Evolution of methicillin-resistant Staphylococcus aureus clones in Latin America

Evolution of MRSA clones in Latin American countries: time line to show where and when clones were isolated.

B=Brazilian MRSA clone and variants; C=Cordobes/Chilean MRSA clone; CA=CMRSA-6 (Canadian MRSA clone); H=Hungarian MRSA clone; I=Iberian-related MRSA clone; M=Mexican MRSA clone; MW2=MW2-related MRSA clone; NY/J=New York/Japan-related MRSA clone; P=pediatric-related MRSA clone; O=Oceania Southwest Pacific MRSA clone; U=Uruguayan hospital MRSA clone; UR6=Uruguayan community outbreak MRSA clone; U3=USA-300 MRSA clone; U8=USA-800 MRSA clone; W=Western Australia 1 MRSA clone.

*First identification of Brazilian MRSA isolates with vancomycin and teicoplanin heterogeneous resistance (1996–1998).

Relationship of Latin American MRSA strains to clonal complexes (CC5, CC8 and CC30) and international MRSA clones according to the model put forward by Robinson and Enright (2003).¹¹

Major international clones are indicated in bold type. Sequence types (ST) and SCCmec types (I to IV and variants) of MRSA clones are indicated where known. Reference numbers are shown in superscript. No Latin American isolates belonging to CC22 or CC45 were described. UR6=Uruguayan community outbreak MRSA clone; OSPC=Oceania Southwest Pacific MRSA clone; WA1=Western Australia 1 MRSA clone.

Distribution and dissemination of MRSA clones in Latin American countries and the Caribbean.

Shading indicates the dissemination of the Brazilian clone. Data were not available for countries shaded in dark gray. Reference numbers are shown in superscript. Underlined text shows multidrug-resistant clones.

^†Includes isolates from community-acquired infection or colonization.

MW2=MW2-related MRSA clone; NY/J=New York/Japan-related MRSA clone; OSPC=Oceania Southwest Pacific MRSA clone; UR6=Uruguayan community outbreak MRSA clone; WA1=Western Australia 1 MRSA clone.