Conclusions A subset of ST612-MRSA-IV isolates from Cape Town hospitals, broadly representative of the total collection with respect to molecular characteristics, as well as the hospital of isolation, was selected

to determine the mechanism of rifampicin Fluorouracil in vivo resistance in this clone. Collectively, the data support a hypothesis of clonal expansion of a rifampicin-resistant ST612-MRSA-IV strain in local hospitals. The data also suggest that these isolates may be related to rifampicin-resistant ST612-MRSA-IV previously described in South Africa and Australia. Studies including additional ST612-MRSA-IV isolates collected from South Africa, Australia and the United Kingdom are required to investigate further the evolution of this C59 wnt ic50 clone. Acknowledgements We are grateful to the Australian Collaborating Centre for Enterococcus and Staphylococcus Species Typing and Research for providing strains 04-17052 and 09-15534, and Professor Richard Goering for providing N83 and N84. We would like to thank the staff of the National Health Laboratory Service microbiology laboratory

at Groote Schuur Hospital for their contributions to this study, particularly Ms Shireen Grimwood for her assistance with antimicrobial susceptibility testing. We are also grateful to Darren Martin and Paul McAdam for helpful discussions regarding the manuscript. This study was supported by grants from the University of Cape Town and

the National Health Laboratory Service. MJJvR was supported by the University of Cape Town, the National Research Foundation and the Ernst and Ethel Eriksen Trust. Aspects of this Non-specific serine/threonine protein kinase work were presented at the 14th International Symposium on Staphylococci and Staphylococcal Infections, 6 – 9 September 2010, Bath, England. References 1. Levy SB: The 2000 Garrod Lecture. Factors impacting on the problem of antibiotic resistance. J Antimicrob Chemoth 2002, 49:25–30.CrossRef 2. Marais E, Aithma N, Perovic O, Oosthuysen WF, Musenge E, Dusé AG: Antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus isolates from South Africa. SAMJ 2009, 99:170–173.PubMed 3. Shittu AO, Lin J: Antimicrobial susceptibility patterns and characterization of clinical isolates of Staphylococcus aureus in KwaZulu-Natal province, South Africa. BMC Infect Dis 2006, 6:125.PubMedCrossRef 4. Groome MJ, Albrich W, Khoosal M, Wadula J, Madhi SA: Staphylococcus aureus bacteraemia on admission in paediatric patients at Chris Hani Baragwanath Hospital, Soweto. Abstracts: 3rd FIDSSA Congress, 2009: 20 – 23 August 2009; South Africa 2009, 26–27. 5. Jansen van Rensburg MJ, Madikane VE, Whitelaw A, Chachage M, Haffejee S, Elisha BG: The dominant methicillin-resistant Staphylococcus aureus clone from hospitals in Cape Town has an unusual genotype: ST612. Clin Microbiol Infect 2011, 17:785–792.PubMedCrossRef 6.