ArticlePloS one2013
Extensive dissemination of methicillin-resistant Staphylococcus aureus (MRSA) between the hospital and the community in a country with a high prevalence of nosocomial MRSA.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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Who cites it
44 citing papers in PubMed, 81 citations in OpenAlex.
- Dissemination and Molecular Characterization ofBioMed research international · 2017Trial
- Persistence of Biofilm-Forming and Multidrug-ResistantJournal of preventive medicine and hygiene · 2026Article
- The fitness connection of antibiotic resistance.Frontiers in microbiology · 2025Article
- ST105 Lineage of MRSA: An Emerging Implication for Bloodstream Infection in the American and European Continents.Antibiotics (Basel, Switzerland) · 2024Review
- Methicillin-ResistantMicroorganisms · 2023Article
- MRSA in Humans, Pets and Livestock in Portugal: Where We Came from and Where We Are Going.Pathogens (Basel, Switzerland) · 2022Review
- Distribution of sasX, qacA/B and mupA genes and determination of genetic relatedness of methicillin-resistant Staphylococcus aureus among clinical isolates and nasal swab samples from the same patients in a hospital in Malaysia.Singapore medical journal · 2022Article
- Article
- High Frequency of the EMRSA-15 Clone (ST22-MRSA-IV) in Hospital Wastewater.Microorganisms · 2022Article
- Clonal Lineages, Antimicrobial Resistance, and PVL Carriage ofAntibiotics (Basel, Switzerland) · 2021Article
- Molecular characterization of methicillin-resistant Staphylococcus aureus among insulin-dependent diabetic individuals in Brazil.Annals of clinical microbiology and antimicrobials · 2021Article
- Prevalence of Methicillin Resistant Staphylococcus aureus Nasal Colonizers among Basic Science MBBS and BDS Students of Kathmandu Medical College.JNMA; journal of the Nepal Medical Association · 2021Article
- Identification of a Human Anti-Alpha-Toxin Monoclonal Antibody AgainstFrontiers in microbiology · 2021Article
- Genetic Relatedness and Diversity ofMicroorganisms · 2020Article
- Molecular epidemiology of antimicrobial resistant microorganisms in the 21th century: a review of the literature.Acta bio-medica : Atenei Parmensis · 2020Review
- Antimicrobial Resistance and Food Animals: Influence of Livestock Environment on the Emergence and Dissemination of Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2020Review
- Emergence of community-acquired methicillin-resistant Staphylococcus aureus EMRSA-15 clone as the predominant cause of diabetic foot ulcer infections in Portugal.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Global Evolution of Pathogenic Bacteria With Extensive Use of Fluoroquinolone Agents.Frontiers in microbiology · 2020Article
- Reducing transmission of methicillin-resistantInfection prevention in practice · 2019Article
- Phenotypic and genotypic characterization of antibiotic resistance in the methicillin-resistantAntimicrobial resistance and infection control · 2019Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
According to the EARS-Net surveillance data, Portugal has the highest prevalence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) in Europe, but the information on MRSA in the community is very scarce and the links between the hospital and community are not known. In this study we aimed to understand the events associated to the recent sharp increase in MRSA frequency in Portugal and to evaluate how this has shaped MRSA epidemiology in the community. With this purpose, 180 nosocomial MRSA isolates recovered from infection in two time periods and 14 MRSA isolates recovered from 89 samples of skin and soft tissue infections (SSTI) were analyzed by pulsed-field gel electrophoresis (PFGE), staphylococcal chromosome cassette mec (SCCmec) typing, spa typing and multilocus sequence typing (MLST). All isolates were also screened for the presence of Panton Valentine leukocidin (PVL) and arginine catabolic mobile element (ACME) by PCR. The results showed that ST22-IVh, accounting for 72% of the nosocomial isolates, was the major clone circulating in the hospital in 2010, having replaced two previous dominant clones in 1993, the Iberian (ST247-I) and Portuguese (ST239-III variant) clones. Moreover in 2010, three clones belonging to CC5 (ST105-II, ST125-IVc and ST5-IVc) accounted for 20% of the isolates and may represent the beginning of new waves of MRSA in this hospital. Interestingly, more than half of the MRSA isolates (8/14) causing SSTI in people attending healthcare centers in Portugal belonged to the most predominant clones found in the hospital, namely ST22-IVh (n = 4), ST5-IVc (n = 2) and ST105-II (n = 1). Other clones found included ST5-V (n = 6) and ST8-VI (n = 1). None of the MRSA isolates carried PVL and only five isolates (ST5-V-t179) carried ACME type II. The emergence and spread of EMRSA-15 may be associated to the observed increase in MRSA frequency in the hospital and the consequent spillover of MRSA into the community.
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