The emergence of spa types and spa-clonal complexes (CC) among clinical methicillin-resistant Staphylococcus aureus isolates collected from the University Clinical Center in Gdańsk between 2008 and 2009 were investigated. Phage typing was used as the initial screening in the study. The basic set of phages and the additional set of phages were used. Most of the isolates (56 %) belonged to the phage group III. With the additional set of phages, eight types were found, with predominant one MR8 (50 %). Sixteen distinct spa types were observed. The most frequent were t003 (22 %), t151 (16 %), and t008 (12 %). The spa types were clustered into two spa-CC and eight singletons. The predominant CC010 (50 %) consisted of six types, with the most common t003 (36.7 %) and t151(26.7 %), and in 80 % was identified as staphylococcal chromosomal casette mec (SCCmec) type II. The second cluster has no founder (12 %) with only two spa types: t037 belonging to SCCmec type III and t029. In the most frequent singleton, spa type t008 alone was clustered in 12 % of the isolates. All singletons correspond to SCCmec type IV. The CC010 was distributed in most of the hospital wards, corresponded to Multilocus sequence typing type ST5/ST225 and was constantly present throughout the observed period. The isolates of CC010 generally belonged to the phage group III, and most of them (53.3 %) were resistant to erythromycin, clindamycin, and ciprofloxacin. The concordance between spa-clone and phage type was very high, but the same phage type MR8 was observed within different spa types of the predominant clone.

Department of Medical Microbiology Medical University of Gdańsk Poland

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Barski P, Piechowicz L, Galiński J, et al. Rapid assay for detection of methicillin-resistant Staphylococcus aureus using multiplex PCR. Molec Cellul Probs. 1996;10:471–475. doi: 10.1006/mcpr.1996.0066. PubMed DOI

Bassetti M, Nicco E, Mikulska M. Why is community-associated MRSA spreading across the world and how will it change clinical practice? Int J Antimicrob Agents. 2009;34:S15–S19. doi: 10.1016/S0924-8579(09)70544-8. PubMed DOI

Blair JE, Williams REO. Phage typing of Staphylococci. Bull World Health Organ. 1961;24:771–784. PubMed PMC

CLSI: Clinical and Laboratory Standards Institute (2006) Performance standards for antimicrobial susceptibility testing; sixteenth informational supplement. M100-S16. Vol. 26, No.3.

Enright MC, Day NPJ, Davies CE et al (2000) Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 38:1008–1015 PubMed PMC

Fenner L, Widmer AF, Dangel M, et al. Distribution of spa types among methicillin-resistant Staphylococcus aureus isolates during a 6-year period at a low-prevalence university hospital. J Med Microbiol. 2008;57:612–616. doi: 10.1099/jmm.0.47757-0. PubMed DOI

Fiebelkorn KR, Crawford SA, Mc Elmeel ML, et al. Practical disc diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol. 2003;41:4740–4744. doi: 10.1128/JCM.41.10.4740-4744.2003. PubMed DOI PMC

Fridrichova M, Zemlickova H, Tyllova K et al (2010). Molecular variability of methicillin-resistant Staphylococcus aureus strains isolated from blood in the Czech Republic, 2000–2005. ESCMID. 20th European Congress of Clinical Microbiology and Infectious Diseases Vienna, Austria, 10–13 April 2010. Abstract number: P1994

Harmsen D, Claus H, Witte W, et al. Typing of methicillin-resistant Staphylococcus aureus in a university hospital setting by using novel software for spa repeat determination and database management. J Clin Microbiol. 2003;41:5442–5448. doi: 10.1128/JCM.41.12.5442-5448.2003. PubMed DOI PMC

Hryniewicz W, Sulikowska A, Szczypa K, et al. Recommendations for susceptibility testing to antimicrobial agents of selected bacterial species. Post Mikrobiol. 2005;44:175–192.

Kluytmans-Vandenbergh MF, Kluytmans JA. Community-aquired methicillin-resistant Staphylococcus aureus: current perspectives. . Clin Microbiol Infect. 2006;12(Suppl. 1):9–15. doi: 10.1111/j.1469-0691.2006.01341.x. PubMed DOI

Kobayashi N, Urasawa S, Uehara N, et al. Analysis of genomic diversity within the Xr-region of the protein A gene in clinical isolates of Staphylococcus aureus. Epidemiol Infect. 1999;122:241–249. doi: 10.1017/S0950268898001721. PubMed DOI PMC

Łuczak-Kadłubowska A, Sulikowska A, Empel J, et al. Countrywide molecular survey of methicillin-resistant Staphylococcus aureus strains in Poland. J Clin Microbiol. 2008;2008:2930–2937. doi: 10.1128/JCM.00869-08. PubMed DOI PMC

Marchese A, Gualco L, Maioli E, et al. Molecular analysis and susceptibility patterns of methicillin-resistant Staphylococcus aureus (MRSA) strains circulating in the community in the Ligurian area, a northen region of Italy: emergence of USA300 and EMRSA-15 clones. Int J Antimicrob Agents. 2009;34:424–428. doi: 10.1016/j.ijantimicag.2009.06.016. PubMed DOI

Milheiriço C, Oliveira DC, de Lancastre H. Update to the multiplex PCR strategy for assigment of mec element types in Staphylococcus aureus. Ant Agents Chemother. 2007;51:3374–3377. doi: 10.1128/AAC.00275-07. PubMed DOI PMC

Murchan S, Kaufmann ME, Deplano A, et al. Harmonisation 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. J Clin Microbiol. 2003;41:1574–1585. doi: 10.1128/JCM.41.4.1574-1585.2003. PubMed DOI PMC

Naimi TS, LeDell KH, Como-Sabetti K, et al. Comparision of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290:2976–2984. doi: 10.1001/jama.290.22.2976. PubMed DOI

Piechowicz L, Wiśniewska K, Galiński J. Ocena przydatności nowego, międzynarodowego zestawu eksperymentalnych fagów do typowania opornych na metycylinę gronkowców złocistych (MRSA) Med Dosw Mikrobiol. 1999;51:31–36. PubMed

Richardson JF, Rosdahl VT, van Leeuwen WJ, et al. Phages for methicillin-resistant Staphylococcus aureus: an international trial. Epidemiol Infect. 1999;122:227–233. doi: 10.1017/S0950268899002174. PubMed DOI PMC

Rupptisch W, Indra A, Stoger A, et al. Classifying spa types in complexes improves interpretation of typing results for methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 2006;44:2442–2448. doi: 10.1128/JCM.00113-06. PubMed DOI PMC

Samra Z, Radba R, Ofir O. Antibiotic susceptibility and phage typing of methicillin-resistant and -sensitive Staphylococcus aureus clinical isolates at three periods during 1991–1997. Eur J Clin Microbiol Infect Dis. 2001;20:425–427. doi: 10.1007/s100960100518. PubMed DOI

Strommenger B, Braulke C, Heuck D, et al. Spa typing of Staphylococcus aureus as a frontline tool in epidemiological typing. J Clin Microbiol. 2008;46:574–581. doi: 10.1128/JCM.01599-07. PubMed DOI PMC

Tang YW, Waddington MG, Smith DH, et al. Comparison of protein A gene sequencing with pulsed-field gel electrophoresis and epidemiologic data for molecular typing of methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 2000;38:1347–1351. PubMed PMC

Tenover FC, Arbeit R, Archer G, et al. Comparision of traditional and molecular methods of typing isolates of Staphylococcus aureus. J Clin Microbiol. 1994;32:407–415. PubMed PMC

Tiemersma EW, Bronzwaer SL, Lyytikainen O, et al. Methicillin-resistant Staphylococcus aureus in Europe, 1999–2002. Emerg Infect Dis. 2004;10:1627–1634. doi: 10.3201/eid1009.040069. PubMed DOI PMC

van Belkum A, van Leeuwen W, Kaufman ME, et al. Assesment of resolution and intercenter reproducibility of results of genotyping Staphylococcus aureus by pulsed-field gel electrophoresis of SmaI macrorestriction fragments; multicenter study. J Clin Microbiol. 1998;36:1653–1659. PubMed PMC

Widemauwe C, Godard C, Verschraegen G, et al. Ten years phage-typing of Belgian clinical methicillin-resistant Staphylococcus aureus isolates (1992–2001) J Hosp Infect. 2004;56:16–21. doi: 10.1016/j.jhin.2003.09.014. PubMed DOI

Wiśniewska K, Piechowicz L, Galiński J. Zmiany fagotypów gronkowców złocistych opornych na metycylinę (MRSA) w regionie gdańskim w latach 1990–1998. Med Dosw Mikrobiol. 2000;52:333–340. PubMed

Wiśniewska K, Garbacz K, Piechowicz L. Bakteriofagowe typy szczepów Staphylococcus aureus opornych na metycylinę izolowanych w latach 2005–2007 w regionie gdańskim i ich oporność na inne antybiotyki. Med Dosw Mikrobiol. 2007;59:279–285. PubMed

Clonal distribution of bone sialoprotein-binding protein gene among Staphylococcus aureus isolates associated with bloodstream infections