Skip to main content
SpringerLink
Log in

Adapting spa typing for national laboratory-based surveillance of methicillin-resistant Staphylococcus aureus

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Laboratory-based surveillance of methicillin-resistant Staphylococcus aureus (MRSA) monitors the baseline occurrence of different genotypes and identifies strains and transmission chains responsible for outbreaks. The consequences of substituting pulsed-field gel electrophoresis (PFGE) with spa typing as a first-line typing method were analyzed by typing 589 strains isolated between 1997 and 2006, with a focus on both short- and long-term correspondence between the PFGE and spa typing results. The study, covering these ten years, included all Finnish MRSA blood isolates and representatives of the two most prevalent MRSA strains (PFGE types FIN-4 and FIN-16) in Finland. In addition, all sporadic isolates from 2006 were included. spa typing was more expensive but approximately four times faster to perform than PFGE. Nearly 90% of FIN-4 and FIN-16 isolates showed consistent spa types, t172 and t067, respectively. spa typing predicted the PFGE result of the blood isolates by a Wallace coefficient of 0.9009, recognized internationally successful strains (t041, t067) to be common also in Finland, and identified a separate cluster of isolates, also related in time and place among the FIN-4 strains. Additional typing by another method was needed to provide adequate discrimination or to characterize isolates with a newly recognized spa type in Finland.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kerttula AM, Lyytikäinen O, Kardén-Lilja M, Ibrahem S, Salmenlinna S, Virolainen A, Vuopio-Varkila J (2007) Nationwide trends in molecular epidemiology of methicillin-resistant Staphylococcus aureus, Finland, 1997–2004. BMC Infect Dis 7:94. doi:10.1186/1471-2334-7-94

    Article  PubMed  Google Scholar 

  2. The Statistical Database of the Infectious Diseases Register of THL. Home page at: http://www3.ktl.fi/stat/. Accessed 8 September 2010

  3. Tang YW, Waddington MG, Smith DH, Manahan JM, Kohner PC, Highsmith LM, Li H, Cockerill FR 3rd, Thompson RL, Montgomery SO, Persing DH (2000) 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 38(4):1347–1351

    PubMed  CAS  Google Scholar 

  4. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, Swaminathan B (1995) Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33(9):2233–2239

    PubMed  CAS  Google Scholar 

  5. Aires-de-Sousa M, Boye K, de Lencastre H, Deplano A, Enright MC, Etienne J, Friedrich A, Harmsen D, Holmes A, Huijsdens XW, Kearns AM, Mellmann A, Meugnier H, Rasheed JK, Spalburg E, Strommenger B, Struelens MJ, Tenover FC, Thomas J, Vogel U, Westh H, Xu J, Witte W (2006) High interlaboratory reproducibility of DNA sequence-based typing of bacteria in a multicenter study. J Clin Microbiol 44(2):619–621. doi:10.1128/JCM.44.2.619-621.2006

    Article  PubMed  CAS  Google Scholar 

  6. Shopsin B, Gomez M, Montgomery SO, Smith DH, Waddington M, Dodge DE, Bost DA, Riehman M, Naidich S, Kreiswirth BN (1999) Evaluation of protein A gene polymorphic region DNA sequencing for typing of Staphylococcus aureus strains. J Clin Microbiol 37(11):3556–3563

    PubMed  CAS  Google Scholar 

  7. Melin S, Haeggman S, Olsson-Liljequist B, Sjölund M, Nilsson PA, Isaksson B, Löfgren S, Matussek A (2009) Epidemiological typing of methicillin-resistant Staphylococcus aureus (MRSA): spa typing versus pulsed-field gel electrophoresis. Scand J Infect Dis 41(6–7):433–439. doi:10.1080/00365540902962749

    Article  PubMed  CAS  Google Scholar 

  8. Vindel A, Cuevas O, Cercenado E, Marcos C, Bautista V, Castellares C, Trincado P, Boquete T, Pérez-Vázquez M, Marín M, Bouza E (2009) Methicillin-resistant Staphylococcus aureus in Spain: molecular epidemiology and utility of different typing methods. J Clin Microbiol 47(6):1620–1627. doi:10.1128/JCM.01579-08

    Article  PubMed  CAS  Google Scholar 

  9. Petersson AC, Olsson-Liljequist B, Miörner H, Haeggman S (2010) Evaluating the usefulness of spa typing, in comparison with pulsed-field gel electrophoresis, for epidemiological typing of methicillin-resistant Staphylococcus aureus in a low-prevalence region in Sweden 2000–2004. Clin Microbiol Infect 16(5):456–462. doi:10.1111/j.1469-0691.2009.02881.x

    Article  PubMed  CAS  Google Scholar 

  10. Kanerva M, Salmenlinna S, Vuopio-Varkila J, Lehtinen P, Möttönen T, Virtanen MJ, Lyytikäinen O (2009) Community-associated methicillin-resistant Staphylococcus aureus isolated in Finland in 2004 to 2006. J Clin Microbiol 47(8):2655–2657. doi:10.1128/JCM.00771-09

    Article  PubMed  Google Scholar 

  11. Murchan S, Kaufmann ME, Deplano A, de Ryck R, Struelens M, Zinn CE, Fussing V, Salmenlinna S, Vuopio-Varkila J, El Solh N, Cuny C, Witte W, Tassios PT, Legakis N, van Leeuwen W, van Belkum A, Vindel A, Laconcha I, Garaizar J, Haeggman S, Olsson-Liljequist B, Ransjo U, Coombes G, Cookson B (2003) Harmonization 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 41(4):1574–1585. doi:10.1128/JCM.41.4.1574-1585.2003

    Article  PubMed  CAS  Google Scholar 

  12. Vainio A, Kardén-Lilja M, Ibrahem S, Kerttula AM, Salmenlinna S, Virolainen A, Vuopio-Varkila J (2008) Clonality of epidemic methicillin-resistant Staphylococcus aureus strains in Finland as defined by several molecular methods. Eur J Clin Microbiol Infect Dis 27(7):545–555. doi:10.1007/s10096-008-0470-1

    Article  PubMed  CAS  Google Scholar 

  13. Struelens MJ, Deplano A, Godard C, Maes N, Serruys E (1992) Epidemiologic typing and delineation of genetic relatedness of methicillin-resistant Staphylococcus aureus by macrorestriction analysis of genomic DNA by using pulsed-field gel electrophoresis. J Clin Microbiol 30(10):2599–2605

    PubMed  CAS  Google Scholar 

  14. Strommenger B, Kettlitz C, Weniger T, Harmsen D, Friedrich AW, Witte W (2006) Assignment of Staphylococcus isolates to groups by spa typing, SmaI macrorestriction analysis, and multilocus sequence typing. J Clin Microbiol 44(7):2533–2540. doi:10.1128/JCM.00420-06

    Article  PubMed  CAS  Google Scholar 

  15. Harmsen D, Claus H, Witte W, Rothgänger J, Claus H, Turnwald D, Vogel U (2003) 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 41(12):5442–5448. doi:10.1128/JCM.41.12.5442-5448.2003

    Article  PubMed  CAS  Google Scholar 

  16. Mellmann A, Weniger T, Berssenbrügge C, Rothgänger J, Sammeth M, Stoye J, Harmsen D (2007) Based Upon Repeat Pattern (BURP): an algorithm to characterize the long-term evolution of Staphylococcus aureus populations based on spa polymorphisms. BMC Microbiol 7:98. doi:10.1186/1471-2180-7-98

    Article  PubMed  Google Scholar 

  17. Huson DH, Bryant D (2006) Application of phylogenetic networks in evolutionary studies. Mol Biol Evol 23(2):254–267. doi:10.1093/molbev/msj030

    Article  PubMed  CAS  Google Scholar 

  18. Enright MC, Day NP, Davies CE, Peacock SJ, Spratt BG (2000) Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 38(3):1008–1015

    PubMed  CAS  Google Scholar 

  19. SpaServer. Home page at: http://www.spaserver.ridom.de/. Accessed 8 September 2010

  20. Kondo Y, Ito T, Ma XX, Watanabe S, Kreiswirth BN, Etienne J, Hiramatsu K (2007) Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. Antimicrob Agents Chemother 51(1):264–274. doi:10.1128/AAC.00165-06

    Article  PubMed  CAS  Google Scholar 

  21. Grundmann H, Hori S, Tanner G (2001) Determining confidence intervals when measuring genetic diversity and the discriminatory abilities of typing methods for microorganisms. J Clin Microbiol 39(11):4190–4192. doi:10.1128/JCM.39.11.4190-4192.2001

    Article  PubMed  CAS  Google Scholar 

  22. Hunter PR, Gaston MA (1988) Numerical index of the discriminatory ability of typing systems: an application of Simpson’s index of diversity. J Clin Microbiol 26(11):2465–2466

    PubMed  CAS  Google Scholar 

  23. Wallace DL (1983) A method for comparing two hierarchical clusterings: comment. J Am Stat Assoc 78:569–576

    Article  Google Scholar 

  24. Comparing Partitions Online Tool. Home page at: http://darwin.phyloviz.net/ComparingPartitions/. Accessed 8 September 2010

  25. Grundmann H, Aanensen DM, van den Wijngaard CC, Spratt BG, Harmsen D, Friedrich AW; European Staphylococcal Reference Laboratory Working Group (2010) Geographic distribution of Staphylococcus aureus causing invasive infections in Europe: a molecular-epidemiological analysis. PLoS Med 7(1):e1000215. doi:10.1371/journal.pmed.1000215

    Article  PubMed  Google Scholar 

  26. Blanc DS, Struelens MJ, Deplano A, De Ryck R, Hauser PM, Petignat C, Francioli P (2001) Epidemiological validation of pulsed-field gel electrophoresis patterns for methicillin-resistant Staphylococcus aureus. J Clin Microbiol 39(10):3442–3445. doi:10.1128/JCM.39.10.3442-3445.2001

    Article  PubMed  CAS  Google Scholar 

  27. Frénay HM, Bunschoten AE, Schouls LM, van Leeuwen WJ, Vandenbroucke-Grauls CM, Verhoef J, Mooi FR (1996) Molecular typing of methicillin-resistant Staphylococcus aureus on the basis of protein A gene polymorphism. Eur J Clin Microbiol Infect Dis 15(1):60–64

    Article  PubMed  Google Scholar 

  28. Koreen L, Ramaswamy SV, Graviss EA, Naidich S, Musser JM, Kreiswirth BN (2004) spa typing method for discriminating among Staphylococcus aureus isolates: implications for use of a single marker to detect genetic micro- and macrovariation. J Clin Microbiol 42(2):792–799. doi:10.1128/JCM.42.2.792-799.2004

    Article  PubMed  CAS  Google Scholar 

  29. Kahl BC, Mellmann A, Deiwick S, Peters G, Harmsen D (2005) Variation of the polymorphic region X of the protein A gene during persistent airway infection of cystic fibrosis patients reflects two independent mechanisms of genetic change in Staphylococcus aureus. J Clin Microbiol 43(1):502–505. doi:10.1128/JCM.43.1.502-505.2005

    Article  PubMed  CAS  Google Scholar 

  30. Börjesson S, Matussek A, Melin S, Löfgren S, Lindgren PE (2010) Methicillin-resistant Staphylococcus aureus (MRSA) in municipal wastewater: an uncharted threat? J Appl Microbiol 108(4):1244–1251. doi:10.1111/j.1365-2672.2009.04515.x

    Article  PubMed  Google Scholar 

  31. Zhang K, McClure JA, Elsayed S, Conly JM (2009) Novel staphylococcal cassette chromosome mec type, tentatively designated type VIII, harboring class A mec and type 4 ccr gene complexes in a Canadian epidemic strain of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 53(2):531–540. doi:10.1128/AAC.01118-08

    Article  PubMed  CAS  Google Scholar 

  32. Salmenlinna S, Vuopio-Varkila J, Kardén-Lilja M, Kanerva M, Möttönen T, Virtanen M, Lyytikäinen O (2008) Community-associated meticillin-resistant Staphylococcusaureus in Finland: ten-year perspective. In: Proceedings of the 18th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), Barcelona, Spain, April 2008. Poster presentation P1441

  33. Aires-de-Sousa M, Correia B, de Lencastre H (2008) Changing patterns in frequency of recovery of five methicillin-resistant Staphylococcus aureus clones in Portuguese hospitals: surveillance over a 16-year period. J Clin Microbiol 46(9):2912–2917. doi:10.1128/JCM.00692-08

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

This work was supported by the Ministry of Social Affairs and Health and the Finnish Cultural Foundation.

We thank Mari Hyvönen, Saija Perovuo, and Terhi Vesa for their skilled technical assistance. We also thank Tiina Hannunen from the Molecular Medicine Sequencing Laboratory (Biomedicum, Helsinki) for offering information on the time required to perform sequencing. This data was partly presented at the 8th International Meeting on Microbial Epidemiological Markers (IMMEM-8), Zakopane, Poland, May 2008, Poster no. A2.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare (THL), P.O. Box 30, 00271, Helsinki, Finland

    A. Vainio, A. Virolainen, J. Vuopio & S. Salmenlinna

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

    S. Koskela

Authors
  1. A. Vainio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Koskela
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Virolainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Vuopio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Salmenlinna
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Vainio.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vainio, A., Koskela, S., Virolainen, A. et al. Adapting spa typing for national laboratory-based surveillance of methicillin-resistant Staphylococcus aureus . Eur J Clin Microbiol Infect Dis 30, 789–797 (2011). https://doi.org/10.1007/s10096-011-1158-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-011-1158-5

Keywords

Search

Navigation