Spread of the Multiresistant Iberian Clone of Methicillin-ResistantStaphylococcus aureus(MRSA) to Italy and Scotland

Abstract

The multidrug-resistant "Iberian" clone of methicillin-resistant Staphylococcus aureus (MRSA) was first identified on the basis of its unique DNA fingerprints as the strain responsible for the massive 1989 outbreak of MRSA disease in the hospital Princeps d'Espanya, Barcelona, Spain. Most Iberian MRSA carry a constitutive beta-lactamase. They are resistant to most beta-lactam antibiotics, macrolides, aminoglycosides, tetracycline, rifampin and ciprofloxacin and are susceptible to fosfomycin, fusidic acid, mupirocin, sulfamethoxazole/trimethoprim and vancomycin. The characteristic DNA fingerprints of the clone include the mecA polymorph I, Tn554 pattern E (or its variants), a chromosomal macrorestriction pattern (pulsed-field gel electrophoretic type) A (or its subtype variants), the lack of the mecI regulatory gene and a homogeneous, high level of expression of methicillin resistance. Molecular surveillance studies have documented the extensive spread of this clone to many Portuguese hospitals during the 1990s. In this article, we describe the spread of the Iberian MRSA to hospitals in Rome, Italy, and Scotland.

The evolution of methicillin resistance in Staphylococcus aureus : Similarity of genetic backgrounds in historically early methicillin-susceptible and -resistant isolates and contemporary epidemic clones

“…The early (''archaic'') MRSA isolates from Denmark and the U.K., which shared similar genetic backgrounds with early MSSA isolates, also were compared with the genetic profiles of several contemporary MRSA clones. Data in Table 3 show the remarkable similarities between properties of the archaic MRSA isolates and those of one of the most widely spread contemporary MRSA, the ''Iberian'' clone (19)(20)(21). Additional, close similarities became apparent between the genetic profile of the phage nontypable MSSA strain E1410 and ''EMRSA 16''-another widely dispersed MRSA clone (22).…”

Spread of the Brazilian epidemic clone of a multiresistant MRSA in two cities in Argentina

“…These results confirm that the Brazilian epidemic clone has also spread and seems to predominate in some Argentinian hospitals. More recently, the spread of MRSA isolates from the Brazilian epidemic clone in Portugal and its rapid displacement of the Iberian clone (an epidemic MRSA clone that was found in Spain, Portugal, Italy and Scotland) by the Brazilian clone, has been reported [7,19].…”

Molecular typing of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated in two metropolitan areas of São Paulo State, southeast Brazil

“…One of these MRSA described clones, the Iberian MRSA, first identified as the dominant clone in a major MRSA disease outbreak in a hospital in Spain in 1989 [7] was subsequently detected in at least eight Portuguese hospitals [8] as well as in hospitals in Western Scotland, United Kingdom, Italy, Belgium, and Germany [9], and in one hospital in the USA [10]. A second multiresistant clone (Brazilian Epidemic clone -BEC) was shown to be widely spread in Brazilian hospitals several thousands of kilometers apart [11] and later it was also associated with infections in Portugal, Argentina, Uruguay, Czech Republic, and Canada [12][13][14][15].…”