ABSTRACT Introduction: The oral mucosa can be affected by traumatic lesions, viral, fungal and bacterial infections, as well as by benign and, malignant tumors, development malformations and autoinmmune genetic and psychosomatic diseases, among others. Objective: To characterize clinically and epidemiologically patients with oral cancer and other lesions of the bucomaxillofacial complex. Methods: A descriptive and cross-sectional study of 56 patients of both sexes, with some evident morphological change in the bucomaxillofacial complex, assisted in the Stomatology Service of Eduardo Mesa Llull Polyclinic, II Frente municipality in Santiago de Cuba was carried out from September, 2015 to the same month in 2017. Among the analyzed variables there were: age, sex, skin color, anatomical localization, definitive diagnosis and histological type. The primary information was obtained from the interviews and of the medical records. On the other hand, an exhaustive physical examination was made and a sample for biopsy was taken with the aim of diagnosing the present disorders. Results: The 35-59 years patients, mestizos and the female sex prevailed in the case material. The most affected areas were the cheek mucosa and the lower lip for the oral cancer and the residual alveolar edges and the cheek mucosa for the other lesions. Oral leukoplakia was the most common definitive diagnosis and the carcinoma epidermoid the preponderant histological variety. Conclusions: Health education, promotion and prevention, are essential in the Stomatology environment, so that it is imperative to evaluate and renew programs for they to have more influence on education and prevention.

RESUMEN Introducción: La mucosa bucal puede estar afectada por lesiones traumáticas, infecciones virales, micóticas y bacterianas, así como también por tumores benignos y malignos, malformaciones del desarrollo y enfermedades autoinmunes, genéticas y psicosomáticas, entre otras. Objetivo: Caracterizar clínica y epidemiológicamente a pacientes con cáncer bucal y otras lesiones del complejo bucomaxilofacial. Métodos: Se realizó un estudio descriptivo y transversal de 56 pacientes de ambos sexos, con alguna alteración morfológica evidente en el complejo bucomaxilofacial, atendidos en el Servicio de Estomatología del Policlínico Eduardo Mesa Llull del municipio II Frente de Santiago de Cuba, desde septiembre de 2015 hasta igual mes de 2017. Entre las variables analizadas figuraron: edad, sexo, color de la piel, localización anatómica, diagnóstico definitivo y tipo histológico. La información primaria se obtuvo de las entrevistas y de las historias clínicas. Por otra parte, se efectuó un examen físico exhaustivo y se tomó muestra para biopsia con vistas a diagnosticar las afecciones presentes. Resultados: En la casuística prevalecieron los pacientes de 35-59 años, los mestizos y el sexo femenino. Las zonas mayormente afectadas fueron la mucosa del carrillo y el labio inferior para el cáncer bucal y los rebordes alveolares residuales y la mucosa del carrillo para las otras lesiones. La leucoplasia bucal resultó el diagnóstico definitivo más común y el carcinoma epidermoide la variedad histológica preponderante. Conclusiones: La educación para la salud, la promoción y la prevención resultan primordiales en el mundo de la estomatología, de ahí que se impone evaluar y renovar los programas para que esta sea más preventiva y educacional.

The aim of this study was to assess the risk factors and clinical and microbiological characteristics of community-acquired pneumonia (CAP) in adult patients in Mexico. Streptococcus pneumoniae classified as the causative agent of CAP in adult patients and patients with invasive S. pneumoniae isolates presented to three tertiary teaching hospitals during the 15-year study period were selected. Serotyping and susceptibility testing were performed for all included isolates. Clinical and demographic data were recorded. A total of 96 patients infected with S. pneumoniae (71 with CAP, 25 with invasive disease) were included. The CAP group involved more males (74.6%) than the invasive disease group (p = 0.03). Head trauma was more common in the CAP group (21.1%) than in the invasive disease group (4.0%; p = 0.03). The most prevalent serotype was 19A, followed by serotypes 3 and 23F. After the introduction of the heptavalent conjugated pneumococcal vaccine (PCV7), the prevalence of included serotypes declined significantly; no such change was found after the introduction of the PCV13 vaccine, including in the prevalence of serotype 19A. Susceptibility to all antimicrobials tested except vancomycin declined over the study period. In conclusion, head trauma was the most common comorbidity in the CAP group. The most prevalent serotype was 19A. Decreased susceptibility to most antimicrobials tested was observed.

El objetivo de este estudio fue evaluar los factores de riesgo y las características clínicas y microbiológicas de la neumonía adquirida en la comunidad (NAC) en pacientes adultos en México. Se seleccionaron pacientes adultos con NAC con Streptococcus pneumoniae como agente causal y pacientes con aislamientos invasivos de S. pneumoniae que concurrieron a tres hospitales de enseñanza de tercer nivel durante el período de estudio de 15 anos (2000-2015). Se realizaron pruebas de serotipificación y sensibilidad con todos los aislados incluidos. Se colectaron los datos clínicos y demográficos. Se incluyeron en total 96 pacientes infectados con S. pneumoniae (71 con NAC y 25 con enfermedad invasiva). El grupo con NAC incluía más varones (74,6%) que el grupo de enfermedad invasiva (p = 0,03). El traumatismo craneoencefálico fue más frecuente en el grupo NAC (21,1%) queen el grupo con enfermedad invasiva (4,0%; p = 0,03). El serotipo más frecuente fue 19A, seguido de los serotipos 3 y 23F. Después de la introducción de la vacuna antineumocócica conjugada heptavalente (PCV7), la prevalencia de los serotipos incluidos en aquella disminuyó significativamente; no sucedió lo mismo después de la introducción de la PCV13, incluso en relación con la prevalencia del serotipo 19A. La sensibilidad a todos los antimicrobianos evaluados, excepto la vancomicina, disminuyó durante el período de estudio. En conclusión, el traumatismo craneoencefálico fue la comorbilidad más frecuente en el grupo con NAC. El serotipo más frecuente fue el 19A, y se observó disminución de la sensibilidad a la mayoría de los antimicrobianos probados a lo largo del período considerado.

ABSTRACT OBJECTIVE: To determine effects of flaxseed oil over plasma concentrations of resistin in women with diagnosis of polycystic ovary syndrome. METHODS: A research was performed in 195 women with diagnosis of polycystic ovary syndrome who were treated with flaxseed oil for 12 weeks (n = 97; group A) and controls treated with placebo (n = 98, group B). Overall characteristics, hormonal, metabolic, lipid profile and resistin concentrations were compared. RESULTS: There were no significant differences between the two groups in relation to the general characteristics (p = ns). There were also no significant differences in hormonal, glycemia and HOMA concentrations between the groups (p = ns). The women in group A and B did not show statistically significant differences in total calories intake, carbohydrate, protein and total fat intake between initial and final values of study (p = ns). Women in group A had decreased concentrations of total cholesterol, low-density lipoprotein and triglycerides (p < 0.0001). Mean values of plasma resistin showed a significant reduction after treatment (p < 0.0001). No statistically significant differences were found in the mean values of the different variables in women of group B (p = ns). CONCLUSION: Flaxseed oil produced a significant decrease in plasma resistin concentrations in women with polycystic ovary syndrome after 12 weeks of consumption.

RESUMEN OBJETIVO: Determinar el efecto del aceite de linaza sobre las concentraciones plasmáticas de resistina en mujeres con diagnóstico de síndrome de ovarios poliquísticos. METODOS: se realizó un estudio en 195 mujeres con diagnóstico de SOPQ que fueron tratadas con aceite de linaza por 12 semanas (n = 97; grupo A) y controles tratados con placebo (n = 98, grupo B). Se compararon las características generales, concentraciones hormonales, perfil lipídico y resistina. RESULTADOS: No se encontraron diferencias significativas entre ambos grupos con relación a las características generales (p = ns). Tampoco se encontraron diferencias significativas en las concentraciones de hormonales, glicemia y HOMA entre los grupos (p = ns). Las mujeres del grupo A y B no mostraron diferencias estadísticamente significativas en la ingesta total, ingesta de carbohidratos, proteínas y grasas totales entre los valores al inicio y al final del estudio (p = ns). Las mujeres del grupo A presentaron disminución concentraciones de colesterol total lipoproteínas de baja densidad y triglicéridos (p < 0,0001). Los valores promedio de resistina mostraron disminución significativa luego del tratamiento (p < 0,0001). No se encontraron diferencias estadísticamente significativas en los valores promedio de las diferentes variables en las mujeres del grupo B (p = ns). CONCLUSION: El aceite de linaza produjo disminución significativa en las concentraciones plasmáticas de resistina en mujeres con síndrome de ovarios poliquísticos luego de 12 semanas de consumo.

ABSTRACT: Objective: To compare plasma concentrations of visfatin in women with diagnosis of polycystic ovary syndrome treated with omega-3 fatty acid supplementation. Material and methods: A research was performed in 195 women with diagnosis of polycystic ovary syndrome who were treated with omega-3 fatty acids for 12 weeks (n = 97; group A) and controls treated with placebo (n = 98, group B). Overall characteristics, hormonal concentrations, insulin resistance markers and visfatin concentrations were compared. Results: There were no significant differences between the two groups in relation to the general characteristics (p = ns). There were also no significant differences in hormonal, glycemia and HOMA concentrations between the groups (p = ns). The women in group A and B did not show statistically significant differences in total calories intake, carbohydrate, protein and total fat intake between initial and final values of study (p = ns). Women in group A had lower values of fasting insulin, HOMA-IR and area under curve of insulin and glycemia (p <0.0001). Mean values of visfatin also showed a statistically significant reduction after treatment (p <0.0001). No statistically significant differences were found in the mean values of the different variables in women of group B (p = ns). Conclusion: Omega-3 fatty acid supplementation for 12 weeks produced a significant decrease of plasma concentrations of visfatin in women with polycystic ovary syndrome.

RESUMEN: Objetivo: Comparar las concentraciones plasmáticas de visfatina en mujeres con diagnóstico de síndrome de ovarios poliquísticos tratadas con suplementación de ácidos grasos omega-3. Material y métodos: Se realizó un estudio en 195 mujeres con diagnóstico de SOPQ que fueron tratadas con ácidos grasos omega 3 por 12 semanas (n = 97; grupo A) y controles tratados con placebo (n = 98, grupo B). Se compararon las características generales, concentraciones hormonales, de indicadores de insulinorresistencia y de visfatina. Resultados: No se encontraron diferencias significativas entre ambos grupos con relación a las características generales (p = ns). Tampoco se encontraron diferencias significativas en las concentraciones hormonales, glicemia y HOMA entre los grupos (p = ns). Las mujeres del grupo A y B no mostraron diferencias estadísticamente significativas en la ingesta total, ingesta de carbohidratos, proteínas y grasas totales entre los valores al inicio y al final del estudio (p = ns). Las mujeres del grupo A presentaron disminución de los valores de insulina en ayunas, HOMA-IR y área bajo la curva de insulina y glicemia (p <0,0001). Los valores promedio de visfatina también mostraron disminución significativa luego del tratamiento (p <0,0001). No se encontraron diferencias estadísticamente significativas en los valores promedio de estas variables en las mujeres del grupo B (p = ns). Conclusión: La suplementación de ácidos grasos omega-3 por 12 semanas produce disminución significativa en las concentraciones plasmáticas de visfatina en mujeres con síndrome de ovarios poliquísticos.

Abstract Introduction The epidemiology of Clostridium difficile infection (CDI) has changed in the last two decades. There is a lack of information regarding incidence and severity of CDI, especially in the developing world. Methods This was a retrospective and observational study from four hospitals of three Mexican cities. Patients were diagnosed with CDI when presented with loose stools and had at least one of the following tests positive: toxins assay, real-time PCR, or an endoscopic image compatible with pseudomembranous colitis. CDI was classified according to international guidelines. Demographic and clinical data as well as information regarding total hospital admissions, total length-of-hospital stay, and other variables related to hospitalization were gathered from the epidemiology and administration departments of each hospital. Results A total of 2050 hospital beds were analyzed with 288,171 patients hospitalized accumulating 1,576,446 days of hospitalization during the study period. The average rate of CDI per 1000 hospital-days was lower than the rates reported in the US and Europe, although in 2015 CDI rates were almost persistently above the mean rate for the study period. More than half of PCR positive patients were ribotype 027. Conclusion Hospital rates of CDI are increasing in Mexican hospitals with a predominance of infections caused by ribotype 027.

Abstract The mechanisms contributing to persistence of coagulase-negative staphylococci are diverse; to better understanding of their dynamics, the characterization of nosocomial isolates is needed. Our aim was to characterize phenotypic and molecular characteristics of Staphylococcus epidermidis and Staphylococcus haemolyticus human blood isolates from two tertiary care hospitals in Mexico, the Hospital Universitario in Monterrey and the Hospital Civil in Guadalajara. Antimicrobial susceptibility was determined. Biofilm formation was assessed by crystal violet staining. Detection of the ica operon and Staphylococcal Cassette Chromosome mec typing were performed by PCR. Clonal relatedness was determined by Pulsed-fiel gel electrophoresis and Multi locus sequence typing. Methicillin-resistance was 85.5% and 93.2% for S. epidermidis and S. haemolyticus, respectively. Both species showed resistance >70% to norfloxacin, clindamycin, levofloxacin, trimethoprim/sulfamethoxazole, and erythromycin. Three S. epidermidis and two S. haemolyticus isolates were linezolid-resistant (one isolate of each species was cfr+). Most isolates of both species were strong biofilm producers (92.8% of S. epidermidis and 72.9% of S. haemolyticus). The ica operon was amplified in 36 (43.4%) S. epidermidis isolates. SCCmec type IV was found in 47.2% of the S. epidermidis isolates and SCCmec type V in 14.5% of S. haemolyticus isolates. No clonal relatedness was found in either species. Resistance to clindamycin, levofloxacin, erythromycin, oxacillin, and cefoxitin was associated with biofilm production for both species (p < 0.05). A G2576T mutation in 23S rRNA gene was detected in an S. haemolyticus linezolid-resistant isolate. All linezolid-resistant S. epidermidis isolates belonged to ST23; isolate with SCCmec type IV belonged to ST7, and isolate with SCCmec type III belonged to ST2. This is the first report of ST7 in Mexico. There was a high genetic diversity in both species, though both species shared characteristics that may contibute to virulence.

Abstract: Objective: To determine the frequency of nine sexually transmitted pathogens, coinfections and risk factors in patients attending obstetrics and gynecology clinics in Jalisco, Mexico. Materials and methods: Samples from 662 patients attending obstetrics and gynecology clinics were analyzed. Treponema pallidum, HIV, and HCV were detected by serology. HPV was detected by Polimerase Chain Reaction (PCR), and its genotype was determined by Restriction Fragment Length Polymorphism (RFLP). Trichomonas vaginalis, HSV-1, HSV-2, Mycoplasma genitalium, Neisseria gonorrhoeae and T. pallidum were detected by multiplex PCR. Results: By serology, HIV frequency was 6.8%, T. pallidum was 2.26%, and HCV was 0.15%. By PCR, HPV frequency was 13.9%, (more frequent genotype was 16, 33.7%), followed by T. vaginalis (14.2%), HSV-1 (8.5%), M. genitalium (2,41%), N. gonorrhoeae (2.11%), HSV-2 (1.8%), and T. pallidum (1.05%). Patients infected with T. vaginalis were more likely to have multiple coinfections (p = 0.01). Conclusion: The frequency of HPV, HVS-1, HSV-2, M. genitalium and T. vaginalis was lower than that reported. However, a high frequency of HIV, T. pallidum, and N. gonorrhoeae was detected.

Resumen: Objetivo: Determinar la frecuencia de nueve patógenos de transmisión sexual, coinfecciones y factores de riesgo en pacientes que acudieron a una consulta de ginecología y obstetricia en Jalisco, México. Material y métodos: Se analizaron muestras de 662 pacientes que asistieron a la consulta de ginecología y obstetricia. Se detectaron Treponema pallidum, VIH y VHC mediante serología. Se detectó VPH por Reacción de Cadena de Polimerasa (PCR) y sus genotipos se detectaron por Polimorfismos de Longitud de Fragmentos de Restricción (RFLP). Se detectaron Trichomonas vaginalis, VHS-1,VHS-2, Mycoplasma genitalium, Neisseria gonorrhoeae y T. pallidum por PCR múltiple. Resultados: Por serología, la frecuencia deVIH fue 6.8%, de T. pallidum fue 2.26% y deVHC fue 0.15%. Por PCR, la frecuencia más alta fue deVPH (13.9%, el genotipo más frecuente fue el 16, 33.7%), seguida deT. vaginalis (14.2%), VHS-1 (8.5%), M. genitalium (2.41%), N. gonorrhoeae (2.11%), VHS-2 (1.8%) y T. pallidum (1.05%). Los pacientes infectados con T. vaginalis presentaron más probabilidades de tener múltiples coinfecciones (p = 0.01). Conclusiones: La frecuencia de infección por VPH, VHS-1,VHS-2, M.genitalium y T. vaginalis fue menor a lo reportado. Sin embargo, se detectó una alta frecuencia de VIH, T. pallidum, y N. gonorrhoeae.

Abstract: Objective: To determine the frequency of nine sexually transmitted pathogens, coinfections and risk factors in patients attending obstetrics and gynecology clinics in Jalisco, Mexico. Materials and methods: Samples from 662 patients attending obstetrics and gynecology clinics were analyzed. Treponema pallidum, HIV, and HCV were detected by serology. HPV was detected by Polimerase Chain Reaction (PCR), and its genotype was determined by Restriction Fragment Length Polymorphism (RFLP). Trichomonas vaginalis, HSV-1, HSV-2, Mycoplasma genitalium, Neisseria gonorrhoeae and T. pallidum were detected by multiplex PCR. Results: By serology, HIV frequency was 6.8%, T. pallidum was 2.26%, and HCV was 0.15%. By PCR, HPV frequency was 13.9%, (more frequent genotype was 16, 33.7%), followed by T. vaginalis (14.2%), HSV-1 (8.5%), M. genitalium (2,41%), N. gonorrhoeae (2.11%), HSV-2 (1.8%), and T. pallidum (1.05%). Patients infected with T. vaginalis were more likely to have multiple coinfections (p = 0.01). Conclusion: The frequency of HPV, HVS-1, HSV-2, M. genitalium and T. vaginalis was lower than that reported. However, a high frequency of HIV, T. pallidum, and N. gonorrhoeae was detected.

Resumen: Objetivo: Determinar la frecuencia de nueve patógenos de transmisión sexual, coinfecciones y factores de riesgo en pacientes que acudieron a una consulta de ginecología y obstetricia en Jalisco, México. Material y métodos: Se analizaron muestras de 662 pacientes que asistieron a la consulta de ginecología y obstetricia. Se detectaron Treponema pallidum, VIH y VHC mediante serología. Se detectó VPH por Reacción de Cadena de Polimerasa (PCR) y sus genotipos se detectaron por Polimorfismos de Longitud de Fragmentos de Restricción (RFLP). Se detectaron Trichomonas vaginalis, VHS-1,VHS-2, Mycoplasma genitalium, Neisseria gonorrhoeae y T. pallidum por PCR múltiple. Resultados: Por serología, la frecuencia deVIH fue 6.8%, de T. pallidum fue 2.26% y deVHC fue 0.15%. Por PCR, la frecuencia más alta fue deVPH (13.9%, el genotipo más frecuente fue el 16, 33.7%), seguida deT. vaginalis (14.2%), VHS-1 (8.5%), M. genitalium (2.41%), N. gonorrhoeae (2.11%), VHS-2 (1.8%) y T. pallidum (1.05%). Los pacientes infectados con T. vaginalis presentaron más probabilidades de tener múltiples coinfecciones (p = 0.01). Conclusiones: La frecuencia de infección por VPH, VHS-1,VHS-2, M.genitalium y T. vaginalis fue menor a lo reportado. Sin embargo, se detectó una alta frecuencia de VIH, T. pallidum, y N. gonorrhoeae.

Introducción. La resistencia bacteriana a los antibióticos es un problema de salud mundial. Las investigaciones relacionadas con este problema emergente son indispensables para reconocer y desarrollar programas para su vigilancia y control. Objetivo. Revisar y comentar las contribuciones de los investigadores mexicanos en el área de la resistencia bacteriana a los antibióticos. Materiales y métodos. Se realizó una búsqueda de la literatura científica relacionada con la resistencia bacteriana a los antibióticos producida por investigadores mexicanos y registrada en Medline-PubMed entre 1973 y julio de 2013. Resultados. En 66 publicaciones, las contribuciones de investigadores mexicanos incluyeron datos sobre la resistencia de agentes patógenos entéricos como Salmonella Typhi, múltiples contribuciones sobre la producción de betalactamasas de espectro extendido, de metalobetalactamasas y de carbapenemasas, los mecanismos de resistencia en Pseudomonas aeruginosa y la evolución de la resistencia en cocos Gram positivos como Streptococcus pneumoniae , Staphylococcus aureus y Enterococcus spp., entre otros. Conclusiones. Los datos publicados en los últimos 40 años son fuente adecuada para entender la evolución de la resistencia bacteriana a los antibióticos y desarrollar programas para su control.

Introduction: Bacterial resistance to antibiotics is a worldwide public health concern. Research priorities for the study and control of this emerging problem include country-wide surveillance. Objective: To review and comment on the contributions by Mexican investigators towards a greater understanding of the mechanisms of bacterial antibiotic resistance. Materials and methods: A comprehensive search of the medical literature on Medline/PubMed between 1973 and July 2013 was performed. Results: The contributions of Mexican investigators have included descriptions of resistance in enteric pathogens, such as Salmonella Typhi, publications on the production of extended spectrum beta-lactamases, metallo-beta-lactamases, and carbapenemases, resistance mechanisms of Pseudomonas aeruginosa , and the evolution of resistance in Gram-positive pathogens, including Streptococcus pneumoniae , Staphylococcus aureus , and Enterococcus spp. Conclusion: The Mexican literature on mechanisms of bacterial resistance is relevant for the development of plans to control the antibiotic resistance crisis.

A propagação global de Staphylococcus aureus resistente à meticilina (methicillin-resistant Staphylococcus aureus - MRSA) significa que se trata agora de um patógeno de interesse para a saúde pública mundial. Na América Latina, o MRSA é altamente prevalente, com a proporção de S. aureus resistente à meticilina em ascensão, no entanto os recursos para o tratamento da infecção são limitados. Embora existam várias diretrizes para o tratamento de infecções por MRSA, muitas são elaboradas para a América do Norte ou a Europa e precisam ser adaptadas para sua utilização na América Latina. Neste artigo, procuramos destacar a importância do tratamento adequado do MRSA nas unidades de saúde e na comunidade na América Latina. Apresentamos um resumo das diretrizes e dos antibióticos disponíveis, e discutimos considerações específicas para os médicos que tratam de MRSA na América Latina.

The global spread of methicillin-resistant Staphylococcus aureus (MRSA) means it is now a pathogen of worldwide public health concern. Within Latin America, MRSA is highly prevalent, with the proportion of S. aureus isolates that are methicillin-resistant on the rise, yet resources for managing the infection are limited. While several guidelines exist for the treatment of MRSA infections, many are written for the North American or European setting and need adaptation for use in Latin America. In this article, we aim to emphasize the importance of appropriate treatment of MRSA in the healthcare and community settings of Latin America. We present a summary of the available guidelines and antibiotics, and discuss particular considerations for clinicians treating MRSA in Latin America

Clones de Staphylococcus aureus resistentes à meticilina (MRSA) pertencentes aos complexos clonais Brasileiro, Pediátrico, Cordobês/Chileno e Nova Iorque/Japão estão amplamente distribuídos pela América Latina, embora seus padrões de distribuição individuais e de resistência a antibióticos estejam constantemente mudando. Ressalte-se ainda que clones com maior virulência estão começando a surgir mais frequentemente, tanto nos hospitais como na comunidade, e há evidência que fatores de virulência podem ser transferidos entre clones nosocomiais e clones associados à comunidade por meio de recombinação. Esses padrões variáveis têm implicações significativas para a prática clínica. Mais importante ainda, os clínicos devem ter ciência do perfil variável de resistência antimicrobiana dos clones de MRSA circulantes na sua região, para que optem pela terapia antimicrobiana empírica mais apropriada. Assim, há necessidade de programas regionais de epidemiologia molecular para que se tenha conhecimento de identificações e caracterizações precisas dos clones de MRSA circulantes.

Methicillin-resistant Staphylococcus aureus (MRSA) clones belonging to the Brazilian, Pediatric, Cordobes/Chilean and New York/Japan clonal complexes are widely distributed across Latin America, although their individual distribution patterns and resistance to antimicrobial drugs are constantly changing. Furthermore, clones with increased virulence are beginning to appear more frequently both in hospital and community settings, and there is evidence that virulence factors can be transferred between hospital- and community-associated clones through recombination. These changing patterns have significant implications for clinical practice in the region. Most importantly, clinicians need to be aware of the changing antimicrobial resistance profile of circulating MRSA clones in their region in order to choose the most appropriate empiric antimicrobial therapy. Thus, regional molecular epidemiology programs are required across the region to provide accurate identification and characterization of circulating MRSA clones