Emergence of community-acquired MRSA in Hungary

Abstract number: 1134_02_199

Tóth Á., Ungvári E., Gacs M., Pászti J., Füzi M.

Objectives:

The methicillin-resistant Staphylococcus aureus typically causes infections in inpatients. However, there are MRSA infections arising also in the community without common risk factors. These community-acquired MRSA (CA-MRSA) infections can cause serious or even fatal infections in otherwise healthy people. Recently, CA-MRSA have been reported in many European countries (France, Switzerland, Scotland, Germany). The aim of this study was to characterize 6 CA-MRSA isolates and compare the data of European CA-MRSA isolates.

Methods:

The 6 isolates were selected from 2312 MRSA strains collected between January 2002 and June 2004 on the basis of epidemiological data and antibiotic resistance profiles. Testing of antimicrobial susceptibility was performed using E-test according to E-test technical manuel. The presence of the mecA, lukF-PV and lukS-PV genes was detected by PCR. The SCCmec type of isolates was determined by a multiplex PCR-based assay (according to the designation of Oliveira). The genetic background of the isolates was analysed by pulsed-field gel electrophoresis (PFGE).

Results:

All of isolates were resistant to beta-lactams and kanamycin. Four of the six strains had identical non-beta-lactam antibiotic resistance pattern, being resistant to fusidic acid and intermediate resistant to ciprofloxacin. All strains shared the Panton-Valentine Leukocidin (PVL) locus and type IV SCCmec element that is typical of CA-MRSA isolates. According to PFGE analyses 5 of 6 strains shared the same pulsotype and the remaining strain that proved resistant to tetracyclin was closely related to the others. All six strains substantially differed from predominant Hungarian hospital-acquired MRSA (HA-MRSA) strains.

Conclusions:

This is the first investigation of CA-MRSA in Hungary. Our results showed that PVL-positive CA-MRSA strains are present in Hungary and the antibiotic resistance pattern of the Hungarian isolates is very similar to those reported from other European countries. The Hungarian CA-MRSA isolates belonged to a single clonal type.