Characterisation of meticillin-resistant Staphylococcus aureus ST97 and ST5 isolated from pigs in Japan

Prevalence and Genetic Characterization of Methicillin-Resistant Staphylococcus aureus Isolated from Pigs in Japan

We investigated the prevalence of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in pig slaughterhouses from 2018 to 2022 in Japan and the isolates were examined for antimicrobial susceptibility and genetic characteristics by whole-genome analysis. Although the positive LA-MRSA rates on farms (29.6%) and samples (9.9%) in 2022 in Japan remained lower than those observed in European countries exhibiting extremely high rates of confirmed human LA-MRSA infections, these rates showed a gradually increasing trend over five years. The ST398/t034 strain was predominant, followed by ST5/t002, and differences were identified between ST398 and ST5 in terms of antimicrobial susceptibility and the resistance genes carried. Notably, LA-MRSA possessed resistance genes toward many antimicrobial classes, with 91.4% of the ST398 strains harboring zinc resistance genes. These findings indicate that the co-selection pressure associated with multidrug and zinc resistance may have contributed markedly to LA-MRSA persistence. SNP analysis revealed that ST398 and ST5 of swine origin were classified into a different cluster of MRSA from humans, showing the same ST in Japan and lacking the immune evasion genes (scn, sak, or chp). Although swine-origin LA-MRSA is currently unlikely to spread to humans and become a problem in current clinical practice, preventing its dissemination requires using antimicrobials prudently, limiting zinc utilization to the minimum required nutrient, and practicing fundamental hygiene measures.

Genetic diversity, antibiotic resistance, and virulence characteristics of Staphylococcus aureus from raw milk over 10 years in Shanghai

Staphylococcus aureus (S. aureus) is a major cause of foodborne infections and its persistence in raw milk is a multifaceted phenomenon that poses a considerable public health challenge. Our study investigated the prevalence, virulence genes, antibiotic resistance, and genetic characterization of S. aureus in raw milk in six Shanghai districts from 2013 to 2022. At 18 dairy farms, a total of 704 S. aureus strains were isolated from 1799 samples tested for drug sensitivity. The highest rates of antibiotic resistance were ampicillin (96.7 %), sulfamethoxazole (65 %), and erythromycin (21.6 %). Between 2018 and 2022, there was a significant decrease in the resistance rates of ceftiofur, ofloxacin, tilmicosin, erythromycin, clindamycin, amoxicillin-clavulanic acid, and sulfamethoxazole in comparison to the period from 2013 to 2017. There were 205 S. aureus strains chosen for whole genome sequencing (WGS), with no more than 2 strains of the same resistance phenotype from each farm per year. The prevalence of mecA-positive strains was 14.15 %, while other antibiotic resistance-associated genes were observed as follows: blaI (70.21 %), lnu(B) (5.85 %), lsa(E) (5.75 %), fexA (6.83 %), erm(C) (4.39 %), tet(L) (9.27 %), and dfrG (5.85 %). Isolates harboring the immune evasion cluster (IEC) genes (scn, chp, and sak) were predominantly categorized as sequence types (STs) 7, 188, 15, 59, and 398. The predominant cluster complexes were CC97, CC1, CC398, and CC1651. In 2017-2022, there was a transition in CC1 from the highly antibiotic-resistant ST9 strain that emerged between 2013 and 2018 to the low-resistant but highly virulent ST1 strain. Retrospective phylogenetic analysis elucidated the evolutionary history of the isolates and demonstrated that the human-animal host transition of S. aureus was linked to the genesis of MRSA CC398. The implementation of extended surveillance will aid in the development of innovative strategies to avoid the transmission of S. aureus along the dairy food chain and the occurrence of public health events.

Diversity and Dissemination of Methicillin-Resistant Staphylococcus aureus (MRSA) Genotypes in Southeast Asia

Methicillin-resistant Staphylococcus aureus (MRSA) is a successful pathogen that has achieved global dissemination, with high prevalence rates in Southeast Asia. A huge diversity of clones has been reported in this region, with MRSA ST239 being the most successful lineage. Nonetheless, description of MRSA genotypes circulating in the Southeast Asia region has, until now, remained poorly compiled. In this review, we aim to provide a better understanding of the molecular epidemiology and distribution of MRSA clones in 11 Southeast Asian countries: Singapore, Malaysia, Thailand, Vietnam, Cambodia, Lao People's Democratic Republic (PDR), Myanmar, Philippines, Indonesia, Brunei Darussalam, and Timor-Leste. Notably, while archaic multidrug-resistant hospital-associated (HA) MRSAs, such as the ST239-III and ST241-III, were prominent in the region during earlier observations, these were then largely replaced by the more antibiotic-susceptible community-acquired (CA) MRSAs, such as ST22-IV and PVL-positive ST30-IV, in recent years after the turn of the century. Nonetheless, reports of livestock-associated (LA) MRSAs remain few in the region.

Prevalence, Infectious Characteristics and Genetic Diversity of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus (MRSA) in Two Raw-Meat Processing Establishments in Northern Greece

In the present study, we investigated the isolation frequency, the genetic diversity, and the infectious characteristics of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) from the incoming meat and the meat products, the environment, and the workers' nasal cavities, in two meat-processing establishments in northern Greece. The isolated S. aureus strains were examined for their resistance to antimicrobials, carriage of the mecA and mecC genes, carriage of genes encoding for the production of nine staphylococcal enterotoxins, carriage of the Panton-Valentine Leukocidin and Toxic Shock Syndrome genes, and the ability to form biofilm. The genetic diversity of the isolates was evaluated using Pulsed Field Gel Electrophoresis (PFGE) and spa typing. S. aureus was isolated from 13.8% of the 160 samples examined, while only one sample (0.6%) was contaminated by MRSA carrying the mecA gene. The evaluation of the antimicrobial susceptibility of the isolates revealed low antimicrobial resistance. The higher resistance frequencies were observed for penicillin (68.2%), amoxicillin/clavulanic acid (36.4%) and tetracycline (18.2%), while 31.8% of the isolates were sensitive to all antimicrobials examined. Multidrug resistance was observed in two isolates. None of the isolates carried the mecC or lukF-PV genes, and two isolates (9.1%) harbored the tst gene. Eight isolates (36.4%) carried the seb gene, one carried the sed gene, two (9.1%) carried both the sed and sei genes, and one isolate (4.5%) carried the seb, sed and sei genes. Twenty-one (95.5%) of the isolates showed moderate biofilm production ability, while only one (4.5%) was characterized as a strong biofilm producer. Genotyping of the isolates by PFGE indicates that S. aureus from different meat-processing establishments represent separate genetic populations. Ten different spa types were identified, while no common spa type isolates were detected within the two plants. Overall, our findings emphasize the need for the strict application of good hygienic practices at the plant level to control the spread of S. aureus and MRSA to the community through the end products.

Comparative Genomics of Borderline Oxacillin-Resistant Staphylococcus aureus Detected during a Pseudo-outbreak of Methicillin-Resistant S. aureus in a Neonatal Intensive Care Unit

Active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) is a component of our neonatal intensive care unit (NICU) infection prevention efforts. Recent atypical trends prompted review of 42 suspected MRSA isolates. Species identification was confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and methicillin resistance was reevaluated by PBP2a lateral flow assay, cefoxitin/oxacillin susceptibility testing, mecA and mecC PCR, and six commercially available MRSA detection agars. All isolates were confirmed S. aureus, but only eight were MRSA (cefoxitin resistant, PBP2a positive, mecA positive, growth on all MRSA screening agars). One MRSA isolate was cefoxitin susceptible but PBP2a and mecA positive, and the remaining 33 were cefoxitin susceptible, PBP2a negative, and mecA negative; interestingly, these isolates grew inconsistently across MRSA screening agars and had susceptibility profiles consistent with that of borderline oxacillin-resistant S. aureus (BORSA). Comparative genomic analyses found these BORSA isolates to be phylogenetically diverse and not representative of clonal expansion or shared gene content, though clones of two NICU strains were infrequently observed over 8 months. We identified 6 features-substitutions and truncations in PBP2, PBP4, and GdpP and beta-lactamase hyperproduction-that were used to generate a random forest classifier to distinguish BORSA from methicillin-susceptible S. aureus (MSSA) in our cohort. Our model demonstrated a robust ability to predict the BORSA phenotype among isolates collected across two continents (validation area under the curve [AUC], 0.902). Taking these findings together, we observed an unexpected prevalence of BORSA in our NICU, BORSA misclassification by existing MRSA screening methods, and markers that are together discriminatory for BORSA and MSSA within our cohort. This work has implications for epidemiological reporting of MRSA rates for centers using different screening methods. IMPORTANCE In this study, we found a high prevalence of Staphylococcus aureus isolates exhibiting a borderline oxacillin resistance phenotype (BORSA) in our neonatal intensive care unit (NICU) serendipitously due to the type of MRSA screening agar used by our laboratory for active surveillance cultures. Subsequent phenotypic and molecular characterization highlighted an unexpected prevalence and variability of BORSA isolates. Through whole-genome sequencing, we interrogated core and accessory genome content and generated a random forest classification model to identify mutations and truncations in the PBP2, PBP4, and GdpP proteins and beta-lactamase hyperproduction, which correlated with BORSA and MSSA phenotypes among S. aureus clinical isolates collected across two continents. In consideration of these findings, this work will help clinical microbiology laboratories and clinicians identify MRSA screening shortfalls and draw attention to the non-mecA-mediated BORSA phenotype.

Comparative Genomic Analysis of the Human Variant of Methicillin-Resistant Staphylococcus aureus CC398 in Japan and Korea

Staphylococcus aureus clonal complex (CC) 398 is a major clonal type of livestock-associated methicillin-resistant S. aureus and comprise both a human variant and a livestock-associated variant. We have previously identified three sequence type (ST) 1232 strains from Japanese patients (THI2018-120 and N1195) and a Vietnamese patient (S36). In this study, we found an ST1232 strain in a Korean patient (BDH17) and compared the genomes of the ST1232 strains isolated in Korea and Japan. Whole-genome sequencing and a phylogenetic tree based on single nucleotide polymorphisms showed that all ST1232 strains were human variants of S. aureus CC398 and were similar to a common lineage of Southeast Asia. All strains carried ϕSa2, ϕSa3, and Tn554, which included Panton-Valentine leukocidin, immune evasion cluster, and antimicrobial resistance genes, respectively. THI2018-120 and N1195 carried slightly different staphylococcal cassette chromosome mec element from BDH17 due to the insertion of a IS30 family. In addition, the strains originating from Japanese patients possessed a unique genetic element, blaZ-Tn4001-Tn554 element. In this study, we found that the ST1232 strains isolated in Korea and Japan are genetically closely related to each other. However, presence of the unique genetic elements suggests that the strains originating from Japanese patients may have evolved independently in Japan.

Arthritis Caused by MRSA CC398 in a Patient without Animal Contact, Japan

Clonal complex 398 methicillin-resistant Staphylococcus aureus (MRSA) is a typical lineage of livestock-associated MRSA. We report a case of intractable arthritis of the shoulder joint caused by a multidrug-resistant Panton-Valentine leukocidin–positive livestock-associated MRSA clonal complex 398 sequence type 1232 clone in a patient in Japan who had no animal contact.

First report of meticillin-resistant Staphylococcus aureus harboring mecC gene in milk samples from cows with mastitis in southeastern Brazil

MRSA infection and colonization have been reported in both companion and food-chain animals, highlighting MRSA as an important veterinary and zoonotic pathogen. Another mec allele, the mecC gene, also confers beta-lactam resistance in Staphylococcus aureus and shows 69% nucleotide identity to mecA. The main aim of this study was to investigate the genotypic and clonal profile of methicillin-resistant S. aureus (MRSA) from cows with mastitis in dairy herds. Thirty-five samples suggestive of bovine subclinical mastitis were evaluated, and S. aureus were detected in all of them using both phenotypic and molecular approaches. According to the multilocus sequence typing (MLST), the S. aureus isolates were assigned in five different STs, 21 (60%) showed ST 742, 6 (17%) ST97, 4 (11%) ST1, 2 (6%) ST30, and 2 (6%) ST126. The presence of mecA was not observed in any of these isolates whereas mecC was detected in nine of them (9/35; 26%). The Panton-Valentine leukocidin (PVL) genes were detected in a total of 4 isolates. Among the 35 isolates analyzed, 26 showed resistance to penicillin. Changes in the S. aureus epidemiology due to the detection of MRSA in milk samples from cows presenting with bovine subclinical mastitis may have consequences for public health in Brazil, challenging the empirical therapy and animal management, with potential medical and social outcomes. To the best of our knowledge, this is the first report describing mecC MRSA in Southeastern Brazil.

Possible Dissemination of a Panton-Valentine Leukocidin-Positive Livestock-Associated Methicillin-Resistant Staphylococcus aureus CC398 Clone in Tokyo, Japan

In the last decade, methicillin-resistant Staphylococcus aureus (MRSA) has been identified in livestock animals, such as swine, poultry, and veal calves, and has been termed livestock-associated MRSA (LA-MRSA). LA-MRSA sequence type (ST) 398 strains can effectively infect and colonize humans, with subsequent human-to-human transmission in both community and hospital settings. Unlike other countries, LA-MRSA had not been reported in Japanese patients until 2019. However, we recently reported a case of intractable arthritis caused by an LA-MRSA CC398 (ST1232) clone, which is a single-locus variant of ST398, in a patient in Tokyo, Japan, with no animal contact (Nakaminami H, et al. Emerg Infect Dis. 2020; 26: 795-7.). Uniquely, the strain was positive for Panton-Valentine leukocidin. Here, we report the second such case in Japan. To prevent the dissemination of LA-MRSA in the Japanese community, the prevalence of the CC398 MRSA clone should be closely monitored in the future.

Isolation of ST398 methicillin-resistant Staphylococcus aureus from pigs at abattoirs in Tohoku region, Japan

Here, we investigated the presence of ST398 livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in nasal swabs of 420 slaughtered pigs from 84 farms at three abattoirs in Tohoku, Japan. MRSA were isolated from 13 (3.1%) samples from 9 (10.7%) farms at two abattoirs. All isolates were classified as ST398 and were resistant to ampicillin and tetracycline. Ten and three isolates were classified as Staphylococcal Cassette Chromosome mec (SCCmec) types V and IVa, respectively. All type V isolates possessed czrC. The minimum inhibitory concentrations (MICs) of zinc chloride against types IVa and V were 1 and 4 mM, respectively. This study shows the presence of ST398 MRSA in pigs in this region. Antimicrobials and zinc compounds in feed and drugs might select SCCmec type V ST398 MRSA.

Antibiotic Resistance and Virulence Gene Characteristics of Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated from Healthy Edible Marine Fish

Thirty-three (33) isolates of methicillin-resistant Staphylococcus aureus (MRSA) from healthy edible marine fish harvested from two aquaculture settings and the Kariega estuary, South Africa, were characterised in this study. The phenotypic antimicrobial susceptibility profiles to 13 antibiotics were determined, and their antibiotic resistance determinants were assessed. A multiplex PCR was used to determine the epidemiological groups based on the type of SCCmec carriage followed by the detection of staphylococcal enterotoxin-encoding genes sea-sed and the Panton Valentine leucocidin gene (pvl). A high antibiotic resistance percentage (67–81%) was observed for Erythromycin, Ampicillin, Rifampicin, and Clindamycin, while maximum susceptibility to Chloramphenicol (100%), Imipenem (100%), and Ciprofloxacin (94%) was recorded. Nineteen (58%) of the MRSA strains had Vancomycin MICs of ≤2 μg/mL, 4 (12%) with MICs ranging from 4–8 μg/mL, and 10 (30%) with values ≥16 μg/mL. Overall, 27 (82%) isolates were multidrug-resistant (MDR) with Erythromycin-Ampicillin-Rifampicin-Clindamycin (E-AMP-RIP-CD) found to be the dominant antibiotic-resistance phenotype observed in 4 isolates. Resistance genes such as tetM, tetA, ermB, blaZ, and femA were detected in two or more resistant strains. A total of 19 (58%) MRSA strains possessed SCCmec types I, II, or III elements, characteristic of healthcare-associated MRSA (HA-MRSA), while 10 (30%) isolates displayed SCCmec type IVc, characteristic of community-associated MRSA (CA-MRSA). Six (18%) of the multidrug-resistant strains of MRSA were enterotoxigenic, harbouring the see, sea, or sec genes. A prevalence of 18% (6/33) was also recorded for the luk-PVL gene. The findings of this study showed that marine fish contained MDR-MRSA strains that harbour SCCmec types, characteristic of either HA-MRSA or CA-MRSA, but with a low prevalence of enterotoxin and pvl genes. Thus, there is a need for continuous monitoring and implementation of better control strategies within the food chain to minimise contamination of fish with MDR-MRSA and the ultimate spread of the bug.

Prevalence and Characteristics of Methicillin-Resistant Staphylococcus aureus Isolates in Pigs and Pig Farmers in Korea

In this study, we investigated the prevalence and characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolates from pigs and pig farmers in Korea. A total of 1245 nasal swabs were collected from pigs and farmers at 53 pig farms in nine provinces from 2012 to 2016. The prevalence of MRSA was 7.9% (88/1119) in pigs and 16.7% (21/126) in farmers. Among 119 farmers working on conventional farms, 21 (17.6%) tested positive for MRSA. However, no MRSA was detected in either pigs or farmers at four organic farms. The individual pig-level prevalence of MRSA differed between age groups, with the percentage of positive samples being highest in weaners (17.3%), followed by growers (9.0%), piglets (6.5%), finishers (4.4%), and sows (0%). Two different lineages of MRSA were detected among the 109 isolates from pigs and farmers: (1) livestock-associated types of MRSA belonging to 27 isolates of ST541-t034-V, 24 isolates of ST398-t571-V, 17 isolates of ST398-t034 variant (G420A)-V, and one isolate of ST541-t8588-V; and (2) community-associated types of MRSA belonging to 21 isolates of ST188-t189-IV, 14 isolates of ST72-t324-IV, three isolates of ST72-t664-IV, one isolate of ST72-t148-IV, and one isolate of ST72-t5440-IV. Identical genotypes were detected in both pigs and farmers at six farms. New MRSA clones were isolated from pigs (ST398-t034 (G420A)-V, ST188-t189-IV, and ST398-t571-V) and pig farmers (ST541-t8588-V and ST72-t5440-IV). The prevalence of MRSA was also correlated with antibiotic usage, and the clones showed diversification between pigs and farmers. Ultimately, the increased frequency and diversification of livestock-associated MRSA could be a potential threat to public health in Korea. To our knowledge, this is the first study to report the prevalence and characteristics of MRSA in pigs and pig farmers in Korea.

Phenotypic and molecular characteristics of methicillin-resistant and methicillin-susceptible Staphylococcus aureus isolated from pigs: implication for livestock-association markers and vaccine strategies

Background

Routine non-therapeutic antimicrobial use and overcrowding in animal farming may facilitate the propagation of methicillin-resistant Staphylococcus aureus (MRSA). This study aimed to examine the carriage prevalence and phenotype–genotype characteristics of MRSA and methicillin-susceptible S. aureus isolated from pigs.

Methods

Nasal swabs were collected from 1,458 pigs in 9 pig farms and 3 slaughterhouses. All strains were tested for antimicrobial susceptibility, resistance genes, and virulence genes, and characterized by multilocus sequence typing. The correspondence analysis was conducted to explore the relationships between multiple phenotypic and molecular characteristics of S. aureus isolates.

Results

In the 1,458 pigs, the carriage prevalence was 9.5% for S. aureus, 3.3% for MRSA, and 9.3% for multidrug-resistant S. aureus. Notably, 97.1% S. aureus isolates were multidrug resistant, and the predominant resistance pattern was non-susceptible to clindamycin, tetracycline, and erythromycin. The predominant genotype was CC9 (ST9) for S. aureus and MRSA isolates. Importantly, all S. aureus isolates were negative for the scn gene and resistant to tetracycline. Notably, all 9 linezolid-resistant isolates were classified as multidrug resistance, including 1 expressing the cfr gene and 6 expressing the optrA gene. The correspondence analysis showed a significant relationship between clonal complexes and resistance pattern or virulence genes. For example, CC9 was associated with extensive drug-resistance and co-carrying chp, sak, and hlb, and CC1 was associated with multidrug resistance and co-carrying sak and hlb.

Conclusion

The significant correspondence relationship between multiple characteristics provides some implication for vaccine strategies and new ideas for monitoring new epidemiologic clones.

A Japanese trial to monitor methicillin-resistant Staphylococcus aureus (MRSA) in imported swine during the quarantine period

OBJECTIVES

This study aimed to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in imported swine during the quarantine period in Japan.

METHODS

Nasal swabs from a total of 125 swine belonging to 15 lots (unit of import) from five countries were investigated for MRSA from July 2016 to February 2017. Two isolates per positive lot were chosen for multilocus sequence typing (MLST). PCR was performed to determine the presence of the czrC gene, and antimicrobial susceptibility testing was performed by the broth dilution method.

RESULTS

MRSA isolates were obtained from six lots (41 heads; 32.8%) from two countries. All 12 isolates that underwent MLST (two per positive lot) were classified as ST398, harboured the czrC gene and were resistant to ampicillin and tetracycline; some isolates showed additional resistance to erythromycin or streptomycin, but resistance to ciprofloxacin, gentamicin or chloramphenicol was not observed.

CONCLUSIONS

MRSA ST398 isolates were obtained from imported swine in this first trial to monitor MRSA during the quarantine period in Japan. For the 'One Health' approach against antimicrobial resistance, monitoring imported animals and generating feedback data would be important.

Closely related methicillin-resistant Staphylococcus aureus isolates from retail meat, cows with mastitis, and humans in Japan

Methicillin-resistant Staphylococcus aureus (MRSA) is a pervasive healthcare-acquired (HA) pathogen with recent emergence as a community-acquired (CA) pathogen. To elucidate whether meat mediates MRSA transmission between animals and humans in Japan, this study examined MRSA isolates from retail meat (n = 8), cows with mastitis (n = 7), and humans (HA-MRSA = 46 and CA-MRSA = 54) by molecular typing, virulence gene analyses, and antimicrobial susceptibility testing. MRSA isolates from retail meat were classified into sequence type (ST) 8/spa type t1767 (n = 4), ST8/t4133 (n = 1), ST59/t3385 (n = 1), ST88/t375 (n = 1), and ST509/t375 (n = 1). All seven MRSA isolates from cows with mastitis were ST8/t1767. 46 HA-MRSA were clonal complex (CC) 5, divided into t002 (n = 30), t045 (n = 12), and t7455 (n = 4). 54 CA-MRSA were classified into 6 different CCs: CC1 (n = 14), CC5 (n = 7), CC8 (n = 29), CC45 (n = 1), CC89 (n = 1), CC509 (n = 1), and into 16 different spa types including newly identified t17177, t17193, and t17194. The majority were CC8/t1767 (n = 16). CC of one CA-MRSA isolate (spa type t1767) was not classified. Among 41 CC8 MRSA (five from meat, seven from cows with mastitis, and 29 CA-MRSA), 14 ST8/SCCmec IVl isolates (three from meat, one from a cow with mastitis, and 10 CA-MRSA) had identical pulsed-field gel electrophoresis patterns and similar spa type (t1767, t4133, and t17177), and were typed as CA-MRSA/J (ST8/SCCmec IVl, positive for sec + sel + tst but negative for Panton–Valentine leukocidin and the arginine catabolic mobile element). These results suggest that there is a transmission cycle of CA-MRSA/J among meat, cows, and humans in Japan, although it is unclear whether the origin is cow.