Ann Clin Microbiol.  2016 Dec;19(4):88-96. 10.5145/ACM.2016.19.4.88.

Molecular Typing and Resistance Profiles of Vancomycin-Intermediate Staphylococcus aureus in Korea: Results from a National Surveillance Study, 2007-2013

• Kim JW
• Kang GS
• Yoo JI
• Kim HS
• Lee YS
• Yu JY
• Lee KJ
• Park C
• Kim IH

• KMID: 2362954
• DOI: http://doi.org/10.5145/ACM.2016.19.4.88

Abstract

BACKGROUND
To investigate the national molecular epidemiology and resistance profiles of vancomycin-intermediate Staphylococcus aureus (VISA), we analyzed the characteristics of methicillin-resistant Staphylococcus aureus (MRSA) collected from clinical samples at tertiary or general hospitals participating in a nationwide surveillance program for VISA and vancomycin-resistant Staphylococcus aureus (VRSA) in Korea during an 12-week period in each year from 2007 to 2013.
METHODS
VISA was defined by agar dilution, broth dilution and E-test methods with vancomycin minimum inhibitory concentrations of >2 μg/mL. All VISA isolates were characterized by multilocus sequence typing, staphylococcal cassette chromosome mec typing, spa typing, accessory gene regulator typing, Diversilab analysis, and antibiogram analysis.
RESULTS
Of 109,345 MRSA isolates, 87,354 were screened and 426 isolates were identified as positive on brain heart infusion agar containing 4 μg/mL vancomycin (BHI-V4). Of 426 isolates, 76 isolates were identified as VISA. No VRSA isolates were detected among the isolates. Overall, a total of 6 genotypes were identified among VISA strains and the predominant clones were ST5-II-t2460, ST72-IV-t324, and ST239-III-t037 (44.7%, 15.8%, and 10.5%, respectively). Of note, ST72-IV-t324 clones are known to be a typical community-associated MRSA. ST239-III-t037 strains were more resistant to trimethoprim-sulfamethoxazole than any other type of strain. ST72-IV-t324 strains were susceptible to all of the antimicrobial agents tested except erythromycin and daptomycin. All of the VISA isolates were susceptible to linezolid and quinupristin-dalfopristin.
CONCLUSION
Although VRSA is still rare, continuous monitoring of VRSA occurrence is needed, as well as VISA prevalence, epidemic clonal shift, and antimicrobial resistance.

Keyword

Sequence type; Vancomycin-intermediate Staphylococcus aureus

MeSH Terms

Agar
Anti-Infective Agents
Brain
Clone Cells
Daptomycin
Erythromycin
Genotype
Heart
Hospitals, General
Korea*
Linezolid
Methicillin-Resistant Staphylococcus aureus
Microbial Sensitivity Tests
Molecular Epidemiology
Molecular Typing*
Multilocus Sequence Typing
Prevalence
Staphylococcus aureus*
Staphylococcus*
Trimethoprim, Sulfamethoxazole Drug Combination
Vancomycin
Agar
Anti-Infective Agents
Daptomycin
Erythromycin
Linezolid
Trimethoprim, Sulfamethoxazole Drug Combination
Vancomycin

Figure

• 

  Fig. 1. Cluster analysis and virtual gel image from Diversilab-generated fingerprints of the 76 VISA isolates, including corresponding typing data from molecular type (class 2) and year (class 3). Colored marks indicate the clonal clustering results.

Reference

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