Multiple-locus variable-number tandem-repeat analysis of meticillin-resistant Staphylococcus aureus discriminates within USA pulsed-field gel electrophoresis types

• Published in: The Journal of hospital infection Vol. 71; no. 4; pp. 333 - 339
• Main Authors: Moser, S.A, Box, M.J, Patel, M, Amaya, M, Schelonka, R, Waites, K.B
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-04-2009; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Bacterial Typing Techniques - methods; Biological and medical sciences; Child; Child, Preschool; Cluster Analysis; DNA Fingerprinting - methods; DNA, Bacterial - genetics; Electrophoresis, Gel, Pulsed-Field; General aspects; Genotype; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Infant; Infant, Newborn; Infectious Disease; Infectious diseases; Medical sciences; Methicillin-Resistant Staphylococcus aureus - classification; Methicillin-Resistant Staphylococcus aureus - genetics; Meticillin-resistant Staphylococcus aureus; Middle Aged; Minisatellite Repeats; Molecular Epidemiology - methods; Multiple-locus variable-number tandem-repeat analysis; Nosocomial infections; Pharmacology. Drug treatments; Pulsed-field gel electrophoresis; Staphylococcal Infections - microbiology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus aureus; United States; Young Adult; United States; North America; America; Pulsed-field gel electrophoresis; Nosocomial infections; Multiple-locus variable-number tandem-repeat analysis; Meticillin-resistant Staphylococcus aureus; Nosocomial infection; Multiple; β-Lactams; Meticillin; Penicillin derivatives; Infection; Antibiotic; Pulsed field electrophoresis; Bacteriosis; Bacteria; Micrococcales; Micrococcaceae; Antibacterial agent; Staphylococcal infection; Public health; Staphylococcus aureus
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2008.12.011

Summary Many isolates of meticillin-resistant Staphylococcus aureus (MRSA) are indistinguishable when compared using the standard pulsed-field gel electrophoresis (PFGE) typing method. This may present a problem when investigating local outbreaks of MRSA transmission in a healthcare setting. It also impedes investigation of the widely disseminated community-acquired MRSA (USA 300-0114) in the inpatient setting, which is displacing other traditional hospital-acquired PFGE types. Combination of methods, including multiple-locus sequence typing (MLST), spa typing and staphylococcal cassette chromosome mec (SCC mec ) typing, have been used with, or in place of, PFGE to characterise MRSA for epidemiological purposes. These methods are technically challenging, time-consuming and expensive and are rarely feasible except in large laboratories in tertiary care medical centres. Another method, which is simpler and with faster turnaround time, is multiple-locus variable-number tandem-repeat analysis (MLVA). We investigated the utility of MLVA to distinguish common PFGE types. The results suggest that MLVA can be used to identify unrelated strains with identical PFGE patterns or confirm close genetic composition of linked isolates. MLVA could potentially be used in conjunction with PFGE to validate relationships, but further prospective evaluation of these relationships will be required in order to define the proper role, if any, for use of this method in hospital epidemiology.