Strains of Staphylococcus aureus were divided into groups on the basis of antimicrobial sensitivity and epidemiology and tested for protein A expression in a simple microtitre test, which detected the non-immunological binding of immunoglobulin to protein A on whole cells of S aureus. Isolates of the methicillin resistant strain prevalent in south east England (EMRSA) showed a low expression of protein A compared with the other strains of methicillin resistant S aureus (MRSA), other multiple resistant strains, and sensitive strains. Protein A and coagulase expression in 27 strains of MRSA from 15 countries associated with hospital outbreaks were compared with 27 strains of MRSA from 11 countries reported to be sporadic isolates. Twenty four of the 27 outbreak associated MRSA showed low expression of protein A and high expression of coagulase. Conversely, sporadic strains generally gave higher levels of protein A and a wide variety of coagulase reactions. The results suggest that many epidemic strains of MRSA may have phenotypic characteristics that distinguish them from sporadic strains.
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