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Keywords:

  • mecA;
  • mecALGA251;
  • mecC;
  • methicillin-resistant Staphylococcus aureus;
  • Panton–Valentine leukocidin;
  • Staphylococcus aureus;
  • SCCmec

Clin Microbiol Infect 2012; 18: 395–400

Abstract

The recent finding of a new mecA homologue, mecALGA251, with only 70% nucleotide homology to the conventional mecA gene has brought the routine testing for mecA as a confirmatory test for methicillin-resistant Staphylococcus aureus (MRSA) into question. A multiplex PCR was designed to differentiate mecALGA251 from the known mecA together with detection of lukF-PV and the spa gene fragments, enabling direct spa typing by sequencing of the PCR amplicons. The PCR analysis and subsequent spa typing were validated on a large collection (= 185) of contemporary MRSA and methicillin-sensitive S. aureus isolates, including 127 isolates carrying mecALGA251. The mecALGA251 gene was situated in staphylococcal cassette chromosome mec type XI elements, and sequence variation within a 631-bp fragment of mecALGA251 in 79 isolates indicated a very conserved gene sequence. Following a successful validation, the multiplex PCR strategy was implemented in the routine testing of MRSA for national surveillance. Over a 2-month period, among 203 samples tested, 12 new MRSA cases caused by isolates carrying mecALGA251 were identified, emphasizing the clinical importance of testing for these new MRSA isolates.