Characterization of a widespread strain of methicillin-susceptible Staphylococcus aureus associated with nosocomial infections.

Thirty Staphylococcus aureus isolates from five hospitals were determined to exhibit borderline susceptibility to the antistaphylococcal penicillins. Of the isolates submitted for phage typing, 96% belonged to phage group 94/96, and 96% possessed a common plasmid, pBW15. Also, four reference borderline-susceptible isolates from the Centers for Disease Control belonged to phage group 94/96 and possessed pBW15. Screening of 43 other phage group 94/96 isolates demonstrated that 36 (84%) contained pBW15 and exhibited the borderline phenotype. In contrast, pBW15 was not identified among 10 penicillin-susceptible, 10 methicillin-resistant, and 40 penicillin-resistant but non-borderline-susceptible S. aureus. These data show a close association between pBW15, phage group 94/96, and the borderline-susceptible phenotype. Furthermore, these isolates were associated with infections in multiple institutions, suggesting the widespread dissemination of a clinically important and pathogenic strain of S. aureus.