Changes in the Population of @entity3256 -Resistant XXXX and Dissemination of Antimicrobial-Resistant Phenotypes in the Netherlands.

@entity3256 @entity235 @entity12088 @entity23819 @entity6793
@entity3256 -resistant @entity23819 (MRSP), which is often multidrug resistant (MDR), has recently emerged as a threat to @entity235 health worldwide. Knowledge of the temporal distribution of specific MRSP lineages, their antimicrobial resistance phenotypes, and their association with clinical conditions may help us to understand the emergence and spread of MRSP in @entity235 . The aim of this study was to determine the yearly proportions of MRSP lineages and their antimicrobial-resistant phenotypes in the Netherlands and to examine possible associations with clinical conditions. MRSP was first isolated from a @entity235 specimen submitted for diagnostics to the Faculty of Veterinary Medicine of Utrecht University in 2004. The annual cumulative incidence of MRSP among @entity23819 increased from 0.9% in 2004 to 7% in 2013. MRSP was significantly associated with @entity6793 and, to a lesser extent, with wound @entity12088 . Multilocus sequence typing (MLST) of 478 MRSP isolates yielded 39 sequence types (ST) belonging to 4 clonal complexes (CC) and 15 singletons. CC71 was the dominant lineage that emerged since 2004, and CC258, CC45, and several unlinked isolates became more frequent during the following years. All but two strains conferred an MDR phenotype, but strains belonging to CC258 or singletons were less resistant. In conclusion, our study showed that MDR CC71 emerged as the dominant lineage from 2004 and onward and that less-resistant lineages were partly replacing CC71.
