Virulence Factors Found in Nasal Colonization and Infection of Methicillin-Resistant (MRSA) Isolates and Their Ability to Form a Biofilm.

Hospitalizations related to Methicillin-resistant (MRSA) are frequent, increasing mortality and health costs. In this way, this study aimed to compare the genotypic and phenotypic characteristics of MRSA isolates that colonize and infect patients seen at two hospitals in the city of Niterói-Rio de Janeiro, Brazil. A total of 147 samples collected between March 2013 and December 2015 were phenotyped and genotyped to identify the protein A (SPA) gene, the staphylococcal chromosomal cassette (SCC), A, Panton-Valentine Leucocidin (PVL), C, R, ACME, and virulence genes. The strength of biofilm formation has also been exploited. The prevalence of SCC type IV (77.1%) was observed in the colonization group; however, in the invasive infection group, SCC type II was prevalent (62.9%). The Multilocus Sequence Typing (MLST), ST5/ST30, and ST5/ST239 analyses were the most frequent clones in colonization, and invasive infection isolates, respectively. Among the isolates selected to assess the ability to form a biofilm, 51.06% were classified as strong biofilm builders. Surprisingly, we observed that isolates other than the Brazilian Epidemic Clone (BEC) have appeared in Brazilian hospitals. The virulence profile has changed among these isolates since the ACME type I and II genes were also identified in this collection.