Molecular Epidemiology of Methicillin-ResistantStaphylococcus aureusStrains: State of Affairs and Tomorrow's Possibilities

Abstract

Methicillin-resistant strains of Staphylococcus aureus (MRSA) have posed a clinical threat for nearly 40 years. During these years, an array of additional technologies suited for identification of MRSA below the species level has become available. The technologies, whether they assess phenotype or genotype, provide data that can be used for elucidation of the routes of dissemination of individual MRSA types. This review summarizes the current state of affairs with respect to the quality of the various laboratory techniques and includes descriptions of novel strategies such as binary typing and multilocus sequence typing (MLST). Drawbacks of procedures will be compared, and the value of molecular typing in the elucidation of complex biological phenomena, such as epidemicity, carriage, and reduced vancomycin susceptibility, will be indicated. Means for integrated assessment of bacterial biology, epidemiology, and population structure will be discussed.

Changes in the Clonal Nature and Antibiotic Resistance Profiles of Methicillin-Resistant Staphylococcus aureus Isolates Associated with Spread of the EMRSA-15 Clone in a Tertiary Care Portuguese Hospital

“…However, criteria for the application of each technique will be different according to the purpose of the study, dealing for example either with local outbreak investigations or with large-scale surveillance studies (55,60). Although PFGE is a powerful technique for evaluating the relatedness of isolates for epidemiological purposes, it might not be the best option for evolutionary studies.…”

Harmonization of Pulsed-Field Gel Electrophoresis Protocols for Epidemiological Typing of Strains of Methicillin-Resistant Staphylococcus aureus : a Single Approach Developed by Consensus in 10 European Laboratories and Its Application for Tracing the Spread of Related Strains

“…Typing plays an important role in understanding the epidemiology of MRSA and evaluating the effectiveness of infection control and antimicrobial prescribing measures. The many different methods employed for MRSA typing include antibiograms and chemical resistograms, phage typing, ribotyping, pulsed-field gel electrophoresis (PFGE) (26), and PCR-based methods (14,31,32).…”

Comparison of Staphylococcus aureus Isolates from Bovine and Human Skin, Milking Equipment, and Bovine Milk by Phage Typing, Pulsed-Field Gel Electrophoresis, and Binary Typing

“…For decades, bacteriophage typing was the standard method for typing of S. aureus. Phage typing is still widely used today, despite a number of drawbacks (31,37,42). Drawbacks include limited typeability of isolates, limited technical reproducibility of results, and variable expression of epidemiological determinants, resulting in limited biological reproducibility.…”