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Antimicrobial Agents and Chemotherapy, February 2009, p. 442-449, Vol. 53, No. 2
0066-4804/09/$08.00+0     doi:10.1128/AAC.00724-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Diversity of Staphylococcal Cassette Chromosome mec Structures in Methicillin-Resistant Staphylococcus epidermidis and Staphylococcus haemolyticus Strains among Outpatients from Four Countries

Etienne Ruppé,^1,2 François Barbier,^1,2 Yasmine Mesli,^1,3 Aminata Maiga,^1,4 Radu Cojocaru,^1,5 Mokhtar Benkhalfat,⁶ Samia Benchouk,³ Hafida Hassaine,⁷ Ibrahim Maiga,⁴ Amadou Diallo,⁴ Abdel Karim Koumaré,⁸ Kalilou Ouattara,⁹ Sambou Soumaré,¹⁰ Jean-Baptiste Dufourcq,¹¹ Chhor Nareth,¹¹ Jean-Louis Sarthou,¹² Antoine Andremont,^1,2 and Raymond Ruimy^1,2*

Laboratoire Associé CNR Résistance Dans les Flores Commensales, Hôpital Bichat-Claude Bernard (AP-HP), 75018 Paris, France,¹ EA 3469 University Paris 7-Diderot, Paris, France,² Service des Maladies Infectieuses, Hôpital Damerdji Tidjani, Tlemcen, Algeria,³ Laboratoire de Biologie Médicale et d'Hygiène, CHU point G, Bamako, Mali,⁴ National Center for Preventive Medicine, Chisinau, Moldova,⁵ Service de Chirurgie Viscérale, Hôpital Damerdji Tidjani, Tlemcen, Algeria,⁶ Faculté des Sciences, Tlemcen, Algeria,⁷ Service de Chirurgie B, CHU point G, Bamako, Mali,⁸ Service d'Urologie, CHU point G, Bamako, Mali,⁹ Service de Chirurgie A, CHU point G, Bamako, Mali,¹⁰ Service des Urgences, Hôpital Calmette, Phnom Penh, Cambodia,¹¹ Institut Pasteur du Cambodge, Phnom Penh, Cambodia,¹²

Received 3 June 2008/ Returned for modification 18 September 2008/ Accepted 29 October 2008

In staphylococci, methicillin (meticillin) resistance (MR) is mediated by the acquisition of the mecA gene, which is carried on the size and composition variable staphylococcal cassette chromosome mec (SCCmec). MR has been extensively studied in Staphylococcus aureus, but little is known about MR coagulase-negative staphylococci (MR-CoNS). Here, we describe the diversity of SCCmec structures in MR-CoNS from outpatients living in countries with contrasting environments: Algeria, Mali, Moldova, and Cambodia. Their MR-CoNS nasal carriage rates were 29, 17, 11, and 31%, respectively. Ninety-six MR-CoNS strains, comprising 75 (78%) Staphylococcus epidermidis strains, 19 (20%) Staphylococcus haemolyticus strains, 1 (1%) Staphylococcus hominis strain, and 1 (1%) Staphylococcus cohnii strain, were analyzed. Eighteen different SCCmec types were observed, with 28 identified as type IV (29%), 25 as type V (26%), and 1 as type III (1%). Fifteen strains (44%) were untypeable for their SCCmec. Thirty-four percent of MR-CoNS strains contained multiple ccr copies. Type IV and V SCCmec were preferentially associated with S. epidermidis and S. haemolyticus, respectively. MR-CoNS constitute a widespread and highly diversified MR reservoir in the community.

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* Corresponding author. Mailing address: Laboratoire de Bactériologie, Hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France. Phone: 33 (0) 1 40 25 85 00. Fax: 33 (0) 1 40 25 85 81. E-mail: raymond.ruimy{at}bch.aphp.fr

Published ahead of print on 10 November 2008.

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Antimicrobial Agents and Chemotherapy, February 2009, p. 442-449, Vol. 53, No. 2
0066-4804/09/$08.00+0     doi:10.1128/AAC.00724-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

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