<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_sjph-2020-0030_s_005">
<h3>Introduction</h3>
<p>Although the distinction between the Community-Associated-Methicillin-Resistant <italic>Staphylococcus aureus</italic> (CA-MRSA) and Hospital-Associated-Methicillin-Resistant <italic>S. aureus</italic> (HA-MRSA) has blurred in recent years, the CA-MRSA is an important group because of its potential to cause fulminant and severe infections. Its importance has further increased with the emergence of Livestock-Associated-Methicillin-Resistant <italic>S. aureus</italic> (LA-MRSA).</p></sec>
<sec id="j_sjph-2020-0030_s_006">
<h3>Methods</h3>
<p>In the present study we analysed clonal distributions and virulence factors in presumptive CA-MRSA isolated from January 2014 to December 2015 and compared the results with our previous study from 2010. Phenotypic definition for presumptive CA-MRSA was based on resistance to cefoxitin and oxacillin and susceptibility to at least two of the following four antibiotics: ciprofloxacin, erythromycin, clindamycin and gentamicin.</p></sec>
<sec id="j_sjph-2020-0030_s_007">
<h3>Results</h3>
<p>In 2014 and 2015 altogether 304 MRSA isolates fulfilled our screening phenotypic definition, 45 isolates were cultivated from clinical specimens and 259 from screening specimens. Sequence types ST398, LA-MRSA and <italic>mec</italic>C MRSA increased significantly in 2015 compared to 2010 (p-value &lt;0.05) and were spread over Slovenia.</p></sec>
<sec id="j_sjph-2020-0030_s_008">
<h3>Conclusion</h3>
<p>The clonal distribution of presumptive CA-MRSA has changed within the study period in Slovenia. In 2015 the most frequent clone among clinical and screening specimens was a pig-associated clone, ST398, but the number of confirmed ST398 infections remains low. While previously ST398 and <italic>mec</italic>C positive MRSA strains were geographically limited, they have spread throughout the country since 2010.</p></sec>
</abstract>

Introduction
Although the distinction between the Community-Associated-Methicillin-Resistant Staphylococcus aureus (CA-MRSA) and Hospital-Associated-Methicillin-Resistant S. aureus (HA-MRSA) has blurred in recent years, the CA-MRSA is an important group because of its potential to cause fulminant and severe infections. Its importance has further increased with the emergence of Livestock-Associated-Methicillin-Resistant S. aureus (LA-MRSA).

Methods
In the present study we analysed clonal distributions and virulence factors in presumptive CA-MRSA isolated from January 2014 to December 2015 and compared the results with our previous study from 2010. Phenotypic definition for presumptive CA-MRSA was based on resistance to cefoxitin and oxacillin and susceptibility to at least two of the following four antibiotics: ciprofloxacin, erythromycin, clindamycin and gentamicin.

Results
In 2014 and 2015 altogether 304 MRSA isolates fulfilled our screening phenotypic definition, 45 isolates were cultivated from clinical specimens and 259 from screening specimens. Sequence types ST398, LA-MRSA and mecC MRSA increased significantly in 2015 compared to 2010 (p-value <0.05) and were spread over Slovenia.

Conclusion
The clonal distribution of presumptive CA-MRSA has changed within the study period in Slovenia. In 2015 the most frequent clone among clinical and screening specimens was a pig-associated clone, ST398, but the number of confirmed ST398 infections remains low. While previously ST398 and mecC positive MRSA strains were geographically limited, they have spread throughout the country since 2010.

Changing epidemiology of presumptive community-associated-methicillin-resistant <italic>Staphylococcus aureus</italic> in Slovenia in 2014-2015 compared to 2010

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Changing epidemiology of presumptive community-associated-methicillin-resistant  in Slovenia in 2014-2015 compared to 2010

Introduction
Although the distinction between the Community-Associated-Methicillin-Resistant Staphylococcus aureus (CA-MRSA) and...

Changing epidemiology of presumptive community-associated-methicillin-resistant Staphylococcus aureus in Slovenia in 2014-2015 compared to 2010

Article Category: Research Article

Published Online: Oct 18, 2020

Page range: 236 - 244

Received: Jan 28, 2020

Accepted: Sep 16, 2020

DOI: https://doi.org/10.2478/sjph-2020-0030

Keywords
Slovenia, CA-MRSA, LA-MRSA, C, types, clones

© 2020 National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Changing epidemiology of presumptive community-associated-methicillin-resistant Staphylococcus aureus in Slovenia in 2014-2015 compared to 2010

Article Category: Research Article

Published Online: Oct 18, 2020

Page range: 236 - 244

Received: Jan 28, 2020

Accepted: Sep 16, 2020

DOI: https://doi.org/10.2478/sjph-2020-0030

KeywordsSlovenia, CA-MRSA, LA-MRSA, C, types, clones

© 2020 National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Slovenia, CA-MRSA, LA-MRSA, C, types, clones