Molecular characteristics of methicillin-resistant Staphylococcus aureus blood isolates: clonal spread of staphylococcal cassette chromosome mec type IVA between the community and the hospital.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is becoming increasingly common worldwide. The purpose of this study was to identify the prevalence and molecular characteristics of MRSA bloodstream isolates in hospitals. Clinical data from patients with MRSA bacteremia between 2003 and 2005 were collected. Isolates were classified as hospital-acquired (HA-MRSA), health care-associated (HCA-MRSA), or CA-MRSA according to the time of isolation and the risk factors for colonization. Available strains were tested for the presence of mecA, staphylococcal cassette chromosome mec (SCCmec), and by multilocus sequence test. Among 129 cases, 78 nonduplicated isolates were analyzed. The proportion of CA-MRSA, HCA-MRSA, and HA-MRSA was 2.6% (2), 23.1% (18), and 74.4% (58), respectively. According to multilocus sequence test and SCCmec, there were seven genotypes with sequence types (STs) and SCCmec types. The predominant genotype, ST5-MRSA-II, was found in 57.7% (45). All type IVA isolates was ST72 (9), and ST72-MRSA-IVA was identified in CA-MRSA (2, 100%), HCA-MRSA (1, 5.6%), and HA-MRSA (6, 10.3%), respectively. In summary, CA-MRSA bacteremia was not common in our hospital during the period.