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The association between biofilm formation and the accessory gene regulator (agr) types of methicillin-resistant Staphylococcus aureus (MRSA) strains in our hospital were investigated. The biofilm index and the incidence of MRSA strains carrying agr-2 in the infection group (n = 91) were significantly higher than were those in the carrier group (n = 225), suggesting that biofilm formation and agr type are associated with nosocomial MRSA infections.

Objective:

To evaluate the usefulness of an assay using two polymerase chain reaction-based genotyping methods in the practical surveillance of methicillin-resistant Staphylococcus aureus (MRSA).

Methods:

Nosocomial infection and colonization were surveyed monthly in a university hospital in Japan for 20 months. Genotyping with mec-HVR is based on the size of the mec-associated hypervariable region amplified by polymerase chain reaction. Toxin genotyping uses a multiplex polymerase chain reaction method to amplify eight staphylococcal toxin genes.

Results:

Eight hundred nine MRSA isolates were classified into 49 genotypes. We observed differing prevalences of genotypes for different hospital wards, and could rapidly demonstrate the similarity of genotype for outbreak isolates. The incidence of genotype D: SEC/TSST1 was significantly higher in isolates causing nosocomial infections (49.5%; 48 of 97) than in nasal isolates (31.4%; 54 of 172) (P = .004), suggesting that this genotype may represent the nosocomial strains.

Conclusion:

The combined use of these two genotyping methods resulted in improved discriminatory ability and should be further investigated.

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Biofilm Formation by and Accessory Gene Regulator Typing of Methicillin-Resistant Staphylococcus aureus Strains Recovered From Patients With Nosocomial Infections

An Epidemiologic Survey of Methicillin-Resistant Staphylococcus Aureus by Combined Use of Mec-HVR Genotyping and Toxin Genotyping in a University Hospital in Japan

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Biofilm Formation by and Accessory Gene Regulator Typing of Methicillin-Resistant Staphylococcus aureus Strains Recovered From Patients With Nosocomial Infections

An Epidemiologic Survey of Methicillin-Resistant Staphylococcus Aureus by Combined Use of Mec-HVR Genotyping and Toxin Genotyping in a University Hospital in Japan