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Cha, Chang, and Hwang: Correlation Between Staphylococcal Cassette Chromosome mec Type and Coagulase Serotype of Methicillin-Resistant Staphylococcus aureus
Original Article

J Bacteriol Virol 2009;39(2):71-78.

Published online: 18 January 2009

DOI: https://doi.org/10.4167/jbv.2009.39.2.71

Correlation Between Staphylococcal Cassette Chromosome mec Type and Coagulase Serotype of Methicillin-Resistant Staphylococcus aureus

Eui Kyung Cha, Kyung Soo Chang, Soo Myung Hwang∗

Department of Clinical Laboratory Science, Catholic University of Pusan, Busan, Korea

∗Corresponding author: Soo Myung Hwang. Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan, Busan 609-757, Korea. Phone: +82-51-510-0563, Fax: +82-51-510-0568 e-mail: smhwang@cup.ac.kr

∗∗ This works was supported by research fund from Catholic University of Pusan in 2007.

      Revised 25 March 200915 April 2009       Accepted 20 April 2009

Copyright © 2009 Korean Society for Legal Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Staphylococcal cassette chromosome mec (SCCmec) type and coagulase serotype are important epidemiologic factors in methicillin-resistant Staphylococcus aureus (MRSA). To investigate correlation between SCCmec type and coagulase serotype of MRSA, we analyzed SCCmec types of MRSA strains isolated from clinical sources and compared the results to coagulase serotypes and antimicrobial susceptibility patterns. A total of 108 MRSA isolates were classified into four SCCmec types: II (55.6%), IV (21.3%) III (13.0%) and IIIA (8.3%), and five coagulase serotypes: II (54.6%), IV (21.3%), V (18.5%) and VII (2.8%). All of coagulase type II, IV and V strains belonged to SCCmec type II, III/IIIA and IV, respectively. SCCmec types II, III and IIIA were multidrug resistant, whereas SCCmec type IV strains were non-multidrug resistant except beta-lactams and erythromycin. The data provide that there is a significant correlation between SCCmec types and phenotypic characteristic of coagulase serotypes.

Keywords: Staphylococcal cassette chromosome mec type, Methicillin-resistant Staphylococcus aureus, Coagulase serotype

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Figure 1.
Detection of mecA genes from MRSA isolates by PCR. Lane 1: S. aureus (ATCC25923), Lanes 2 to 3: MRSA isolates, Lanes 4 to 5: MSSA isolates, M, molecular markers, 100 bp DNA ladder (Bioneer).
jbv-39-71f1.tif
Figure 2.
SCCmec types identified by multiplex PCR. Lanes 1, 4, 7, 10 (loci A and B primers): lanes 2, 5, 8, 11 (loci C and D): lanes 3, 6, 9, 12 (loci E to H): SCCmec type II, lanes 1 to 3 (284 bp, 209 bp, 342 bp): type III, lanes 4 to 6 (209 bp, 243 bp, 414 bp): type IIIA, lanes 7 to 9 (209 bp, 243 bp, 303 bp, 414 bp): type IV, lanes 10 to 12 (342 bp). M, molecular markers, 100 bp DNA ladder (Bioneer).
jbv-39-71f2.tif
Table 1.
Primers and predicted sizes of PCR products for SCCmec typing
Locus Primer names Primer sequence Amplicon sizes (bp) SCCmec type
A CIF2 F2 CIF2 R2 TTCGAGTTGCTGATGAAGAAGG ATTTACCACAAGGACTACCAGC 495 I
B KDP F1 KDP R1 AATCATCTGCCATTGGTGATGC CGAATGAAGTGAAAGAAAGTGG 284 II
C MECI P2 MECI P3 ATCAAGACTTGCATTCAGGC GCGGTTTCAATTCACTTGTC 209 II, III
D DCS F2 DCS R1 CATCCTATGATAGCTTGGTC CTAAATCATAGCCATGACCG 342 I, II, IV
E RIF4 F3 RIF4 R9 GTGATTGTTCGAGATATGTGG CGCTTTATCTGTATCTATCGC 243 III
F RIF5 F10 RIF5 R13 TTCTTAAGTACACGCTGAATCG GTCACAGTAATTCCATCAATGC 414 III
G IS431 P4 pUB110 R1 CAGGTCTCTTCAGATCTACG GAGCCATAAACACCAATAGCC 381 IA
H IS431 P4 pT181 R1 CAGGTCTCTTCAGATCTACG GAAGAATGGGGAAAGCTTCAC 303 IIIA

Reference, Oliveria et al. (10)

Table 2.
SCCmec types of MRSA strains isolated from clinical sources
Source No. of strains SCCmec type
I II III IIIA IV ND
Pus 36 0 17 4 4 10 1
Ear discharge 25 0 8 8 3 6 0
Sputum 18 0 17 0 1 0 0
Blood 7 0 5 1 1 0 0
Skin 6 0 0 0 0 5 1
Pleural fluid 3 0 2 1 0 0 0
Ascitic fluid 2 0 1 0 0 1  
Urine 3 0 2 0 0 1 0
Catheter tips 3 0 3 0 0 0 0
Nasal discharge 2 0 2 0 0 0 0
Throat 2 0 2 0 0 0 0
Stool 1 0 1 0 0 0 0
Total 108 (100) 0 60 (55.6) 14 (13.0) 9 (8.3) 23 (21.3) 2 (1.9)

ND, Not Determined

Table 3.
Distribution of coagulase serotypes of MRSA strains
Source No. of strains (%) Coagulase serotype
I II III IV V VI VII VIII ND
Pus 36 0 16 0 8 10 0 1 0 1
Ear discharge 25 0 8 0 11 4 0 1 0 1
Sputum 18 0 17 0 1 0 0 0 0 0
Blood 7 0 5 0 2 0 0 0 0 0
Skin 6 0 0 0 0 5 0 1 0 0
Pleural fluid 3 0 2 0 1 0 0 0 0 0
Ascitic fluid 2 0 1 0 0 1 0 0 0 0
Urine 3 0 2 1 0 0 0 0 0 0
Catheter tips 3 0 3 0 0 0 0 0 0 0
Nasal discharge 2 0 2 0 0 0 0 0 0 0
Throat 2 0 2 0 0 0 0 0 0 0
Stool 1 0 1 0 0 0 0 0 0 0
Total 108 (100) 0 (0) 59 (54.6) 1 (0.9) 23 (21.3) 20 (18.5) 0 (0) 3 (2.8) 0 (0) 2 (1.9)

ND, Not Determined

Table 4.
Correlation between SCCmec type and coagulase serotype of MRSA
SCCmec type No. of strains Coagulase serotype
II III IV V VII ND
II 60 59 0 0 0 0 1
III 14 0 0 14 0 0 0
IIIA 9 0 0 9 0 0 0
IV 23 0 1 0 20 1 1
ND 2 0 0 0 0 2 0
Total 108 59 1 23 20 3 2

ND, Not Determined

Table 5.
Antimicrobial susceptibility profile of MRSA strains according to SCCmec
Antimicrobial agent No. (%) of susceptible isolates
Type II Type III Type IIIA Type IV
Penicillin 0 (0) 0 (0) 0 (0) 0 (0)
Oxacillin 0 (0) 0 (0) 0 (0) 0 (0)
Clindamycin 7 (11.7) 1 (7.1) 1 (11.1) 22 (95.6)
Ciprofloxacin 2 (3.3) 0 (0) 0 (0) 23 (100)
Erythromycin 1 (1.7) 0 (0) 0 (0) 5 (21.7)
Gentamycin 0 (0) 0 (0) 0 (0) 20 (86.9)
Tetracycline 0 (0) 0 (0) 0 (0) 22 (96.8)
Teicoplanin 57 (95.0) 14 (100) 9 (100) 23 (100)
Trimethoprim-Sulfamethoxazole 56 (93.3) 11 (78.6) 2 (22.2) 23 (100)
Vancomycin 60 (100) 14 (100) 9 (100) 23 (100)
Total 60 (100) 14 (100) 9 (100) 23 (100)
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