93 Genetic determinants in MRSA carriage 5 Table 4. Virulence factors and genes stratified by decolonization outcome Virulence factors Genes Treatment failure Successful decolonization P N = 12 (%) N = 44 (%) Capsule type 5 cap5H 6 (50.0) 28 (63.6) 0.51 cap5J 6 (50.0) 28 (63.6) 0.51 cap5K 6 (50.0) 27 (61.4) 0.52 Capsule type 8 cap8H 5 (41.7) 16 (36.4) 0.75 cap8I 6 (50.0) 16 (36.4) 0.51 cap8J 6 (50.0) 16 (36.4) 0.51 cap8K 6 (50.0) 16 (36.4) 0.51 Chemotaxis-inhibiting protein chp 6 (50.0) 27 (61.4) 0.52 Enolase eno 11 (91.7) 44 (100.0) 0.21 Fibrinogen-binding protein fib 11 (91.7) 36 (81.8) 0.67 Leukocidin D/E lukD 8 (66.7) 24 (54.5) 0.53 lukE 8 (66.7) 23 (52.3) 0.52 Panton-Valentine leucocidin lukF_PV 2 (16.7) 13 (29.5) 0.48 lukS_PV 2 (16.7) 13 (29.5) 0.48 Staphylokinase sak 11 (91.7) 34 (77.3) 0.67 Staphylococcal complement inhibitor scn 11 (91.7) 38 (86.4) 1.00 Enterotoxin genes seg 7 (58.3) 20 (45.5) 0.52 sei 7 (58.3) 20 (45.5) 0.52 sem 7 (58.3) 20 (45.5) 0.52 sen 7 (58.3) 18 (40.9) 0.51 seo 7 (58.3) 20 (45.5) 0.52 seu 6 (50.0) 17 (38.6) 0.52 seh 2 (16.7) 1 (2.3) 0.11 sek 2 (16.7) 5 (11.4) 0.64 seq 2 (16.7) 3 (6.8) 0.31 sea_sep 2 (16.7) 9 (20.5) 1.00 sej 1 (8.3) 6 (13.6) 1.00 ser 1 (8.3) 6 (13.6) 1.00 Serine protease A/B/E splA 8 (66.7) 20 (45.5) 0.33 splB 8 (66.7) 21 (47.7) 0.33 splE 5 (41.7) 13 (29.5) 0.50 Toxic shock syndrome toxin-1 tst1 0 (0.0) 6 (13.6) 0.32 The resistance to fluoroquinolones is generally high in healthcare-associated MRSA [22]. Successful hospital-adapted ciprofloxacin-resistant lineages have emerged among several nosocomial species as E. coli, K. pneumoniae, vancomycin-resistant E. faecium, and MRSA. These lineages have acquired stable point-mutations in gyrase and/or topoisomerase IV enzymes [23]. It is unsure what drives this evolution, besides the exposure to fluoroquinolones.
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