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Of the 172 consecutive MRSA isolates analyzed, 13 (8%) were categorized as CO\u2010MRSA. The mean age of patients with CO\u2010MRSA was significantly younger than that of patients with HA\u2010MRSA. Most CO\u2010MRSA strains were isolated from skin and more likely to be susceptible to erythromycin, clindamycin, tetracycline, levofloxacin, and spectinomycin compared to HA\u2010MRSA isolates. Pulsed\u2010field gel electrophoresis (PFGE) analysis, staphylococcal cassette chromosome <jats:italic>mec<\/jats:italic> (SCC<jats:italic>mec<\/jats:italic>) typing, and multi\u2010locus sequence typing (MLST) revealed that CO\u2010MRSA strains were divided into the following multi\u2010clones: 3 clone A: II: ST5 (PFGE type: SCC<jats:italic>mec<\/jats:italic> 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 HA\u2010MRSA strains, 124 (78%) belonged to a single clone (PFGE clone A: SCC<jats:italic>mec<\/jats:italic> type II: <jats:italic>tst<\/jats:italic> and <jats:italic>sec<\/jats:italic> positive: coagulase type II: multi\u2010drug resistance). Four CO\u2010MRSA strains belonging to PFGE clone B: SCC<jats:italic>mec<\/jats:italic> type IV: MLST clonal complex 509 (ST89, 91, 379) had the exfoliative toxin B (<jats:italic>etb<\/jats:italic>) genes, but all CO\u2010MRSA and HA\u2010MRSA strains did not possess the Panton\u2010Valentine leukocidin (<jats:italic>pvl<\/jats:italic>) genes. These results demonstrate that multiple lineages of CO\u2010MRSA have the potential for dissemination in the community in Japan.<\/jats:p>","DOI":"10.1111\/j.1348-0421.2005.tb03691.x","type":"journal-article","created":{"date-parts":[[2013,11,14]],"date-time":"2013-11-14T15:08:45Z","timestamp":1384441725000},"page":"959-970","source":"Crossref","is-referenced-by-count":43,"title":["Prospective Surveillance of Community\u2010Onset and Healthcare\u2010Associated Methicillin\u2010Resistant <i>Staphylococcus aureus<\/i> Isolated from a University\u2010Affiliated Hospital in Japan"],"prefix":"10.1111","volume":"49","author":[{"given":"Chuncheng","family":"Piao","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Tokyo Women's Medical University School of Medicine  Shinjuku\u2010ku Tokyo 162\u20108666 Japan"}]},{"given":"Toshiko","family":"Karasawa","sequence":"additional","affiliation":[{"name":"Central Clinical Laboratory Tokyo Women's Medical University School of Medicine  Shinjuku\u2010ku Tokyo 162\u20108666 Japan"}]},{"given":"Kyoichi","family":"Totsuka","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Tokyo Women's Medical University School of Medicine  Shinjuku\u2010ku Tokyo 162\u20108666 Japan"}]},{"given":"Takehiko","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Tokyo Women's Medical University School of Medicine  Shinjuku\u2010ku Tokyo 162\u20108666 Japan"},{"name":"Department of Microbiology and Immunology Tokyo Women's Medical University School of Medicine  Shinjuku\u2010ku Tokyo 162\u20108666 Japan"}]},{"given":"Ken","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Tokyo Women's Medical University School of Medicine  Shinjuku\u2010ku Tokyo 162\u20108666 Japan"}]}],"member":"311","published-online":{"date-parts":[[2013,11,14]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.8.3806-3815.2003"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2000.6.253"},{"key":"e_1_2_2_4_1","doi-asserted-by":"crossref","first-page":"2548","DOI":"10.1128\/JCM.36.9.2548-2553.1998","article-title":"Rapid and specific detection of toxigenic Staphylococcus aureus: use of two multiplex PCR enzyme immunoassays for application and hybridization of staphylococcal enterotoxin genes, exfoliative toxin genes and toxic shock syndrome toxin 1 gene","volume":"36","author":"Becker K.","year":"1998","journal-title":"J. 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