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Approximately 39% of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 239 (ST239)-like bloodstream isolates from Liverpool Hospital (obtained between 1997 and 2008) carry an arginine catabolic mobile element (ACME). Whole-genome sequencing revealed that an ACME II variant is located between orfX and SCCmec III, and based on pulsed-field gel electrophoresis patterns and temporal relationships of all ST239-like isolates (n = 360), ACME carriage may have contributed to subpulsotype strain replacement.

antimicrobial agents and chemotherapy

Carriage of an ACME II Variant May Have Contributed to Methicillin-Resistant Staphylococcus aureus Sequence Type 239-Like Strain Replacement in Liverpool Hospital, Sydney, Australia