Previous Article |
Table of Contents
| Next Article
* Department of Biology and Biochemistry, University of Bath, Bath
BA2 7AY, United Kingdom; Edited by Christopher T. Walsh, Harvard Medical School, Boston,
MA, and approved April 16, 2002 (received for review February 22, 2002)
Methicillin-resistant Staphylococcus aureus (MRSA)
is a major cause of hospital-acquired infections that are becoming
increasingly difficult to combat because of emerging resistance to all
current antibiotic classes. The evolutionary origins of MRSA are poorly understood, no rational nomenclature exists, and there is no consensus on the number of major MRSA clones or the relatedness of clones described from different countries. We resolve all of these issues and
provide a more thorough and precise analysis of the evolution of MRSA
clones than has previously been possible. Using multilocus sequence
typing and an algorithm, BURST, we analyzed an
international collection of 912 MRSA and methicillin-susceptible
S. aureus (MSSA) isolates. We identified 11 major MRSA
clones within five groups of related genotypes. The putative ancestral
genotype of each group and the most parsimonious patterns of descent of
isolates from each ancestor were inferred by using BURST,
which, together with analysis of the methicillin resistance genes,
established the likely evolutionary origins of each major MRSA clone,
the genotype of the original MRSA clone and its MSSA progenitor, and the extent of acquisition and horizontal movement of the methicillin resistance genes. Major MRSA clones have arisen repeatedly from successful epidemic MSSA strains, and isolates with decreased susceptibility to vancomycin, the antibiotic of last resort, are arising from some of these major MRSA clones, highlighting a depressing progression of increasing drug resistance within a small number of
ecologically successful S. aureus genotypes.
Microbiology
The evolutionary history of methicillin-resistant
Staphylococcus aureus (MRSA)
,
,
Institute of Molecular
Medicine, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom;
§ Division of Microbiology and Infectious Diseases,
University Hospital Nottingham, Nottingham, NG7 2UH, United
Kingdom; and ¶ Department of Infectious Disease
Epidemiology, Faculty of Medicine, Imperial College, St. Mary's
Hospital, London W2 1PG, United Kingdom
To whom reprint requests should be addressed. E-mail:
m.c.enright{at}bath.ac.uk.
www.pnas.org/cgi/doi/10.1073/pnas.122108599
![]()
CiteULike
Complore
Connotea
Del.icio.us
Digg What's this?
This article has been cited by other articles in HighWire Press-hosted journals:
![]() |
M. J. Noto, B. N. Kreiswirth, A. B. Monk, and G. L. Archer Gene Acquisition at the Insertion Site for SCCmec, the Genomic Island Conferring Methicillin Resistance in Staphylococcus aureus J. Bacteriol., February 15, 2008; 190(4): 1276 - 1283. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Strommenger, C. Braulke, D. Heuck, C. Schmidt, B. Pasemann, U. Nubel, and W. Witte spa Typing of Staphylococcus aureus as a Frontline Tool in Epidemiological Typing J. Clin. Microbiol., February 1, 2008; 46(2): 574 - 581. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Woodford Successful, multiresistant bacterial clones J. Antimicrob. Chemother., February 1, 2008; 61(2): 233 - 234. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. D. Kennedy, M. Otto, K. R. Braughton, A. R. Whitney, L. Chen, B. Mathema, J. R. Mediavilla, K. A. Byrne, L. D. Parkins, F. C. Tenover, et al. From the Cover: Epidemic community-associated methicillin-resistant Staphylococcus aureus: Recent clonal expansion and diversification PNAS, January 29, 2008; 105(4): 1327 - 1332. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. A. Faria, J. A. Carrico, D. C. Oliveira, M. Ramirez, and H. de Lencastre Analysis of Typing Methods for Epidemiological Surveillance of both Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Strains J. Clin. Microbiol., January 1, 2008; 46(1): 136 - 144. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. S. Blanc, C. Petignat, A. Wenger, G. Kuhn, Y. Vallet, D. Fracheboud, S. Trachsel, M. Reymond, N. Troillet, H. H. Siegrist, et al. Changing Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Small Geographic Area over an Eight-Year Period J. Clin. Microbiol., November 1, 2007; 45(11): 3729 - 3736. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. F. Rabello, B. M. Moreira, R. M. M. Lopes, L. M. Teixeira, L. W. Riley, and A. C. D. Castro Multilocus sequence typing of Staphylococcus aureus isolates recovered from cows with mastitis in Brazilian dairy herds J. Med. Microbiol., November 1, 2007; 56(11): 1505 - 1511. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Milheirico, D. C. Oliveira, and H. de Lencastre Update to the Multiplex PCR Strategy for Assignment of mec Element Types in Staphylococcus aureus Antimicrob. Agents Chemother., September 1, 2007; 51(9): 3374 - 3377. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. L. Amorim, N. A. Faria, D. C. Oliveira, C. Vasconcelos, J. C. Cabeda, A. C. Mendes, E. Calado, A. P. Castro, M. H. Ramos, J. M. Amorim, et al. Changes in the Clonal Nature and Antibiotic Resistance Profiles of Methicillin-Resistant Staphylococcus aureus Isolates Associated with Spread of the EMRSA-15 Clone in a Tertiary Care Portuguese Hospital J. Clin. Microbiol., September 1, 2007; 45(9): 2881 - 2888. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. J. Stephens, F. Huygens, and P. M. Giffard Systematic Derivation of Marker Sets for Staphylococcal Cassette Chromosome mec Typing Antimicrob. Agents Chemother., August 1, 2007; 51(8): 2954 - 2964. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Holtfreter, D. Grumann, M. Schmudde, H. T. T. Nguyen, P. Eichler, B. Strommenger, K. Kopron, J. Kolata, S. Giedrys-Kalemba, I. Steinmetz, et al. Clonal Distribution of Superantigen Genes in Clinical Staphylococcus aureus Isolates J. Clin. Microbiol., August 1, 2007; 45(8): 2669 - 2680. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Mayor, J. Ortellado, C. Menacho, G. Lird, C. Courtier, C. Gardon, H. Meugnier, M. Bes, F. Vandenesch, and J. Etienne Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Isolates Collected in Asuncion, Paraguay J. Clin. Microbiol., July 1, 2007; 45(7): 2298 - 2300. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. Abbott, N. Leonard, B. Markey, A. Rossney, and J. Dunne Persistence of MRSA infection Vet Rec., June 16, 2007; 160(24): 851 - 852. [Full Text] [PDF] |
||||
![]() |
M. Aires-de-Sousa, C. E. S. R. Parente, O. Vieira-da-Motta, I. C. F. Bonna, D. A. Silva, and H. de Lencastre Characterization of Staphylococcus aureus Isolates from Buffalo, Bovine, Ovine, and Caprine Milk Samples Collected in Rio de Janeiro State, Brazil Appl. Envir. Microbiol., June 15, 2007; 73(12): 3845 - 3849. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Bhattacharya, H. Carleton, C. J. Tsai, E. J. Baron, and F. Perdreau-Remington Differences in Clinical and Molecular Characteristics of Skin and Soft Tissue Methicillin-Resistant Staphylococcus aureus Isolates between Two Hospitals in Northern California J. Clin. Microbiol., June 1, 2007; 45(6): 1798 - 1803. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. D. Cookson, D. A. Robinson, A. B. Monk, S. Murchan, A. Deplano, R. de Ryck, M. J. Struelens, C. Scheel, V. Fussing, S. Salmenlinna, et al. Evaluation of Molecular Typing Methods in Characterizing a European Collection of Epidemic Methicillin-Resistant Staphylococcus aureus Strains: the HARMONY Collection J. Clin. Microbiol., June 1, 2007; 45(6): 1830 - 1837. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. O'Neill, C. Pozzi, P. Houston, D. Smyth, H. Humphreys, D. A. Robinson, and J. P. O'Gara Association between Methicillin Susceptibility and Biofilm Regulation in Staphylococcus aureus Isolates from Device-Related Infections J. Clin. Microbiol., May 1, 2007; 45(5): 1379 - 1388. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Delgado, J. T. Riordan, R. Lamichhane-Khadka, D. C. Winnett, J. Jimenez, K. Robinson, F. G. O'Brien, S. A. Cantore, and J. E. Gustafson Hetero-Vancomycin-Intermediate Methicillin-Resistant Staphylococcus aureus Isolate from a Medical Center in Las Cruces, New Mexico J. Clin. Microbiol., April 1, 2007; 45(4): 1325 - 1329. [Abstract] [Full Text] [PDF] |
||||
![]() |
I. Verdier, G. Durand, M. Bes, K. L. Taylor, G. Lina, F. Vandenesch, A. I. Fattom, and J. Etienne Identification of the Capsular Polysaccharides in Staphylococcus aureus Clinical Isolates by PCR and Agglutination Tests J. Clin. Microbiol., March 1, 2007; 45(3): 725 - 729. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Ghebremedhin, W. Konig, W. Witte, K. J. Hardy, P. M. Hawkey, and B. Konig Subtyping of ST22-MRSA-IV (Barnim epidemic MRSA strain) at a university clinic in Germany from 2002 to 2005 J. Med. Microbiol., March 1, 2007; 56(3): 365 - 375. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Kuhn, P. Francioli, and D. S. Blanc Double-Locus Sequence Typing Using clfB and spa, a Fast and Simple Method for Epidemiological Typing of Methicillin-Resistant Staphylococcus aureus J. Clin. Microbiol., January 1, 2007; 45(1): 54 - 62. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Hallin, A. Deplano, O. Denis, R. De Mendonca, R. De Ryck, and M. J. Struelens Validation of Pulsed-Field Gel Electrophoresis and spa Typing for Long-Term, Nationwide Epidemiological Surveillance Studies of Staphylococcus aureus Infections J. Clin. Microbiol., January 1, 2007; 45(1): 127 - 133. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. K. Bonnstetter, D. J. Wolter, F. C. Tenover, L. K. McDougal, and R. V. Goering Rapid Multiplex PCR Assay for Identification of USA300 Community-Associated Methicillin-Resistant Staphylococcus aureus Isolates J. Clin. Microbiol., January 1, 2007; 45(1): 141 - 146. [Abstract] [Full Text] [PDF] |
||||
![]() |
X. X. Ma, T. Ito, P. Chongtrakool, and K. Hiramatsu Predominance of Clones Carrying Panton-Valentine Leukocidin Genes among Methicillin-Resistant Staphylococcus aureus Strains Isolated in Japanese Hospitals from 1979 to 1985 J. Clin. Microbiol., December 1, 2006; 44(12): 4515 - 4527. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Nadarajah, M. J. S. Lee, L. Louie, L. Jacob, A. E. Simor, M. Louie, and M. J. McGavin Identification of different clonal complexes and diverse amino acid substitutions in penicillin-binding protein 2 (PBP2) associated with borderline oxacillin resistance in Canadian Staphylococcus aureus isolates. J. Med. Microbiol., December 1, 2006; 55(Pt 12): 1675 - 1683. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Luczak-Kadlubowska, J. Krzyszton-Russjan, and W. Hryniewicz Characteristics of Staphylococcus aureus Strains Isolated in Poland in 1996 to 2004 That Were Deficient in Species-Specific Proteins J. Clin. Microbiol., November 1, 2006; 44(11): 4018 - 4024. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. R. Gomes, H. Westh, and H. de Lencastre Origins and Evolution of Methicillin-Resistant Staphylococcus aureus Clonal Lineages. Antimicrob. Agents Chemother., October 1, 2006; 50(10): 3237 - 3244. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Revazishvili, L. Bakanidze, T. Gomelauri, E. Zhgenti, G. Chanturia, M. Kekelidze, C. Rajanna, A. Kreger, and A. Sulakvelidze Genetic Background and Antibiotic Resistance of Staphylococcus aureus Strains Isolated in the Republic of Georgia. J. Clin. Microbiol., October 1, 2006; 44(10): 3477 - 3483. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Huygens, J. Inman-Bamber, G. R. Nimmo, W. Munckhof, J. Schooneveldt, B. Harrison, J. A. McMahon, and P. M. Giffard Staphylococcus aureus Genotyping Using Novel Real-Time PCR Formats. J. Clin. Microbiol., October 1, 2006; 44(10): 3712 - 3719. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. J. Gill, J. C. Pacan, M. E. Carson, K. E. Leslie, M. W. Griffiths, and P. M. Sabour Efficacy and Pharmacokinetics of Bacteriophage Therapy in Treatment of Subclinical Staphylococcus aureus Mastitis in Lactating Dairy Cattle. Antimicrob. Agents Chemother., September 1, 2006; 50(9): 2912 - 2918. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Perez-Roth, C. Lopez-Aguilar, J. Alcoba-Florez, and S. Mendez-Alvarez High-Level Mupirocin Resistance within Methicillin-Resistant Staphylococcus aureus Pandemic Lineages. Antimicrob. Agents Chemother., September 1, 2006; 50(9): 3207 - 3211. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Paul Surveillance and management of all types of Staphylococcus aureus bacteraemia. BMJ, August 5, 2006; 333(7562): 269 - 270. [Full Text] [PDF] |
||||
![]() |
M. J. Noto and G. L. Archer A Subset of Staphylococcus aureus Strains Harboring Staphylococcal Cassette Chromosome mec (SCCmec) Type IV Is Deficient in CcrAB-Mediated SCCmec Excision. Antimicrob. Agents Chemother., August 1, 2006; 50(8): 2782 - 2788. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Jury, M. Al-Mahrous, M. Apostolou, S. Sandiford, A. Fox, W. Ollier, and M. Upton Rapid cost-effective subtyping of meticillin-resistant Staphylococcus aureus by denaturing HPLC. J. Med. Microbiol., August 1, 2006; 55(Pt 8): 1053 - 1060. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. Ruppitsch, A. Indra, A. Stoger, B. Mayer, S. Stadlbauer, G. Wewalka, and F. Allerberger Classifying spa Types in Complexes Improves Interpretation of Typing Results for Methicillin-Resistant Staphylococcus aureus. J. Clin. Microbiol., July 1, 2006; 44(7): 2442 - 2448. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Strommenger, C. Kettlitz, T. Weniger, D. Harmsen, A. W. Friedrich, and W. Witte Assignment of Staphylococcus Isolates to Groups by spa Typing, SmaI Macrorestriction Analysis, and Multilocus Sequence Typing. J. Clin. Microbiol., July 1, 2006; 44(7): 2533 - 2540. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. H. Goldstein, G. Hradecky, G. M. Vilke, and T. C. Chan Impact of a Standardized Protocol to Address Methicillin-Resistant Staphylococcus aureus Skin Infections at a Large, Urban County Jail System Journal of Correctional Health Care, July 1, 2006; 12(3): 181 - 188. [Abstract] [PDF] |
||||
![]() |
D. C. Oliveira, C. Milheirico, S. Vinga, and H. de Lencastre Assessment of allelic variation in the ccrAB locus in methicillin-resistant Staphylococcus aureus clones J. Antimicrob. Chemother., July 1, 2006; 58(1): 23 - 30. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. S. Liao, G. A. Storch, R. S. Buller, R. C. Orscheln, E. R. Mardis, J. R. Armstrong, and W. M. Dunne Jr. Blinded Comparison of Repetitive-Sequence PCR and Multilocus Sequence Typing for Genotyping Methicillin-Resistant Staphylococcus aureus Isolates from a Children's Hospital in St. Louis, Missouri. J. Clin. Microbiol., June 1, 2006; 44(6): 2254 - 2257. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y.-C. Huang, L.-H. Su, T.-L. Wu, and T.-Y. Lin Changing Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Bloodstream Isolates from a Teaching Hospital in Northern Taiwan. J. Clin. Microbiol., June 1, 2006; 44(6): 2268 - 2270. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. T. Cho, H. Y. Cha, H.-H. Chang, S.-W. Kim, J. M. Chung, J. Kim, Y. C. Lee, S. Y. Seol, and J. C. Lee Risk factors for specific methicillin-resistant Staphylococcus aureus clones in a Korean hospital J. Antimicrob. Chemother., June 1, 2006; 57(6): 1122 - 1127. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. M. Vivoni, B. A. Diep, A. C. de Gouveia Magalhaes, K. R. N. Santos, L. W. Riley, G. F. Sensabaugh, and B. M. Moreira Clonal Composition of Staphylococcus aureus Isolates at a Brazilian University Hospital: Identification of International Circulating Lineages. J. Clin. Microbiol., May 1, 2006; 44(5): 1686 - 1691. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Durand, M. Bes, H. Meugnier, M. C. Enright, F. Forey, N. Liassine, A. Wenger, K. Kikuchi, G. Lina, F. Vandenesch, et al. Detection of New Methicillin-Resistant Staphylococcus aureus Clones Containing the Toxic Shock Syndrome Toxin 1 Gene Responsible for Hospital- and Community-Acquired Infections in France. J. Clin. Microbiol., March 1, 2006; 44(3): 847 - 853. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Chongtrakool, T. Ito, X. X. Ma, Y. Kondo, S. Trakulsomboon, C. Tiensasitorn, M. Jamklang, T. Chavalit, J.-H. Song, and K. Hiramatsu Staphylococcal Cassette Chromosome mec (SCCmec) Typing of Methicillin-Resistant Staphylococcus aureus Strains Isolated in 11 Asian Countries: a Proposal for a New Nomenclature for SCCmec Elements Antimicrob. Agents Chemother., March 1, 2006; 50(3): 1001 - 1012. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Koessler, P. Francois, Y. Charbonnier, A. Huyghe, M. Bento, S. Dharan, G. Renzi, D. Lew, S. Harbarth, D. Pittet, et al. Use of Oligoarrays for Characterization of Community-Onset Methicillin-Resistant Staphylococcus aureus. J. Clin. Microbiol., March 1, 2006; 44(3): 1040 - 1048. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Fang and G. Hedin Use of Cefoxitin-Based Selective Broth for Improved Detection of Methicillin-Resistant Staphylococcus aureus J. Clin. Microbiol., February 1, 2006; 44(2): 592 - 594. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Aires-de-Sousa, K. Boye, H. de Lencastre, A. Deplano, M. C. Enright, J. Etienne, A. Friedrich, D. Harmsen, A. Holmes, X. W. Huijsdens, et al. High Interlaboratory Reproducibility of DNA Sequence-Based Typing of Bacteria in a Multicenter Study J. Clin. Microbiol., February 1, 2006; 44(2): 619 - 621. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Kuhn, P. Francioli, and D. S. Blanc Evidence for Clonal Evolution among Highly Polymorphic Genes in Methicillin-Resistant Staphylococcus aureus J. Bacteriol., January 1, 2006; 188(1): 169 - 178. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Sola, P. Cortes, H. A. Saka, Cordoba MRSA Collaborative Study Group, A. Vindel, and J. L. Bocco Evolution and Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Epidemic and Sporadic Clones in Cordoba, Argentina J. Clin. Microbiol., January 1, 2006; 44(1): 192 - 200. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. McAleese, E. Murphy, T. Babinchak, G. Singh, B. Said-Salim, B. Kreiswirth, P. Dunman, J. O'Connell, S. J. Projan, and P. A. Bradford Use of Ribotyping To Retrospectively Identify Methicillin-Resistant Staphylococcus aureus Isolates from Phase 3 Clinical Trials for Tigecycline That Are Genotypically Related to Community-Associated Isolates Antimicrob. Agents Chemother., November 1, 2005; 49(11): 4521 - 4529. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Wisplinghoff, B. Ewertz, S. Wisplinghoff, D. Stefanik, G. Plum, F. Perdreau-Remington, and H. Seifert Molecular Evolution of Methicillin-Resistant Staphylococcus aureus in the Metropolitan Area of Cologne, Germany, from 1984 to 1998 J. Clin. Microbiol., November 1, 2005; 43(11): 5445 - 5451. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. H. Deurenberg, C. Vink, G. J. Oudhuis, J. E. Mooij, C. Driessen, G. Coppens, J. Craeghs, E. De Brauwer, S. Lemmen, H. Wagenvoort, et al. Different Clonal Complexes of Methicillin-Resistant Staphylococcus aureus Are Disseminated in the Euregio Meuse-Rhine Region Antimicrob. Agents Chemother., October 1, 2005; 49(10): 4263 - 4271. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Zhang, J.-A. McClure, S. Elsayed, T. Louie, and J. M. Conly Novel Multiplex PCR Assay for Characterization and Concomitant Subtyping of Staphylococcal Cassette Chromosome mec Types I to V in Methicillin-Resistant Staphylococcus aureus J. Clin. Microbiol., October 1, 2005; 43(10): 5026 - 5033. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Ip, R. W. H. Yung, T. K. Ng, W. K. Luk, C. Tse, P. Hung, M. Enright, and D. J. Lyon Contemporary Methicillin-Resistant Staphylococcus aureus Clones in Hong Kong J. Clin. Microbiol., October 1, 2005; 43(10): 5069 - 5073. [Abstract] [Full Text] [PDF] |
||||