Methicillin-SusceptibleStaphylococcus aureusST398, New York and New Jersey, USA

To the Editor: Clinical infections with livestock-associated Staphylococcus aureus sequence type (ST) 398 have been reported in Europe, Canada, and the People's Republic of China (1), as well as the Caribbean (2,3), and Colombia (4).Most reports describe infection with methicillinresistant S. aureus; relatively few describe infection with methicillinsusceptible S. aureus (MSSA).In the United States, colonization of healthy adults by ST398 has been reported in Iowa (5) and in New York, New York (2); MSSA infections have been anecdotally reported in St. Louis, Missouri (6), and The Bronx, New York (7).We describe 8 infections with MSSA ST398 in the New York City area during a 7-year period (2004)(2005)(2006)(2007)(2008)(2009)(2010).Five infections with a related ST (ST291) from clonal complex (CC) 398 also were identifi ed.These fi ndings highlight the emergence of clinical infections with 2 distinct CC398 sequence types in the New York City area.Retrospective typing of 4,167 clinical S. aureus isolates from various studies involving inpatients and outpatients in the New York City area identifi ed 13 mecA-negative isolates with CC398-associated spa types (Table ).Nine isolates were obtained from cultures of outpatients