Distribution of , , and genes in epidemic methicillin-resistant strains isolated from East China.

BACKGROUND

Methicillin-resistant (MRSA) is a major nosocomial pathogen. Various virulence and antiseptic-resistant factors increase the pathogenicity of MRSA strains and allow for increased infection rates.

PURPOSE

The purpose of this study was to investigate the prevalence and distribution of virulence-associated and antiseptic-resistant genes from epidemic MRSA strains isolated from East China.

METHODS

A newly designed multiplex PCR assay was used to assess whether the virulence-associated genes and and the chlorhexidine tolerance gene were present in 189 clinical isolates of MRSA. Multilocus sequence typing (MLST) and Staphylococcal protein A () typing of these isolates were also performed. The frequency of these genes in isolates with epidemic sequence types (STs) was investigated.

RESULTS

Twenty STs and 36 types with five epidemic clones (ST5-t311, ST59-t437, ST5-t002, ST239-t030, and ST239-t037) were identified. The prevalence of , , and in all isolates was 5.8%, 10.1%, and 20.1%, respectively. The prevalences of these genes in isolates with ST5, ST59, ST239, and other ST genetic backgrounds were all significantly different (<0.001). Isolates that had the highest frequency of , , or were ST239 (33.3%), ST59 (28.9%), and ST5 (34.1%), respectively. The gene distribution pattern from all of the isolates showed that --, -+-, and -- were closely associated with epidemic clones ST5-t311, ST59-t437, and ST239-t037, respectively.

CONCLUSION

There are significant differences in the prevalence of virulence-associated and antiseptic-resistant genes in epidemic MRSA strains. Using this information, more effective control and prevention strategies for nosocomial MRSA infections can be developed.