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Outbreak analysis and typing of MRSA isolates by automated repetitive-sequence-based PCR in a region with multiple strain types causing epidemics

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Abstract

The usefulness and performance of repetitive-sequence-based polymerase chain reaction (rep-PCR), the DiversiLab system, in the epidemiological surveillance for methicillin-resistant Staphylococcus aureus (MRSA) strain typing was assessed. MRSA isolates from five distinct outbreaks with precise epidemiological data (n = 69) and from the culture collection of well-characterized MRSA strains (n = 132) consisting of 35 spa and 23 pulsed-field gel electrophoresis (PFGE) types were analyzed. The typing results of the DiversiLab system in outbreak analysis were compared to the spa and PFGE typing methods. The DiversiLab system proved to be a reliable tool for the rapid first-line typing of MRSA isolates, showing a good reliability in distinguishing MRSA strains in an area where several MRSA types were causing epidemics. This, however, required that the automatic clustering was combined with manual interpretation using the pattern overlay function when the strain types showing high similarity were clustered together. All outbreaks were distinguished with the DiversiLab system and the PFGE method, but not with the spa typing method. The overall discriminatory power of the DiversiLab system in differentiating diverse MRSA strains proved to be good. We also demonstrated that, in addition to the genetic relatedness analysis of MRSA strains, it is important to obtain accurate epidemiological information in order to perform reliable epidemiological surveillance studies.

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Acknowledgments

Sointu Mero is gratefully acknowledged for her help in performing the reproducibility studies described in this paper and participating in the DiversiLab strain typing process. Additionally, we thank Nina Elomaa for her help in the epidemiological data analysis. This study was supported by the EVO Fund and the Emil Aaltonen Foundation. The results were presented, in part, at the 1st International Conference on Prevention and Infection Control (ICPIC), June/July 2011, Geneva, Switzerland, Poster no. 176.

Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Clinical Microbiology, Vaasa Central Hospital, Hietalahdenkatu 2-4 B2, 65130, Vaasa, Finland

    J. J. Hirvonen & S.-S. Kaukoranta

  2. Division of Clinical Microbiology, HUSLAB, Helsinki University Hospital, Haartmaninkatu 3, 00029, Helsinki, Finland

    T. Pasanen & P. Tissari

  3. Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare (THL), Mannerheimintie 166, P.O. Box 30, 00270, Helsinki, Finland

    S. Salmenlinna & J. Vuopio

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  1. J. J. Hirvonen
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  2. T. Pasanen
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  4. S. Salmenlinna
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Correspondence to J. J. Hirvonen.

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Hirvonen, J.J., Pasanen, T., Tissari, P. et al. Outbreak analysis and typing of MRSA isolates by automated repetitive-sequence-based PCR in a region with multiple strain types causing epidemics. Eur J Clin Microbiol Infect Dis 31, 2935–2942 (2012). https://doi.org/10.1007/s10096-012-1644-4

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  • DOI: https://doi.org/10.1007/s10096-012-1644-4

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