Ann Lab Med.  2016 Nov;36(6):536-541. 10.3343/alm.2016.36.6.536.

Prevalence of Major Methicillin-Resistant Staphylococcus aureus Clones in Korea Between 2001 and 2008

• Kang GS
• Jung YH
• Kim HS
• Lee YS
• Park C
• Lee KJ
• Cha JO

• KMID: 2373591
• DOI: http://doi.org/10.3343/alm.2016.36.6.536

Abstract

BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) are important pathogens causing nosocomial infections in Korean hospitals. This study aimed to investigate the epidemiological and genetic diversity of clinical S. aureus isolates in healthcare settings from 2001 to 2008.
METHODS
Samples and data were obtained from 986 individuals as part of the National Antimicrobial Surveillance Project, involving 10 regions nationwide. Molecular typing studies, including multilocus sequence typing (MLST) and staphylococcal cassette chromosome mec (SCCmec) typing were performed, and a representative clone of Korean MRSA was classified by combinational grouping using a DiversiLab (DL; bioMérieux, France) repetitive element polymerase chain reaction (rep-PCR) system.
RESULTS
Nine Korean MRSA clones (KMRSA-1 to -9) were identified by analysis of genetic backgrounds and molecular characteristics. KMRSA-1 to -3, expressing clonal complex (CC) 5 (carrying SCCmec II), CC8 (carrying SCCmec III), and CC72 (carrying SCCmec IV) were spread nationwide. In contrast, KMRSA-6 was highly prevalent in Gyeongsangnam-do, and KMRSA-4 was highly prevalent in Jeollanam-do and Jeollabuk-do.
CONCLUSIONS
Epidemic KMRSA clones were genetically similar to major clones identified from the USA, with the exception of KMRSA-2, which had the SCCmec III type. Our results provide important insights into the distribution and molecular genetics of MRSA strains in Korea and may aid in the monitoring of MRSA spread throughout the country.

Keyword

Korean MRSA clones; Multilocus sequence typing; DiversiLab; Genetic diversity

MeSH Terms

Bacterial Proteins/genetics
DNA, Bacterial/genetics/metabolism
Electrophoresis, Gel, Pulsed-Field
Hospitals
Humans
Methicillin-Resistant Staphylococcus aureus/*genetics/isolation & purification
Multilocus Sequence Typing
Multiplex Polymerase Chain Reaction
Prevalence
Republic of Korea/epidemiology
Staphylococcal Infections/diagnosis/*epidemiology/microbiology
Bacterial Proteins
DNA, Bacterial

Figure

• 

  Fig. 1 Distribution of clonal complexes (CCs) by staphylococcal cassette chromosome mec (SCCmec) type. Singleton refers to sequence types (STs) that could not be assigned to any group.

• 

  Fig. 2 Clonal distribution of all methicillin-resistant Staphylococcus aureus (MRSA) isolates by district. The prevalence of CCs in (A) general hospitals, (B) hospitals and clinics, and (C) geriatric hospitals is shown. Singleton refers to STs that could not be assigned to any group.Abbreviations: CB, Chungcheongbuk-do; CN/DJ, Chungcheongnam-do/Daejeon; GB/US/DG, Gyeongsangbuk-do/Ulsan/Daegu; GG/IC, Gyeonggi-do/Incheon; GN/BU, Gyeongsangnam-do/Busan; GW, Gangwon-do; JB, Jeollabuk-do; JJ, Jejudo; JN/GJ, Jeollanam-do/Gwangju; SE, Seoul.

• 

  Fig. 3 Geographical distribution of Korean MRSA (KMRSA).Abbreviations: See Fig. 2.

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  Fig. 4 Dendrogram analysis of nine representative Korean MRSA (KMRSA) strains (circled) obtained by using the DiversiLab (DL; bioMérieux, Mercy l'Etoile, France) MRSA library sheets. The gel-like image generated by the DL software illustrates band similarities.

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