Genotype mrsa

Fifty MRSA and 50 MSSA isolates, as well as 50 vancomycin-resistant E. faecium (VR-E. faecium) and 50 vancomycin-susceptible E. faecium (VS-E. faecium) clinical isolates were used in the study. Only one isolate per patient was included. Species identification was confirmed by MALDI-TOF MS. Methicillin resistance in S. aureus and vancomycin resistance in E. faecium isolates were confirmed by GenoType MRSA (Hain Lifescience, Nehren, Germany) assay and vanA/vanB PCR, respectively. Among VREs, 24 and 26 isolates were vanA-positive and vanB-positive, respectively.

At the University Hospital of Münster, Germany, MRSA is generally cultured, identified, and differentiated by routine microbiological diagnostic methods using dextrose broth enrichment; chromID MRSA selective agar (bioMérieux, Marcy-l’Étoile, France), which contains cefoxitin; VITEK 2 automated system (bioMérieux) applying the antimicrobial susceptibility test card AST-P632; PBP2a detection kit (PBP2a Culture Colony Test, Alere, San Diego, CA, USA); S. aureus–specific PCR targeting mecA/mecC (GenoType MRSA, Hain-Lifescience, Nehren, Germany); and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (Microflex-LT system, MALDI-Biotyper 3.0; Bruker Daltonik, Bremen, Germany). In February 2016, an S. aureus isolate (which we numbered UKM4229) was recovered during routine MRSA screening. The isolate displayed a β-lactam–resistant phenotype without carrying the methicillin resistance genes mecA or mecC. For further characterizations, isolate UKM4229 was stored at −80°C and was cultivated on chromID MRSA agar (bioMérieux) at 37°C.