I. Within group L, ST8 and ST228 were found, belonging to clonal complexes 8 and 5, respectively. Most strains from group Q included SCCmec type II and were sequence typed as ST225. Both ST225-MRSA-II and ST241-MRSA-III were novel findings in Germany. In addition, the SCCmec type of two isolates has not been described previously. One strain was classified as SCCmec type III but harbored the pls gene and the dcs region. Another strain was characterized as SCCmec type IV but lacked the dcs region. In addition, one isolate harbored both SCCmec type V and Panton-Valentine leukocidin. Finally, the SCCmec type of the strains was found to be correlated with the antibiotic susceptibility pattern.

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

“…To confirm the association between spa typing and MLST, MLST was performed on two or three MSSA isolates randomly selected from each of the spa CCs. MLST was performed with primers described by Enright et al (19), with the modifications described by Deurenberg et al (11). The amplification was performed on a conventional PCR system (Perkin Elmer GeneAmp 9600), using the following program: 15 min at 95°C, followed by 35 cycles of 1 min at 95°C, 1 min at 55°C, and 1 min at 72°C, and with a final step for 5 min at 72°C.…”

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

“…tal-isolated MRSA (23.6%, 13.8%, and 0.6% in Belgium, Germany, and the Netherlands, respectively) (2). Consequently, cross-border transfer of patients may affect the dissemination and prevalence of MRSA, particularly when patients are transferred from countries with a relatively high prevalence to a country with a low prevalence.…”

Countrywide Molecular Survey of Methicillin-Resistant Staphylococcus aureus Strains in Poland

“…In contrast to CC8, CC5 constituent clones were represented by a small number of isolates. Two of the clones (Rhine-Hesse [ST225-II] and South German [ST228-I]) recently have been observed in neighboring countries as epidemic clones (12). For one of the novel clones in Poland, ST225, 9 of 14 isolates harbored SCCmec type IV.…”

“…Because of free access to healthcare facilities within the EU in general, there is a risk that clones previously existing in other countries will appear in Poland, and vice versa. It has been shown that easy cross-border patient mobility may be a major reason for the appearance of new clones in the hospital setting (12).…”