CMAJ • July 18, 2006; 175 (2).
First published June 27, 2006; doi:10.1503/cmaj.051565
© 2006 CMA Media Inc. or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
Outbreak in Alberta of community-acquired (USA300) methicillin-resistant Staphylococcus aureus in people with a history of drug use, homelessness or incarceration
Mark Gilbert,
Judy MacDonald,
Dan Gregson,
Jennifer Siushansian,
Kunyan Zhang,
Sameer Elsayed,
Kevin Laupland,
Tom Louie,
Karen Hope,
Michael Mulvey,
John Gillespie,
Diane Nielsen,
Virginia Wheeler,
Marie Louie,
Agnes Honish,
Gloria Keays and
John Conly
From the Canadian Field Epidemiology Program (Gilbert, Siushansian), Public Health Agency of Canada, Ottawa, Ont.; the Centre for Antimicrobial Resistance (Zhang, Laupland, Conly), Calgary Laboratory Services (Gregson, Zhang, Elsayed, Laupland, Conly), Calgary Health Region (MacDonald, Gregson, Zhang, Elsayed, Laupland, T. Louie, M. Louie, Hope, Gillespie, Nielsen, Wheeler, Conly) and the Departments of Pathology and Laboratory Medicine (Gregson, Zhang, Elsayed, Laupland, T. Louie, M. Louie, Conly), Medicine (Gregson, Zhang, Laupland, T. Louie, M. Louie, Conly), Microbiology and Infectious Diseases (Zhang, Elsayed, T. Louie, M. Louie, Conly) and Community Health Sciences (MacDonald, Laupland), University of Calgary, Calgary; Alberta Provincial Laboratory for Public Health (M. Louie), Alberta Health and Wellness (Honish, Keays), Edmonton, Alta.; and the National Microbiological Laboratory (Mulvey), Public Health Agency of Canada, Winnipeg, Man.
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Fig. 1: Typing results for outbreak-related clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) in the Calgary Health Region (CHR). Left panel: Staphylococcal cassette chromosome mec (SCCmec) typing results. Lanes 1–6, representative outbreak-associated clinical isolates; lane M, molecular size markers, 1 Kb Plus DNA Ladder (Invitrogen). Control strains used: types I (NCTC10442), II (N315), III (85/ 2082), IVa (CA05), IVb (8/6–3P), IVc (MR108), IVd (JCSC 4469) and V (WIS [WBG8318]-JCSC3624), corresponding to distinct amplicon sizes of 613, 398, 280, 776, 493, 200, 881 and 325 bp, respectively. In addition, a 147-bp mecA gene (methicillin-resistant determinant) amplicon was present in all strains. Note: bp = base pairs. Right panel: Pulsed-field gel electrophoresis patterns of USA 300 strains of MRSA circulating in the CHR between Jan. 1 and Sept. 30, 2004. Lane 1, pattern A (31 of 40 cases, 78%); lane 2, USA300 reference strain pattern; lane 3, pattern B (7 cases, 18%); lane 4, pattern C (2 cases, 5%).
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Fig. 2: Number of cases that furnished the USA300 strain of methicillin-resistant Staphylococcus aureus (MRSA) in the Calgary Health Region by month of specimen collection, from Jan. 1, 2004 through Sept. 30, 2004 (n = 40; 7 historical isolates were included for comparison). A further 310 infections were identified through ongoing surveillance up to Dec. 31, 2005 (8–34 cases per month).
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