Fig. 4. Circular visualization of MRSA complete genomes with HL21008 as a reference strain. The inner genome rings showed 100% identity (black), >= 98% (dark magenta) and >= 96% (red) for these reference isolates, reflecting similarity percentages determined by BLAST hit. Black peaks indicate GC content, and the innermost green and purple peaks denote positive and negative GC skews, respectively. MRSA: methicillin-resistant Staphylococcus aureus
Ann Clin Microbiol 2025;28(3):15. Complete genome analysis of representative methicillin-resistant Staphylococcus aureus clinical strains prevalent in Korea during 2014-2017 Download image
Fig. 3. Minimal spanning tree (MSTreeV2) based on cgMLST (left) and wgMLST (right) allelic profiles of the representative S. aureus strains, illustrating relationships between major clones. The Korean clinical MRSA strains are indicated by bolded rectangles. SCCmec II strains from Korea clustered closely with other representative SCCmec II strains. In contrast, SCCmec IVA strains of CC8 (HL16278 and HL18840) formed a distinct clade, separate from other SCCmec IV reference strains of CC8 in both allelic analysis of cgMLST and wgMLST, which is consistent with the findings of SNP-based phylogenetic tree analysis. A total of 2,009 cgMLST loci and 3,567 wgMLST loci were included in this analysis. MLST: multilocus sequence typing; SCCmec: staphylococcal cassette chromosome mec; SNP: single-nucleotide polymorphism
Ann Clin Microbiol 2025;28(3):15. Complete genome analysis of representative methicillin-resistant Staphylococcus aureus clinical strains prevalent in Korea during 2014-2017 Download image
Fig. 2. SNP-based phylogenetic tree with Snippy, Gubbins, and RAxML-NG analysis of the representative S. aureus strains, illustrating relationships between major clones. The Korean clinical MRSA strains are indicated by bolded rectangles. SCCmec II strains from Korea clustered closely with other representative SCCmec II strains. In contrast, SCCmec IVA strains of CC8 (HL16278 and HL18840) formed a distinct clade, separate from other SCCmec IV reference strains of CC8. A total of 112,574 SNP loci were included in the analysis.SNP: single-nucleotide polymorphism; MRSA: methicillin-resistant Staphylococcus aureus; SCCmec: staphylococcal cassette chromosome mec
Ann Clin Microbiol 2025;28(3):15. Complete genome analysis of representative methicillin-resistant Staphylococcus aureus clinical strains prevalent in Korea during 2014-2017 Download image
Fig. 1. Genome alignments of MRSA strains using multiple alignment of conserved genomic sequences (MAUVE). Pairwise comparisons of MRSA genome sequences revealed a large genomic inversion in strain HL17064. MRSA: methicillin-resistant Staphylococcus aureus
Ann Clin Microbiol 2025;28(3):15. Complete genome analysis of representative methicillin-resistant Staphylococcus aureus clinical strains prevalent in Korea during 2014-2017 Download image
Table 3. Virulence gene profiles of methicillin-resistant Staphylococcus aureus strains
Ann Clin Microbiol 2025;28(3):15. Complete genome analysis of representative methicillin-resistant Staphylococcus aureus clinical strains prevalent in Korea during 2014-2017 Download table Strain HL18888 HL20835 HL17064 HL18807 HL18883 HL21008 HL17078 HL18380 HL16278 HL18840 SCCmec type II II II II II II IV IV IVA IVA spa type t002 t002 t2460 t2460 t9353 t9353 t008 t008 t324 […]
Table 2. Phenotypic and genotypic antimicrobial susceptibility test (AST) results of methicillin-resistant Staphylococcus aureus strains
Ann Clin Microbiol 2025;28(3):15. Complete genome analysis of representative methicillin-resistant Staphylococcus aureus clinical strains prevalent in Korea during 2014-2017 Download table Strain HL18888 HL20835 HL17064 HL18807 HL18883 HL21008 HL17078 HL18380 HL16278 HL18840 SCCmec type II II II II II II IV IV IVA IVA spa type t002 t002 t2460 t2460 t9353 t9353 t008 t008 t324 t324 […]
Table 1. Summary metrics of the assembled (circular) and annotated genomes of methicillin-resistant Staphylococcus aureus strains
Ann Clin Microbiol 2025;28(3):15. Complete genome analysis of representative methicillin-resistant Staphylococcus aureus clinical strains prevalent in Korea during 2014-2017 Download table Strain HL18888 HL20835 HL17064 HL18807 HL18883 HL21008 HL17078 HL18380 HL16278 HL18840 SCCmec type II II II II II II IV IV IVA IVA spa type t002 t002 t2460 t2460 t9353 t9353 t008 t008 t324 […]
Fig. 2. Results of five years of testing applied according to the diagnostic guidelines. Abbreviations: GDH, glutamate dehydrogenase; CDI, C. difficile infection. Footnotes: CDI; CDI is likely to be present, No CDI; No further testing required. CDI is unlikely to be present, No CDI*: Clinical evaluation required (CDI or carriage of toxigenic C. difficile is possible) [2].
Ann Clin Microbiol 2025;28(3):14. Application of diagnostic algorithms for Clostridioides difficile infection using a GDH/ toxin test for five years from a single center in Korea: a diagnostic accuracy study Download image
Fig. 1. Summary of Discrepant Cases Between GDH/ Toxin, Toxin B PCR, and C. difficile Culture Results.
Ann Clin Microbiol 2025;28(3):14. Application of diagnostic algorithms for Clostridioides difficile infection using a GDH/ toxin test for five years from a single center in Korea: a diagnostic accuracy study Download image
Table 5. Comparison of C. difficile growth in cultured isolates and toxin production status with GDH positivity rate
Ann Clin Microbiol 2025;28(3):14. Application of diagnostic algorithms for Clostridioides difficile infection using a GDH/ toxin test for five years from a single center in Korea: a diagnostic accuracy study Download table Bacterial growth Toxin status GDH GDH positivity rate (%) + − 1 CFU Toxin+ 18 24 42.9 Toxin− 12 26 28.9 2 […]