耐甲氧西林金黄色葡萄球菌的分子流行病学研究

了解我院患者耐甲氧西林金黄色葡萄球菌（MRSA）的分子流行病学特点,为临床抗感染治疗提供依据。收集2007年1月~2008年9月我院分离的耐甲氧西林金黄色葡萄球菌共54株,采用PCR进行SCCmec基因分型、葡萄球菌A蛋白（SPA）分型,并检测杀白细胞毒素（PVL）基因,同时应用脉冲场凝胶电泳（PFGE）进行同源性分析。54株MRSA菌株SCCmec基因分型为SCCmecⅡ型17株,SCCmecⅢ型33株,SCCmecⅣ型2株,SCCmecⅤ型2株;SPA基因分型将28株归属为t030,9株为t002,8株为t037,5株为t570,2株为t437,t163和t796各1株;PVL毒素检测只有2株SCCmecⅣ型菌株阳性;PFGE证实院内MRSA感染主要为2种克隆株传播,同时还有其他型别出现。本院MRSA流行传播的SCCmec基因型主要以Ⅲ型占优势,同时发现有携带PVL毒素的CA-MRSA分离株流行,应引起密切关注。     

耐甲氧西林金黄色葡萄球菌的两种新SCCmec型别及其抗药性研究

为探明本地区耐甲氧西林金黄色葡萄球菌(Staphylococcusaureus)的耐药性、流行病学分布状况及携带的葡萄球菌染色体mec盒(SCCmec)型别,用K-B琼脂扩散法、E-test和多位点PCR,对临床分离的金黄色葡萄球菌菌株进行了SCCmec分型及耐药性测定。结果发现了两种新的SCCmec型别,新1型含Ⅱ型的mecA上游特异性位点B和位于mecA内的M位点以及Ⅲ型的下游位点F,缺乏Ⅱ型上游位点C和下游位点D、G;新2型含Ⅰ、Ⅱ型的上游特异性位点A、B和两个Ⅲ型的下游位点F、H,同样缺乏位点C、D、G,可能分别为原有Ⅱ型和Ⅰ、Ⅱ型与Ⅲ型的基因重组株;且携带有新SCCmec型别的MRSA菌株,其流行病学分布特点及抗药性也与国外已报导的菌株不同,多分自门诊病人,且耐药性高,抗药谱广,值得引起高度重视和关注。     

金黄色葡萄球菌的耐药性分析及基因分型研究

目的通过分析上海地区院内分离金黄色葡萄球菌的药敏谱型及对耐甲氧西林的金黄色葡萄球菌（MRSA）进行基因谱型的研究,了解金黄色葡萄球菌的院内流行状况。方法对临床分离出的43株金黄色葡萄球菌进行药敏试验和SCCmec基因盒的多重PCR检测,并将结果整合后用MEGA3．1软件分析其进化相关关系。结果药敏结果显示43株金葡菌对青霉素和甲氧西林的耐药率最高。甲氧西林的耐药率达到62．8％。MecA阳性菌株SCCmec的分型显示均为Ⅱ型或Ⅲ型,且所占比例相近,未见Ⅰ型和Ⅳ型。进化树分析发现了在同一医院中亲缘关系相近的菌株,为院内感染流行株。结论MecA基因介导的MRSA在分离菌株中所占比例高,存在院内感染爆发性流行。     

金黄色葡萄球菌儿童临床分离株携带PVL基因状况的分析

目的了解金黄色葡萄球菌儿童分离株携带Panton-Valentine杀白细胞素（PVL）基因的状况及感染类型。方法采用多重PCR同时检测金黄色葡萄球菌16SrRNA基因、PVL基因和mecA基因;多重PCR检测MR—SA的SCCmec基因型及亚型。结果66株金黄色葡萄球菌JL童临床分离株经多重PCR检测,其中MRSA有7株（10．6％）,MSSA有59株（89．4％）;携带PVL基因金黄色葡萄球菌有31株,总阳性率为47．O％（31／66）,其中2株为MRSA,29株为MSSA,阳性率分别为28．6％（2／7）和49。2％（29／59）。2株MRSA都属于SCCmecIV型;31株PVL基因阳性分离株有21株分离自脓液,7株分离自血液,仅1株分离自痰液。结论儿童MSSA是携带PVL基因的主要菌株,携带PVL基因的金黄色葡萄球菌主要引起化脓性感染和血流感染。     

深圳住院患儿MRSA的分子分型和耐药性

目的了解深圳住院患儿耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)分子型别及其抗生素的耐药情况,为深圳地区和我国其他地区儿童MRSA感染的监控提供实验依据,为研究该地区儿童MRSA菌株的耐药机制提供依据。方法收集2014年1月至2015年10月深圳市儿童医院临床分离的社区获得性MRSA(community-acquired,CA-MRSA)、院内获得性MRSA(hospital-acquired,HA-MRSA)共129株,应用SCCmec、spa、MLST等方法进行分子分型及追溯同源性。结果 129株MRSA SCCmec分型中只有SCCmecⅤ型、SCCmecⅣ和未分出型别(non-typeableNT型),spa分型中t437是最主要型别,MLST分型ST59为最主要型别。两类MRSA对非β-内酰胺酶抗生素如红霉素、克林霉素耐药高达70%以上。结论深圳住院患儿MRSA中的ST59-SCCmecⅣ-t437为主要流行克隆。CA-MRSA与HA-MRSA在分子分型上无差异性。MRSA对部分非β-内酰胺酶抗生素高度耐药,暂无耐万古霉素MRSA菌株。     

耐碳氢霉烯类铜绿假单胞菌金属β-内酰胺酶和 基因捕获元件基因检测及同源性分析

摘要：目的　了解大连地区分离的耐碳氢霉烯类铜绿假单胞菌的金属β-内酰胺酶、整合子I和ISCR1的分布情况,并分析其基因多态性特征。方法　收集临床分离的89株耐亚胺培南铜绿假单胞菌,PCR检测金属酶、整合子I、ISCR1耐药基因。脉冲场凝胶电泳（PFGE）进行细菌基因分型。结果　89株亚胺培南耐药的铜绿假单胞菌中,ISCR1基因阳性菌25株（25/89,28%）,其中84%（21/25）为多重耐药,5类及以上药物耐药的菌株占64%（16/25）,金属酶基因阳性为11株（11/89,12%）,其中有8株携带IMP-1基因,3株携带VIM-2,整合子I基因阳性43株（43/89,48%）。但携带金属酶的菌株整合子I、ISCR1基因扩增均为阴性;PFGE分型结果显示：89株耐亚胺培南的铜绿假单胞菌分为15基因型（A~O）,其中A型46株、B型16株、C型4株、D型5株、E型4株、F型3株、G型2株、H型2株,I型~O型各有1株。基因型集中的A型~G型,各型中的菌株来源于不同医院,呈多态性,每群均存在克隆株。结论　基因捕获元件整合子I基因及ISCR1广泛分布在大连地区耐碳氢霉烯类铜绿假单胞菌中,并与细菌的多重耐药、泛耐药显著相关,特别是ISCR1基因;大连地区整合子I、ISCR1并未携带金属酶基因盒。PFGE结果提示本地区铜绿假单胞菌具有基因多态性,但仍存在高度同源性的流行优势基因型。     

Ⅲ型中国株HCVE2/NS1基因与已知分离株的同源性比较

利用逆转录套式ＰＣＲ扩增Ⅲ型中国株ＨＣＶＥ２／ＮＳ１基因片段,将其克隆到ｐｃＤＮＡ３载体上．采用双脱氧链终止法测定插入片段的核苷酸序列．并与已知分离株的相应区域进行同源性比较．首次克隆出Ⅲ型中国株ＨＣＶＥ２／ＮＳ１基因（ＨＣ－Ｗ１４）,其核苷酸序列与Ⅲ型日本株ＨＣＶ（ＨＣ－Ｊ６）该区域同源性为８８．３７％,其推定的氨基酸同源性为８９．２９％．而与已知的非Ⅲ型株ＨＣＶ该区域相比,核苷酸及氨基酸的同源性均相对较低．Ⅲ型中国株ＨＣＶ与Ⅱ型中国株ＨＣＶ在Ｅ２／ＮＳ１区域有较大的变异,揭示研制我国的ＨＣＶ疫苗应该考虑这种基因型之间的变异性．     

新疆猪粪便戊型肝炎病毒RNA的检测及序列分析

从戊型肝炎病毒(Hepatitis Evirus,HEV)IgG检测阳性的新疆某猪场采集70份猪粪便,利用逆转录套式聚合酶链方法(RT-nPCR),检测HEV RNA,其中13份为阳性,阳性率18．57％。将PCR扩增产物克隆到pMD18-T载体上,构建成重组质粒并测序,结果表明,13株猪源HEV分离株在HEV ORF2 348bp核苷酸序列的同源性为97．1％～100％,为同一基因型;与HEVⅠ、Ⅱ、Ⅲ、Ⅳ的同源性分别为74．1％-77．6％,71．6％-74．1％,73.3％～78．2％和82．8％-91.4％,与ⅣA亚型的同源性同源性最高达89．4％-91．4％。以该核苷酸片段绘制的基因进化树显示13株猪源HEV与HEV Ⅳ T1株在同一分支上,属基因Ⅳ型;与国内其他猪源HEV分离株该片段核苷酸序列的同源性为82．6％-91．3％,提示中国猪源HEV的基因型比较一致,同属HEV Ⅳ型。     

广西不同时期IBV分离株S1基因高变区Ⅰ的遗传变异分析

对广西1985-2007年间分离到的22株传染性支气管炎病毒（IBV）的S1基因高变区I（HVRI）进行序列测定,并与发表的其他IBV参考株及鸽子分离的冠状病毒株的基因序列进行比较和分析。系统进化关系显示毒株可分为5个基因群,其中有16个广西分离株属第1群,它们与鸽子冠状病毒分离株的氨基酸序列同源性较高,与Massachusetts（Mass）型疫苗株的同源性较低。有15个分离株在33-34位和34～35之间分别有4个和3个氨基酸残基的插入,GX-NN6在33～34位和34～35位之间则均有4个氨基酸残基的插入;GX-YL1、GX-NN2与常用的Mass型疫苗株的亲缘关系最近,同属于第Ⅱ群;GX-G、GX-XD与日本同一时期分离的毒株JP Miyazaki 89亲缘关系最近,属于第Ⅲ群;GX-YL6、GX-NN7与欧洲毒株4／91亲缘关系较近,属于第V群。结果表明广西存在着多种类型IBV毒株的流行,毒株S1基因HVRI碱基的突变或插入比较普遍,可导致其氨基酸序列的变化,绝大部分毒株与目前常用的Mass型疫苗株的亲缘关系较低。同一时期的分离株同源性较高,但无明显的地域性差异。     

鲍曼不动杆菌的基因分型及耐药性分析

目的分析上海某综合性医院不同科室来源的鲍曼不动杆菌菌株的同源性及耐药状况,了解鲍曼不动杆菌院内感染流行情况。方法采用重复序列PCR技术（REP-PCR）,对51株临床分离的鲍曼不动杆菌菌株进行基因分型,并用纸片扩散法进行药敏试验。结果51株鲍曼不动杆菌分为13个基因型,其中A型16株,为主要流行型别;C型、D型各6株;M型有5株;E型、F型和G型各3株;B型、H型和K型各2株;I型、J型、L型各1株。药敏试验结果显示分离出的菌株对常用抗菌药呈现出多重耐药的现象。其中对阿米卡星和亚胺培南的耐药性最低,均为33.3%;对头孢唑啉耐药性最高,为100%。结论鲍曼不动杆菌基因的同源性分析表明,该院存在着以A型鲍曼不动杆菌为主的感染流行,估计该型菌株可能以克隆株的形式播散。鲍曼不动杆菌的耐药性很强,应加强其耐药性监测,合理使用抗菌药物。     

Integron-bearing methicillin-resistant coagulase-negative staphylococci in South China, 2001-2004.

A total of 53 methicillin-resistant coagulase-negative staphylococci strains isolated in a hospital in Guangzhou, China, were analyzed to detect class 1 integrons and SCCmec typing. Thirty strains had the class 1 integrase (intI1) gene and 26 strains possessed the 3' conserved region of qacEDelta1-sul1. Four different types of gene cassette arrays were found and a highly prevalent array of dfrA12-orfF-aadA2 gene cassettes was observed. Thirty class 1 integron-positive coagulase-negative staphylococci strains were subjected to Southern hybridization analysis; the result showed that class 1 integrons were located on chromosome, not plasmid. According to the results of SCCmec typing for 30 integron-bearing MRCNS strains, five, 15 and five strains belonged to type I, II and III SCCmec, respectively, and five strains were untypeable. For 23 non-integron-bearing methicillin-resistant coagulase-negative staphylococci strains, four, nine and seven strains belonged to type I, II and III SCCmec, respectively, and three strains were untypeable. None of the strains belonged to type IV or V. Twenty-three coagulase-negative staphylococci isolates of three Staphylococcal species that contained the dfrA12-orfF-aadA2 gene cassette array were phylogenetically unrelated to each other by randomly amplified polymorphic DNA, indicating that the gene cassettes might be disseminated in the clinical strains by a horizontal gene transfer.     

Severity-related molecular differences among nineteen strains of dengue type 2 viruses

Comparative nucleotide sequencing was carried out on dengue type 2 virus (DEN-2) strains isolated from patients in Northeast Thailand during the epidemic season in 1993. The patients exhibited different clinical manifestations ranging from dengue fever (DF) to dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS). The results classified 19 DEN-2 strains into 3 subtypes according to nonsynonymous amino acid replacements. The strain isolated from a DSS patient eliciting secondary serological response belonged to subtype I, whereas 13 strains isolated from DHF patients with secondary response and 2 strains from DF patients with primary response belonged to subtype II. On the other hand, 3 strains isolated from DF cases evoking either primary or secondary response belonged to subtype III. These results suggest that subtype III virus infection could result in clinically milder manifestation irrespective of the serological response compared with subtype I or II viruses. The RNA secondary structure predicted for the 3' noncoding region showed 4 different structures (A, B, C, and D). The result also indicates that different subtypes of DEN-2 serotypes are circulating in a single epidemic in Thailand.     

Methicillin-resistant coagulase-negative staphylococci on pig farms as a reservoir of heterogeneous staphylococcal cassette chromosome mec elements

Methicillin-resistant Staphylococcus aureus (MRSA) likely originated by acquisition of the staphylococcal cassette chromosome mec (SCCmec) from coagulase-negative staphylococci (CNS). However, it is unknown whether the same SCCmec types are present in MRSA and CNS that reside in the same niche. Here we describe a study to determine the presence of a potential mecA reservoir among CNS recovered from 10 pig farms. The 44 strains belonged to 10 different Staphylococcus species. All S. aureus strains belonged to sequence type 398 (ST398), with SCCmec types V and IVa. Type IVc, as well as types III and VI, novel subtypes of type IV, and not-typeable types, were found in CNS. S. aureus, S. epidermidis, and S. haemolyticus shared SCCmec type V. The presence of SCCmec type IVc in several staphylococcal species isolated from one pig farm is noteworthy, suggesting exchange of this SCCmec type in CNS, but the general distribution of this SCCmec type still has to be established. In conclusion, this study shows that SCCmec types among staphylococcal species on pig farms are heterogeneous. On two farms, more than one recovered staphylococcal species harbored the same SCCmec type. We conclude that staphylococci on pig farms act as a reservoir of heterogeneous SCCmec elements. These staphylococci may act as a source for transfer of SCCmec to S. aureus.     

Phylogenetic analysis of the rDNA intergenic spacer subrepeats and its implication for the domestication history of foxtail millet, Setaria italica

We sequenced ribosomal DNA intergenic spacer subrepeats and their flanking regions of foxtail millet landraces from various regions in Europe and Asia and its wild ancestor to elucidate phylogenetic differentiation within each of types I–III found in our previous work and to elucidate relationships among these three types. Type I was classified into seven subtypes designated as Ia–Ig based on subrepeat sequences; C repeats downstream of those subrepeats are also polymorphic. Of these, subtypes Ia–Id and Ig were found in foxtail millet landraces. Subtypes Ia and Ib were distributed broadly throughout Asia and Europe. Subtype Ic was distributed in China, Korea and Japan. Subtype Id has a 20-bp deletion in subrepeat 3 and has a unique C repeat sequence. This subtype was found in a morphologically primitive landrace group from Afghanistan and northwestern Pakistan and differed greatly from other type I subtypes, implying that these landraces were domesticated independently. Subtypes Ig was found in a landrace from Pakistan and Ia and Ie–Ig were in six wild ancestor accessions. Type II was also highly polymorphic and four subtypes were found and designated as subtypes IIa–IId, but sequence analyses indicated type III as monomorphic. The present work indicates that type III should be classified as a subtype of type II (subtype IIe). Sequence polymorphism of subrepeats of types I–III indicated that subrepeats of subtype IIa are greatly divergent from others. Relationships among types I–III are much more complicated than anticipated based on previous RFLP work.     

Multiple-locus variable number of tandem repeats fingerprinting (MLVF) and virulence factor analysis of methicillin resistant Staphylococcus aureus SCCmec type III

Methicillin resistant Staphylococcus aureus (MRSA), particularly strains with type III staphylococcal cassette chromosome mec (SCCmec), represent a serious human pathogen in Tehran, Iran. The disease-causing capability depends on their ability to produce a wide variety of virulent factors. The prevalence of exotoxin genes and multiple-locus variable number of tandem repeats fingerprinting (MLVF) profile among MRSA isolates, from patients in Tehran, was evaluated by PCR and Multiplex-PCR. The MLVF typing of 144 MRSA isolates with type III SCCmec produced 5 different MLVF types. Generally, 97.2% (140/144) of all the isolates were positive for at least one of the tested exotoxin genes. The most prevalent genes were hld, found in 87.5% (126/144) of the isolates followed by lukE-lukD and hla found in 72.9% (105/144) and 70.1% (101/144) of the isolates, respectively. The tst gene, belonging to MLVF types I, IV and V, was found among three of the isolates from blood and wound samples. The sea gene was detected in 58.3% (84/144) of the isolates and the sed and see genes were found in one isolate with MLVF type V. The coexistence of genes was observed in the 87.5% (126/144) of the isolates. The rate of coexistence of hld with lukE-lukD, hla with lukE-lukD and sea with lukE-lukD were 66.7% (96/144), 44.4% (64/144) and 44.4% (64/144), respectively. The present study demonstrated that MRSA strains with type III SCCmec show different MLVF patterns and exotoxin profiles.     

Morphological characterization of the spermatogonial subtypes in the neonatal mouse testis

Spermatogenesis is the process of differentiation of diploid type A spermatogonia to haploid spermatozoa. Several subtypes of A spermatogonia have been characterized in the adult mouse testis. These include A-single (A(s)), A-paired (A(pr)), A-aligned (A(al)), and A1-A4. However, in the immature testis, very little information is available on subtypes and morphological features of type A spermatogonia. Six-day-old mouse testes, fixed either in Bouin solution or 5% glutaraldehyde, were embedded in paraffin and Epon, respectively. Thick sections (approximately 1 microm) of Epon-embedded tissue were stained with toluidine blue and revealed three subtypes of spermatogonia by light microscopy. The smallest spermatogonia (subtype I) appeared as single cells and exhibited a round or oval flattened nucleus with one or two prominent dense nucleoli and a characteristic unstained round and centrally located vacuole. These cells bound toluidine blue more avidly and appeared darker in comparison with the other cell types. Electron microscopy of thin sections (90 nm) revealed a finely granulated chromatin homogeneously distributed in the nucleus and sparse organelles in the cytoplasm. The second subtype of spermatogonia (subtype II) also displayed dark staining but was larger than subtype I; there was no central vacuole in the nucleus and heterochromatin clumps were observed. The largest subtype of spermatogonia (subtype III) showed large heterochromatin clumps and a pale staining nucleus. Intercellular bridges were noted between subtypes II and III. Based on the dye avidity, the three subtypes were classified as dark, transitional, and pale spermatogonia, respectively. Image analyses of 30 different cells of each subtype revealed a decline in gray-scale intensity from subtype I to III. Five-micrometer sections of paraffin-embedded tissue were immunoassayed with an antibody against the glial cell-derived neurotrophic factor family receptor alpha-1 (GFRalpha-1) receptor, a putative marker for undifferentiated spermatogonia, showing positive reaction only in germ cells. The pattern of GFRalpha-1 expression, coupled to the overall morphology of the cells, indicates that at this stage of development, mouse seminiferous tubules contain essentially A(s), A(pr), and possibly A(al) spermatogonia. Thus, the present study indicates the presence of subtypes of type A spermatogonia in the immature mouse testis similar to that described previously in adult monkey and man.     

Antibiotic Resistance and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus from Lower Respiratory Tract: Multi-resistance and High Prevalence of SCCmec III Type

We sought to study antibiotic resistance and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) from lower respiratory tracts of patients in Shanghai Pulmonary Hospital. Hundred and seven strains of MRSA were isolated from the patients of nine wards. The tests for antibiotic resistance (Kirby–Bauer paper dispersion method), the Panton–Valentine Leukocidin (PVL) and Staphyloccoccal Cassette Chromosome mec (SCCmec) genes (PCR), and homology analysis (32 randomly selected MRSA strains; pulsed-field gel electrophoresis) were carried out. All 107 strains were susceptible to vancomycin, teicoplanin, and linezolid, but highly or completely resistant to tetracycline, gentamicin, clindamycin, levofloxacin, azithromycin, erythromycin, trimethoprim/sulphamethoxazole, and ciprofloxacin. All 107 strains were negative for PVL gene. Most of the strains (81.3 %) were SCCmec III type, while the SCCmec II and IV types were less frequent (15.9 and 2.8 %, respectively). No SCCmec I or V types were detected. The homology analysis test showed that 32 MRSA strains could be divided into 4 groups: type A (25 strains), type B (5 strains), type C (1 strain), and type D (1 strain). The type A included 3 subtypes: A1 (17 strains), A2 (1 strain), and A3 (7 strains). Further, most of the strains were isolated from the same wards or units (e.g., intensive care unit or tuberculosis wards) within a short period of time, indicating an outbreak status. In conclusion, the observed MRSA from low respiratory tracts from patients at Shanghai Pulmonary Hospital were multiple-resistant, with the SCCmec III being the main documented genotype.     

Sensitivity in vitro of mature and immature mouse thymocytes to dexamethasone cytotoxicity and its correlation to poly ADP-ribosylation.

Mouse thymocytes were fractionated into heavy (subtype I, 79% of total cell number), medium (subtype II, 18%) and light (subtype III, 3%) ones by Percoll density centrifugation and they were identified as immature (subtype I and II) and mature (subtype III) thymocytes based on their proliferative response to mitogens. Whereas the nuclear activity of poly (ADP-ribose) polymerase (EC 2.4.2.30) in the subtype III was only one half that of denser subtypes, it increased two-fold upon mitogen stimulation. The sensitivity of three thymocyte subtypes to the dexamethasone cytotoxicity, as judged by the extent of the DNA cleavage, depletion of NAD and cell viability, was highest in the subtype I and lowest in the subtype III. The possible involvement of poly ADP-ribosylation in the apoptotic (programmed) cell death during intrathymic development of immature to mature thymocytes is discussed.     

Prospective surveillance of community-onset and healthcare-associated methicillin-resistant Staphylococcus aureus isolated from a university-affiliated hospital in Japan

We conducted a prospective comparative study of community-onset (CO) and healthcare-associated (HA) methicillin-resistant Staphylococcus aureus(MRSA) strains between 2000 and 2001 at Tokyo Women's Medical University Hospital (1,500 beds) in Japan. Of the 172 consecutive MRSA isolates analyzed, 13 (8%) were categorized as CO-MRSA. The mean age of patients with CO-MRSA was significantly younger than that of patients with HA-MRSA. Most CO-MRSA strains were isolated from skin and more likely to be susceptible to erythromycin, clindamycin, tetracycline, levofloxacin, and spectinomycin compared to HA-MRSA isolates. Pulsed-field gel electrophoresis (PFGE) analysis, staphylococcal cassette chromosome mec(SCCmec) typing, and multi-locus sequence typing (MLST) revealed that CO-MRSA strains were divided into the following multi-clones: 3 clone A: II: ST5 (PFGE type: SCCmec type: MLST sequence type); 1 L: II: ST5; 1 H: IV: ST1; 1 I: IV: ST81; 2 D: IV: ST8; 1 B: IV: ST89; 1 B: IV: ST379; and 3 B: IV: ST91. Of the 159 HAMRSA strains, 124 (78%) belonged to a single clone (PFGE clone A: SCCmec type II: tst and sec positive: coagulase type II: multi-drug resistance). Four CO-MRSA strains belonging to PFGE clone B: SCCmec type IV: MLST clonal complex 509 (ST89, 91, 379) had the exfoliative toxin B (etb) genes, but all CO-MRSA and HA-MRSA strains did not possess the Panton-Valentine leukocidin (pvl) genes. These results demonstrate that multiple lineages of CO-MRSA have the potential for dissemination in the community in Japan.