Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) 
carrying pvl is an emerging problem worldwide. CA-MRSA tends to harbor 
staphylococcal cassette chromosome mec type IV (SCCmec IV), to be 
non-multiantibiotic resistant, and to have different genotypes from the local 
hospital-acquired MRSA (HA-MRSA). However, in Ireland, 80% of HA-MRSA isolates 
have the non-multiantibiotic-resistant genotype ST22-MRSA-IV. This study 
investigated MRSA isolates from Ireland (CA-MRSA, health care-associated MRSA, 
and HA-MRSA) for the carriage of pvl and determined the genotypic 
characteristics of all pvl-positive isolates identified. All 1,389 MRSA isolates 
were investigated by antibiogram-resistogram typing and SmaI DNA 
macrorestriction analysis. pvl-positive isolates were further characterized by 
multilocus sequence typing and SCCmec, agr, and toxin gene typing. Twenty-five 
(1.8%) MRSA isolates belonging to six genotypes (ST30, ST8, ST22, ST80, ST5, and 
ST154) harbored pvl. Nineteen of these (76%) were CA-MRSA isolates, but a 
prospective study of MRSA isolates from 401 patients showed that only 6.7% 
(2/30) of patients with CA-MRSA yielded pvl-positive isolates. Thus, pvl cannot 
be used as a sole marker for CA-MRSA. Fifty-two percent of pvl-positive MRSA 
isolates were recovered from patients with skin and soft tissue infections; 
thirty-six percent were from patients of non-Irish ethnic origin, reflecting the 
increasing heterogeneity of the Irish population due to immigration. All 25 
pvl-positive isolates carried SCCmec IV; 14 (56%) harbored SCCmec IV.1 or IV.3, 
and the remaining 11 isolates could not be subtyped. This study demonstrates 
that pvl is not a reliable marker for CA-MRSA in Ireland and reveals the 
emergence and importation of diverse genotypes of pvl-positive MRSA in Ireland.