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Spa sequence typing was performed on S.?aureus isolates with the Ridom Staph Type standard protocol (http://www.ridom.com/doc/Ridom_spa_sequencing.pdf) and the Ridom SpaServer, which automatically analyses spa repeats and assigns spa types (http://spa.server.ridom.de). By application of the BURP algorithm implemented in Ridom StaphType software version?1.4 (Ridom GmbH, W��rzburg, Germany), spa types with more than four repeats were clustered into different spa clonal complexes (CCs), with the calculated cost between members Transducin of a group being 4 or less. The associated MLST CCs were allocated with the Ridom SpaServer [12], if possible. To confirm the concordance between the MLST and spa CCs, MLST was performed as described elsewhere [13] on a set of representative strains from each spa type found within the five major spa CCs, each spa CC including more than 20 strains, and also within the spa CCs corresponding to three major MRSA CCs (associated GSK126 MLST CC5, CC8, and CC88) described elsewhere [3,4]. Susceptibility to penicillin, oxacillin, cefoxitin, gentamicin, kanamycin, tobramycin, tetracycline, erythromycin, lincomycin, pristinamycin, fosfomycin, fusidic acid, rifampicin, pefloxacin, co-trimoxazole and vancomycin was determined by each participating laboratory, following the guidelines of the French Society for Microbiology. S.?aureus strain ATCC?25923 was used for quality control. External quality control was ensured by the French National Antibiotic Reference Centre (Institut Pasteur, Paris). Pearson��s chi-square test and Staurosporine chemical structure Fisher��s exact test were used as appropriate to test associations between qualitative variables. Significance was assumed at p?