Epidemiological typing of methicillin-resistant Staphylococcus aureus isolates from India and Pakistan
Abstract number: P532
Shabir S., Hardy K., Abassi W., McMurray C., Malik S., Hawkey P.
Objectives: To gain a greater understanding of the epidemiology of MRSA in the subcontinental regions of India and Pakistan.
Methods: Sixty MRSA isolates were obtained from three regions; Pakistan (2) and India (1). All isolates were confirmed as MRSA using biochemical tests and typed using a range of genotypic methods. Detailed epidemiological relationships were identified using pulsed field gel electrophoresis (PFGE) and staphylococcal interspersed repeats (SIRU), whilst the overall global epidemiology was studied using the restriction modification (RM) method and multi locus sequence typing (MLST).
Results: All isolates were typable by PFGE, SIRU and RM assignment. 57/60 isolates were all closely related, all belonging to CC8, differing at only one locus using SIRU and clustering within 67% relatedness by PFGE. Within CC8, SIRU typing sub-divided the isolates into 12 different profiles all of which were closely related. Two of the SIRU profiles were present in isolates from both India and Pakistan, whilst nine were distinct to Pakistan and one to India. If the strict criterion of one band difference was applied to the PFGE profiles a total of 24 different types were identified within the CC8 isolates. Unlike the SIRU profiles where the same profiles were present in both Pakistani and Indian isolates, all PFGE profiles were distinct between the two countries. MLST typing of ten CC8 strains with diverse SIRU and PFGE patterns revealed eight belonged to ST239, one to ST113 and ST8 respectively. The 3 isolates with a different clonal complex all belonged to CC30 and were all from the same hospital in Pakistan.
Conclusion: Epidemiological typing of strains from three distinct locations in India and Pakistan reveals that ST239 is the predominant ST type and could be presumed to have been present for some time. SIRU and PFGE differentiated within ST239 demonstrating their utility and the importance of using epidemiological typing methods with a high degree of discrimination when investigating clusters and outbreaks within these countries.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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