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Published on: November 4, 2016

Epidemiology of European community-associated methicillin-resistant Staphylococcus aureus clonal complex 80 type IV

A R Larsen1, S Böcher, M Stegger

  • 1Statens Serum Institut, National Center for Antimicrobials and Infection Control, Artillerivej 5 (B.47/204), 2300 Copenhagen S, Denmark. arl@ssi.dk

Journal of Clinical Microbiology
|November 9, 2007
PubMed

Insights

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Denmark increased due to the European CA-MRSA clone, primarily causing skin infections outside hospitals. This clone appears less adapted to hospital environments than US strains.

Area of Science:

  • Microbiology
  • Epidemiology
  • Infectious Diseases

Background:

  • Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a growing concern in Europe.
  • The 'European CA-MRSA' clone (ST80, SCCmec IV) has been the predominant cause of these infections.
  • Denmark has historically had low MRSA prevalence but observed recent increases.

Purpose of the Study:

  • To investigate the nationwide epidemiology of the European CA-MRSA clone in Denmark from 1993 to 2004.
  • To understand the contribution of this clone to the rise in MRSA cases.
  • To compare its characteristics with other prevalent clones, such as USA300.

Main Methods:

  • Nationwide epidemiological investigation of MRSA isolates.
  • Analysis of isolate data from 1993 to 2004.
  • Characterization of European CA-MRSA isolates, including pulsed-field gel electrophoresis (PFGE) and staphylococcal protein A gene (spa) typing.

Main Results:

  • European CA-MRSA significantly contributed to the increase in MRSA cases in Denmark.
  • The clone predominantly caused skin and soft tissue infections (SSTIs) in the community.
  • Household transmission was the main spread mechanism; nosocomial spread was limited.
  • European CA-MRSA showed less adaptation to hospital environments compared to USA300.
  • Patients with travel history to the Mediterranean/Middle East were overrepresented.
  • Multiple introductions and increasing genetic diversity (PFGE, spa types, susceptibility) of the European CA-MRSA clone were observed.

Conclusions:

  • European CA-MRSA has emerged as a significant pathogen in Denmark, driving an increase in MRSA infections.
  • Community transmission, particularly within households, is the primary driver.
  • The clone's limited adaptation to hospitals suggests endogenous infections are important in hospitalized patients.
  • Genetic diversity indicates multiple introductions and evolution of the European CA-MRSA clone in Denmark.

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