Analysis of an outbreak of variably methicillin-resistant Staphylococcus aureus with chromosomal RFLPs and mec region probes.

An outbreak of infections with multi-resistant Staphylococcus aureus with unusual methicillin resistance at a Melbourne hospital was investigated by examining restriction fragment length polymorphisms (RFLPs) of total DNA digested with the rare-cutting endonuclease SmaI. The polymorphisms were identified by pulsed-field gel electrophoresis (PFGE) and were analysed numerically to give quantitative estimates of genetic distances between isolates. The majority of the isolates were found to belong to one group, with only minor genetic differences between the isolates that showed varying resistance to methicillin, thereby suggesting development of resistant variants from one clonal type during the outbreak. These results were confirmed by DNA hybridisation analysis with specific resistance gene probes for parts of a multi-resistance gene cluster (including methicillin) in the chromosome. Analysis of the RFLP patterns of S. aureus isolates is potentially a useful procedure in clinical epidemiology.