Molecular Characterization Of Methicillin-Resistant Staphylococcus Aureus Spread By Neonates Transferred From Primary Obstetrics Clinics To A Tertiary Care Hospital In Korea

Objective. To investigate the characteristics and origins of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from neonatal patients admitted to a tertiary care hospital from local and primary care obstetrics clinics.Design. Molecular typing study.Setting. A 1,278-bed tertiary care hospital ( Samsung Medical Center) and 2 primary obstetrics clinics in Seoul, Korea.Patients. The genotypic characteristics of 12 MRSA samples isolated from 11 neonatal patients transferred from 2 primary care obstetrics clinics to a tertiary care hospital were investigated by means of multilocus sequence typing, spa ( staphylococcal protein A) typing, and SCCmec typing. Ten MRSA strains isolated from workers and environments in the associated obstetrics clinics were also investigated.Results. Although the antibiograms of isolates from 2 obstetrics clinics differed, no strain showed multidrug resistance to antimicrobials. Multilocus sequence typing analysis showed that all 22 MRSA isolates analyzed in this study had sequence type 1 ( with the allelic profile 1-1-1-1-1-1-1), sequence type 493 (62-1-1-1-1-1-1), or a novel sequence type (25-1-1-1-1-1-1) and that all belonged to a single clonal complex ( clonal complex 1). Moreover, they all contained SCCmec type IVA and the identical spa type (UJEBKBP). These genotypic characteristics are similar to those of typical community-associated MRSA strains rather than the hospital-acquired MRSA strains common in Korea.Conclusion. The findings of this study suggest that community-acquired MRSA strains can spread in primary care clinics and be imported into tertiary care settings.