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Profile of Antimicrobial Resistance of Staphylococcus aureus and Molecular Epidemiologic Characterization of Methicillin-resistant Staphylococcus aureus (MRSA) Isolated from Hands of People Using Multitude Facilities
Tae Sun Kim1, Min Ji Kim1, Sun Hee Kim1, Hye-young Kee1, Jin-jong Seo1, Eun-Sun Kim1, Yong-Un Moon1, Puil Youl Ryu2, and Dong-Ryong Ha1
Health & Environment Institute of Gwangju, Health Research Department, Microbioloy Division1, Department of Microbiology, Chonnam National University Medical School2, Gwangju, Korea
Vol.44 Num.4 (p289~298)
Background: The purpose of this study was to investigate perception of hand hygiene and actual hand washing practices of people who used public facilities as well as the presence of indicator bacteria and food-borne pathogens on their hands. Data from this study will be used as a tool for public education and provide basic information on the potential risk for the spread of infectious disease by hands.
Materials and Methods: Sixty S. aureus and 15 methicillin-resistant S. aureus (MRSA) were recovered from 500 swab samples from hands of people in public places, including super markets and amusement facilities in Gwangju Metropolitan City during February to May 2011. Using conventional methods and the Vitek system, all of the isolates were confirmed as Staphylococcus auerus (S. aureus). Antimicrobial susceptibility was determined by performing disk diffusion testing according to the Clinical Laboratory Standard Institute guidelines. The minimum inhibition concentrations (MICs) of MRSA isolates were tested using E-test strips. To confirm the MRSA, polymerase chain reaction (PCR) for the S.aureus-specific gene and mecA gene was performed. Gene detection using PCR, SCCmec typing, Panton-Valentine Leukocidin (PVL), and Multilocus sequence typing (MLST) were performed on all isolates of MRSA.
Results: Of 60 S. aureus isolates, 48 (80%) harbored at least one type of enterotoxin gene: two, three, four, and five types of enterotoxin gene were found in 16 (26.7%), seven (11.7%), 10 (16.7%), and eight (13.3%) isolates, respectively. The most prevalent antimicrobial resistance observed in the S. aureus isolates was to penicillin (92%, 55/60), followed by erythromycin (35%, 21/60), oxacillin (32%, 19/60), and ampicillin (23%, 14/60). No resistance was observed against vancomycin, clindamycin, linazolid, rifampin, imipenem, trimethoprim/sulfamethoxazole, and telithromycin. In this study, based on molecular characterization of MRSA isolates, all MRSA, except for one isolate, belonged to ST72 and SCCmec type IV. Eleven of 15 (78.6%) MRSA were ST72:SCCmecIV:t324.
Conclusions: In this study, we detected serious pathogens, including S. aureus and MRSA, from swab samples of peoples hands. Most S. aureus isolates harbored the enterotoxin gene and the types of MRSA isolated in this study were communityassociated MRSA, indicating the importance of washing hands for public health.

Keywords : Methicillin-resistant S. aureus , Antimicrobial resistance, Enterotoxin, SCCmectype, Panton-Valentine Leukocidin, Multilocus sequence