USA300 Methicillin-resistant Staphylococcus aureus in Cuba

The predominant clone was of the spa type t149, followed by community-associated MRSA USA300.We report the first molecular typing results of MRSA isolates from Cuba.In this study we aim to investigate the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates from 4 major hospitals in Cuba. MRSA is an increasing problem in the Americas and the Caribbean including Cuba[1-4]. Although epidemiological data on MRSA in Cuba is available, so far no molecular typing has been performed[1,3]. Percentages of nosocomial S. aureus isolates resistant to methicillin ranges between 6% in Cuba to 85% in Peru[1]. Recently, MRSA isolates are emerging as significant pathogens in the community [3,5]. In the USA, the most prevalent CA- MRSA clone is USA300 (CC8, spa type t008, PVL+). In settings with a high prevalence of MRSA, MRSA is an important cause of nosocomial infections [6]. High MRSA prevalence rates have major consequences for infection control policies in hospitals. Microbiological surveillance is an important tool to evaluate this local infection control policy and to assess which microorganisms are causative pathogens in these settings. Surveillance per se probably results in a decrease of nosocomial infections as is shown by the International Nosocomial Infection Control Consortium (INICC)[7]. INICC and the World Health Organization's global program of "clean care, is safer care" advocate cost-effectiveness of microbiological surveillance in low-resource settings. Despite the fact that device-associated (DA-) and other healthcare-associated infection (HAI) rates are much higher in low and middle income countries, most studies on MRSA and HAIs have been conducted in high resource countries [7-9]. A prospective cohort study in two adult intensive care units of Cuban university hospitals showed a DA-HAI overall rate of 30.6 (95% CI 27.8-33.5) per 1000 ICU-days. DA-HAI rates for Ventilator Associated Pneumonia (VAP), Central line-associa