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J Med Microbiol 56 (2007), 614-619; DOI: 10.1099/jmm.0.47074-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Rapid determination of hospital-acquired meticillin-resistant Staphylococcus aureus lineages

Joshua D. Cockfield1, Smriti Pathak2, Jonathan D. Edgeworth2,3 and Jodi A. Lindsay1

1 Centre for Infection, Department of Cellular & Molecular Medicine, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK

2 Department of Nephrology & Transplantation, King's College London, Guy's, King's & St Thomas' Medical School, Guy's Hospital, London, UK

3 Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK

Correspondence
Jodi A. Lindsay
jlindsay{at}sgul.ac.uk

Received 14 November 2006
Accepted 24 January 2007

Multilocus sequence typing (MLST) and multi-strain microarray analysis have shown that most human Staphylococcus aureus strains belong to ten dominant clonal complexes (CCs) or lineages, each with unique surface architecture. Meticillin-resistant S. aureus (MRSA) strains currently belong to six of these lineages (CC1, CC5, CC8, CC22, CC30 and CC45), each of which has independently acquired mobile genetic elements (MGEs) carrying antibiotic resistance genes. MLST and microarrays are expensive and time consuming methods for routine determination of S. aureus lineage. A restriction-modification (RM) test has now been developed that is rapid, simple, inexpensive and accurately determines lineage of hospital-acquired MRSA. The RM test is based on three PCRs for hsdS gene variants, as hsdS genes likely control the independent evolution of S. aureus lineages. The RM test correctly identified 102 MRSA isolates as belonging to one of the six lineages/CCs. Real-time MRSA typing can be used to identify and track changes in local MRSA outbreaks, and provide support for targeting infection control strategies. Simple and accurate typing methods will also support large scale epidemiological studies, and could lead to greater understanding of the carriage, spread and virulence of different MRSA lineages.

Abbreviations: CA-MRSA, community-acquired MRSA; CC, clonal complex; HA-MRSA, hospital-acquired meticillin-resistant Staphylococcus aureus; MGE, mobile genetic element; MLST, multilocus sequence typing; MRSA, meticillin-resistant Staphylococcus aureus; RM, restriction modification; ST, sequence type.

Details of the isolates and assays are available as supplementary material with the online version of this paper.






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