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. 2016 Nov;36(6):536-41.
doi: 10.3343/alm.2016.36.6.536.

Prevalence of Major Methicillin-Resistant Staphylococcus aureus Clones in Korea Between 2001 and 2008

Gi Su Kang  1 , Yung Hee Jung  1 , Hwa Su Kim  1 , Yeong Seon Lee  1 , Chan Park  1 , Kwang Jun Lee  1 , Jeong Ok Cha  2
Affiliations

Prevalence of Major Methicillin-Resistant Staphylococcus aureus Clones in Korea Between 2001 and 2008

Gi Su Kang et al. Ann Lab Med. 2016 Nov.

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) are important pathogens causing nosocomial infections in Korean hospitals. This study aimed to investigate the epidemiological and genetic diversity of clinical S. aureus isolates in healthcare settings from 2001 to 2008.

Methods: Samples and data were obtained from 986 individuals as part of the National Antimicrobial Surveillance Project, involving 10 regions nationwide. Molecular typing studies, including multilocus sequence typing (MLST) and staphylococcal cassette chromosome mec (SCCmec) typing were performed, and a representative clone of Korean MRSA was classified by combinational grouping using a DiversiLab (DL; bioMérieux, France) repetitive element polymerase chain reaction (rep-PCR) system.

Results: Nine Korean MRSA clones (KMRSA-1 to -9) were identified by analysis of genetic backgrounds and molecular characteristics. KMRSA-1 to -3, expressing clonal complex (CC) 5 (carrying SCCmec II), CC8 (carrying SCCmec III), and CC72 (carrying SCCmec IV) were spread nationwide. In contrast, KMRSA-6 was highly prevalent in Gyeongsangnam-do, and KMRSA-4 was highly prevalent in Jeollanam-do and Jeollabuk-do.

Conclusions: Epidemic KMRSA clones were genetically similar to major clones identified from the USA, with the exception of KMRSA-2, which had the SCCmec III type. Our results provide important insights into the distribution and molecular genetics of MRSA strains in Korea and may aid in the monitoring of MRSA spread throughout the country.

Keywords: DiversiLab; Genetic diversity; Korean MRSA clones; Multilocus sequence typing.

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Conflict of interest statement

Authors' Disclosures of Potential Conflicts of Interest: No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1
Fig. 1. Distribution of clonal complexes (CCs) by staphylococcal cassette chromosome mec (SCCmec) type. Singleton refers to sequence types (STs) that could not be assigned to any group.
Fig. 2
Fig. 2. Clonal distribution of all methicillin-resistant Staphylococcus aureus (MRSA) isolates by district. The prevalence of CCs in (A) general hospitals, (B) hospitals and clinics, and (C) geriatric hospitals is shown. Singleton refers to STs that could not be assigned to any group.
Abbreviations: CB, Chungcheongbuk-do; CN/DJ, Chungcheongnam-do/Daejeon; GB/US/DG, Gyeongsangbuk-do/Ulsan/Daegu; GG/IC, Gyeonggi-do/Incheon; GN/BU, Gyeongsangnam-do/Busan; GW, Gangwon-do; JB, Jeollabuk-do; JJ, Jejudo; JN/GJ, Jeollanam-do/Gwangju; SE, Seoul.
Fig. 3
Fig. 3. Geographical distribution of Korean MRSA (KMRSA).
Abbreviations: See Fig. 2.
Fig. 4
Fig. 4. Dendrogram analysis of nine representative Korean MRSA (KMRSA) strains (circled) obtained by using the DiversiLab (DL; bioMérieux, Mercy l'Etoile, France) MRSA library sheets. The gel-like image generated by the DL software illustrates band similarities.
See this image and copyright information in PMC

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