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Updated: Apr 3, 2026
Multiplex PCR Assay for Typing of Staphylococcal Cassette Chromosome Mec Types I to V in Methicillin-resistant Staphylococcus aureus
Published on: September 5, 2013
Characteristics of SCCmec IV and V Methicillin-Resistant Staphylococcus aureus (MRSA) in Israel
Background:
Isolation of methicillin-resistant Staphylococcus aureus (MRSA) in healthy individuals is not common in Israel. In our hospital, about 30% of MRSA isolates were SCCmec types IV and V.
Objectives:
To identify the demographic and clinical characteristics of patients carrying MRSA SCCmec type IV or V, and to compare them with each other and with those of patients with SCCmec types I-III.
Methods:
We conducted a case-control study that included 501 patients from whom MRSA was isolated: 254 with SCCmec type I, II, or III, and 243 isolates from SCCmec types IV or V.
Results:
MRSA was isolated from surveillance cultures in 75% of patients and from a clinical site in 25%. The majority of our study population was elderly, from nursing homes, and with extensive exposure to health care. First, we compared characteristics of patients identified through screening. Statistically significant predictors of SCCmec V vs. IV were Arab ethnicity (OR 7.44, 95% CI 1.5-37.9) and hospitalization in the year prior to study inclusion (OR 5.7, 95% CI 1.9-16.9). No differences were found between patients with SCCmec types I-III and patients with SCCmec type IV or V. Analysis of the subset of patients who had clinical cultures yielded similar results.
Conclusions:
SCCmec types IV and V were common in the hospital setting although rare in the community. It seems that in Israel, SCCmec IV and V are predominantly health care-associated MRSA.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) with SCCmec types IV and V are common in Israeli hospitals, unlike in the community. These strains are predominantly health care-associated, particularly in elderly patients with extensive healthcare exposure.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) isolation in healthy individuals is uncommon in Israel.
- Approximately 30% of hospital-acquired MRSA isolates in this study were identified as SCCmec types IV and V.
- SCCmec types IV and V are often associated with community-acquired MRSA in other regions.
Purpose of the Study:
- To characterize demographic and clinical features of patients harboring MRSA with SCCmec types IV or V.
- To compare these characteristics with patients carrying SCCmec types I-III.
- To investigate the prevalence and characteristics of specific MRSA strains in an Israeli hospital setting.
Main Methods:
- A case-control study involving 501 patients with MRSA isolates.
- Categorization of isolates into SCCmec types I-III (254 patients) and SCCmec types IV-V (243 patients).
- Analysis of demographic data, clinical presentation, and healthcare exposure for all participants.
Main Results:
- MRSA was detected in surveillance cultures for 75% of patients and clinical cultures for 25%.
- No significant differences in characteristics were observed between patients with SCCmec types I-III and those with SCCmec types IV-V.
- Arab ethnicity and prior year hospitalization were predictors for SCCmec V over SCCmec IV.
Conclusions:
- SCCmec types IV and V are prevalent in the hospital environment in Israel, contrasting with their rarity in the community.
- These specific MRSA strains appear to be primarily health care-associated in the Israeli context.
- Findings highlight the importance of understanding MRSA strain epidemiology in healthcare settings.
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