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TO THE EDITOR—Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) of clonal complex (CC) 398 were first reported to cause severe infections in humans in 2005 [1].Direct animal exposure is considered the most effective means of MRSA CC398 transmission from livestock to humans. However, about 20%–38% of MRSA CC398 cases among humans cannot be epidemiologically linked to direct livestock contact, indicating other transmission pathways [2]. As recently reported in this journal by Larsen et al [3], poultry meat may serve as a vehicle for livestock-to-human transmission. Here, we present similar findings for CC9/CC398 MRSA (displaying spa type t899 and related), which shares unique characteristics with human clinical isolates in Denmark as shown by Larsen et al [3], strongly supporting the implication of poultry, especially turkey meat, as the source of CC9/CC398. Of a collection of >14 000 compromising strains, mainly of food and livestock origin, we identified 37 CC9/CC398 MRSA strains in addition to those described by Larsen et al [3]. Among these, 31 strains (all of poultry origin) were positive for sak/scn/chp (indicative genes carried by the φSa3 prophage) by DNA microarray (see [4] for details), and 8 of 31 (7 from turkey meat, 1 from broiler meat) also carried the φAvβ prophage (SAAV_2008/2009 genetic markers, respectively), as tested by a polymerase chain reaction assay [5]. The nucleotide sequence of the 4 turkey meat isolates— 12S01032, 13-ST00660, 14-ST01012, and 14-ST00667—was determined using a PacBio RSII sequencer (Pacific Biosciences). De novo assembling of the readings by HGAP3 resulted in a closed draft genome for each isolate. In general, all 4 isolates exhibit similar genome features, chromosomal resistance genes, and virulence factors (Supplemental Material Table S1). However, distinct differences were

Turkey Meat as Source of CC9/CC398 Methicillin-Resistant Staphylococcus aureus in Humans?