The aim of the present study was to investigate the antibiotic susceptibility 
patterns and molecular epidemiology of clinical methicillin-resistant 
Staphylococcus aureus (MRSA) isolates recovered in 24 hospitals in 20 cities in 
Croatia from October to December 2004. A total of 1815 consecutive S. aureus 
isolates were recovered, 248 of which were MRSA. The MRSA isolates were analysed 
using spa typing, multilocus sequence typing and SCCmec typing. Furthermore, the 
presence of Panton-Valentine leukocidin (PVL) genes was determined as a genetic 
marker for community-associated MRSA. The MRSA prevalence was 14%. Ninety-six 
per cent of the MRSA isolates were resistant to ciprofloxacin, 95% to 
clindamycin and azithromycin, 94% to gentamicin, and 93% to erythromycin. The 
majority of the MRSA isolates (78%) was associated with the ST111-MRSA-I clone. 
In addition, various other endemic MRSA clones were observed, such as the 
ST247-MRSA-I (4%), the ST45-MRSA-IV (2%), the ST5-MRSA-I (2%), the 
ST239-MRSA-III (2%), the ST5-MRSA-II (1%), the ST8-MRSA-IV (1%) and the 
ST5-MRSA-IV (<1%) clones. Furthermore, we observed one PVL-negative ST80-MRSA-IV 
isolate. Four PVL-positive MRSA isolates were found, associated with 
ST8-MRSA-IV, ST80-MRSA-IV and ST80-MRSA-I. The ST111-MRSA-I clone was 
predominant in Croatia. Future surveillance studies of MRSA are important to 
elucidate whether changes in the clonal distribution of MRSA will occur, and if 
the minor endemic MRSA clones observed in the present study will replace the 
ST111-MRSA-I clone on a large scale.