Methicillin-resistant Staphylococcus aureus (MRSA) isolated at Fukuoka University Hospital and hospitals and clinics in the Fukuoka city area

Bacteriological and epidemiological studies were carried out on 106 isolates of methicillin-resistant Staphylococcus aureus (MRSA) isolated at our hospital (56 isolates) and from 15 other hospitals and clinics (50 isolates) in the Fukuoka city area. Strains were studied regarding coagulase-type, beta-lactamase production, and antimicrobial susceptibility; genotype studies used pulsed-field gel electrophoresis (PFGE) with cluster analysis. The majority of isolates produced coagulase type II (75.5%) and beta-lactamase (72. 6%); there was high susceptibility to arbekacin (84.9%) but no resistance to vancomycin. Dendrogram analysis of PFGE patterns identified five major clusters that generally correlated with coagulase-type and beta-lactamase production. Though isolates of two clusters were both coagulase type II and beta-lactamase producing, which was the most common circulating strain both in our hospital and other hospitals and clinics, dendrogram analysis of PFGE patterns showed that they were heterogeneous. Four genetically identical isolates from the same hospital suggested the existence of hospital-specific strains. Nine genetically identical isolates from intensive care units (ICU) in our hospital suggested that a unique strain of MRSA was found there. It had not been transmitted from another area. PFGE with cluster analysis seemed to be an essential tool to detect area-specific or hospital-specific strains undifferentiated by phenotyping. These findings confirmed that a combination of PFGE, including cluster analysis along with coagulase-type and beta-lactamase production may provide more detailed information for the epidemiological study of MRSA.