1
|
Hu W, Wang Y, Zhou L, Chu K, Jin P, Liang Q, Li J, Tan Z, Zhu F. Nasal Staphylococcus aureus Carriage and Antimicrobial Resistance Profiles Among Community-Dwelling Adults in Jiangsu, China. Infect Dis Ther 2024; 13:1215-1233. [PMID: 38700654 PMCID: PMC11128426 DOI: 10.1007/s40121-024-00969-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/27/2024] [Indexed: 05/28/2024] Open
Abstract
INTRODUCTION Persistent nasal carriage has been associated with Staphylococcus aureus infection. Previous S. aureus studies in Asia have primarily focused on clinical patients, providing limited information on persistent nasal carriage among the general adult population. METHODS This study examined 143 healthy adults in a community in Jiangsu, China. Nasal swab samples were collected 10 times. The colonization status was identified using SPA typing. We also determined antimicrobial susceptibility, genotype, and genomic characteristics of S. aureus. RESULTS The prevalence of S. aureus nasal carriage among the community individuals was on average 16.78%. The carriage rates of methicillin-resistant S. aureus and multidrug-resistant S. aureus were 6.29% and 7.69%, respectively. We identified 8.39% persistent carriers, 39.16% intermittent carriers, and 52.45% noncarriers. Furthermore, family members displayed concordance in terms of genotype and genomic characteristics. CONCLUSION Persistent nasal sampling captured intermittent carriers that were missed during short-term sampling, thus highlighting the necessity for regular community testing. SPA typing can serve as a rapid method for determining S. aureus colonization. The potential for intrafamilial transmission of S. aureus is evident, with persistent carriers being the most probable source of infection.
Collapse
Affiliation(s)
- Wenjing Hu
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Yang Wang
- Department of Science and Education, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lu Zhou
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Kai Chu
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Pengfei Jin
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Qi Liang
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Jingxin Li
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Zhongming Tan
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
| | - Fengcai Zhu
- School of Public Health, Southeast University, Nanjing, Jiangsu, China.
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
| |
Collapse
|
2
|
Li J, Leung SYS, Chung YL, Chow SKH, Alt V, Rupp M, Brochausen C, Chui CS, Ip M, Cheung WH, Wong RMY. Hydrogel Delivery of DNase I and Liposomal Vancomycin to Eradicate Fracture-related Methicillin-resistant Staphylococcus aureus Infection and Support Osteoporotic Fracture Healing. Acta Biomater 2023; 164:223-239. [PMID: 37019168 DOI: 10.1016/j.actbio.2023.03.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023]
Abstract
Fracture-related infection (FRI) is a devastating complication in orthopedic surgery. A recent study showed that FRI causes more severe infection and further delays healing in osteoporotic bone. Moreover, bacterial biofilm formed on implants cannot be eradicated by systemic antibiotics, warranting novel treatments. Here, we developed a DNase I and Vancomycin hydrogel delivery vehicle to eradicate Methicillin-resistant Staphylococcus aureus (MRSA) infection in vivo. Vancomycin was encapsulated in liposomes, and DNase I and Vancomycin/liposomal-Vancomycin was loaded on thermosensitive hydrogel. In vitro drug release test showed a burst release of DNase I (77.2%) within 72 hours and sustained release of Vancomycin (82.6%) up to day 14. The in vivo efficacy was evaluated in a clinically relevant ovariectomy (OVX) induced osteoporotic metaphyseal fracture model with MRSA infection, and a total of 120 Sprague Dawley rats were used. In the OVX with infection group, biofilm development caused a drastic inflammatory response, trabecular bone destruction, and non-union. In the DNase I and Vancomycin co-delivery hydrogel group (OVX-Inf-DVG), bacteria on bone and implant were eradicated. X-ray and micro-CT showed preservation of trabecular bone and bone union. HE staining showed the absence of inflammatory necrosis, and fracture healing was restored. The local elevation of TNF-α and IL-6 and increased number of osteoclasts were prevented in the OVX-Inf-DVG group. Our findings suggest that dual release of DNase I and Vancomycin initially followed by Vancomycin only later up to 14 days effectively eliminates MRSA infection, prevents biofilm development and provides a sterile environment to promote fracture healing in osteoporotic bone with FRI. STATEMENT OF SIGNIFICANCE: The biofilm formation on the implant is difficult to eradicate, causing recurrent infection and non-union in fracture-related infection (FRI). Here we developed a hydrogel therapy with high in vivo efficacy to eliminate MRSA biofilm infection in a clinically-relevant FRI model in osteoporotic bone. By loading DNase I and vancomycin/liposomal-vancomycin on thermosensitive poly-(DL-lactic acidco-glycolic acid) (PLGA)-polyethylene glycol (PEG)-PLGA hydrogel, a dual release of DNase I and Vancomycin was achieved whilst preserving enzyme activity. In this model, the progressive development of infection caused a drastic inflammatory response, osteoclastogenesis, trabecular bone destruction, and non-union of fracture. These pathological changes were successfully prevented by the dual delivery of DNase I and vancomycin. Our findings provide a promising strategy for FRI in osteoporotic bone.
Collapse
Affiliation(s)
- Jie Li
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Yik Lok Chung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Simon Kwoon Ho Chow
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Volker Alt
- Department of Trauma Surgery, University Hospital Regensburg, Germany
| | - Markus Rupp
- Department of Trauma Surgery, University Hospital Regensburg, Germany
| | | | - Chun Sing Chui
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Margaret Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ronald Man Yeung Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
3
|
Monecke S, Bedewy AK, Müller E, Braun SD, Diezel C, Elsheredy A, Kader O, Reinicke M, Ghazal A, Rezk S, Ehricht R. Characterisation of Methicillin-Resistant Staphylococcus aureus from Alexandria, Egypt. Antibiotics (Basel) 2023; 12:78. [PMID: 36671279 PMCID: PMC9855118 DOI: 10.3390/antibiotics12010078] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/28/2022] [Accepted: 12/09/2022] [Indexed: 01/03/2023] Open
Abstract
The present study aims to characterise clinical MRSA isolates from a tertiary care centre in Egypt's second-largest city, Alexandria. Thirty isolates collected in 2020 were genotypically characterised by microarray to detect their resistance and virulence genes and assign them to clonal complexes (CC) and strains. Isolates belonged to 11 different CCs and 14 different strains. CC15-MRSA-[V+fus] (n = 6), CC1-MRSA-[V+fus+tir+ccrA/B-1] (PVL+) (n = 5) as well as CC1-MRSA-[V+fus+tir+ccrA/B-1] and CC1153-MRSA-[V+fus] (PVL+) (both with n = 3) were the most common strains. Most isolates (83%) harboured variant or composite SCCmec V or VI elements that included the fusidic acid resistance gene fusC. The SCCmec [V+fus+tir+ccrA/B-1] element of one of the CC1 isolates was sequenced, revealing a presence not only of fusC but also of blaZ, aacA-aphD and other resistance genes. PVL genes were also common (40%). The hospital-acquired MRSA CC239-III strain was only found twice. A comparison to data from a study on strains collected in 2015 (Montelongo et al., 2022) showed an increase in fusC and PVL carriage and a decreasing prevalence of the CC239 strain. These observations indicate a diffusion of community-acquired strains into hospital settings. The beta-lactam use in hospitals and the widespread fusidic acid consumption in the community might pose a selective pressure that favours MRSA strains with composite SCCmec elements comprising mecA and fusC. This is an unsettling trend, but more MRSA typing data from Egypt are required.
Collapse
Affiliation(s)
- Stefan Monecke
- Leibniz Institute of Photonic Technology (IPHT), 07745 Jena, Germany
- InfectoGnostics Research Campus, 07743 Jena, Germany
- Institute for Medical Microbiology and Virology, Dresden University Hospital, 01307 Dresden, Germany
| | - Amira K. Bedewy
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria 5424041, Egypt
| | - Elke Müller
- Leibniz Institute of Photonic Technology (IPHT), 07745 Jena, Germany
- InfectoGnostics Research Campus, 07743 Jena, Germany
| | - Sascha D. Braun
- Leibniz Institute of Photonic Technology (IPHT), 07745 Jena, Germany
- InfectoGnostics Research Campus, 07743 Jena, Germany
| | - Celia Diezel
- Leibniz Institute of Photonic Technology (IPHT), 07745 Jena, Germany
- InfectoGnostics Research Campus, 07743 Jena, Germany
| | - Amel Elsheredy
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria 5424041, Egypt
| | - Ola Kader
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria 5424041, Egypt
| | - Martin Reinicke
- Leibniz Institute of Photonic Technology (IPHT), 07745 Jena, Germany
- InfectoGnostics Research Campus, 07743 Jena, Germany
| | - Abeer Ghazal
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria 5424041, Egypt
| | - Shahinda Rezk
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria 5424041, Egypt
| | - Ralf Ehricht
- Leibniz Institute of Photonic Technology (IPHT), 07745 Jena, Germany
- InfectoGnostics Research Campus, 07743 Jena, Germany
- Institute of Physical Chemistry, Friedrich-Schiller University, 07743 Jena, Germany
| |
Collapse
|
4
|
Coppens J, Xavier BB, Vlaeminck J, Larsen J, Lammens C, Van Puyvelde S, Goossens H, Larsen AR, Malhotra-Kumar S. Genomic analysis of methicillin-resistant Staphylococcus aureus clonal complex 239 isolated from Danish patients with and without an international travel history. Front Microbiol 2022; 13:1016829. [PMID: 36504833 PMCID: PMC9730231 DOI: 10.3389/fmicb.2022.1016829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction International travel has been a major determinant for the introduction of pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) into naïve geographic areas. MRSA clonal complex 239 (CC239) is a highly virulent clone that is predominant in Asia. The objective of this study was to determine the geographic origin of MRSA CC239 isolates recovered from Danish cases with or without a history of international travel during 2004-2016. Materials and methods Human MRSA isolates with spa types t030 and t037 (n = 60) were obtained from the National Reference Laboratory for Antimicrobial Resistance. For each case, the following data were collected from notification forms: sex, age, isolation year, specimen source (screening swab or clinical sample), infection type, and international travel history. All isolates were whole-genome sequenced, and a comparative genome and phylogenetic analysis was performed. Results The majority of isolates originated from skin and soft tissue (SST) infections and screening swabs. In 31 out of 60 cases reported international travel to different parts of the world. Fifty-four isolates belonged to CC239, including sequence type 239 (ST239) (n = 43), ST241 (n = 5), ST4377 (n = 2), ST4378 (n = 1), ST1465 (n = 1), ST343 (n = 1), and ST592 (n = 1). The majority of the CC239 MRSA isolates (40/54) belonged to well-known geographic clades, including the Asian (n = 12), Serbian (n = 11), South American (n = 2), and Turkish (n = 15). Most MRSA ST239 isolates belonging to the highly virulent Asian clade carried sasX and were recovered from individuals who had travelled to Asia, Africa and the Middle East. Conclusion Our data reveal multiple introductions of MRSA CC239 into Denmark through international travel, which highlights the importance of continued genomic surveillance of MRSA in persons returning from international travel to areas where MRSA is endemic.
Collapse
Affiliation(s)
- Jasmine Coppens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Basil Britto Xavier
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Jelle Vlaeminck
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Jesper Larsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Christine Lammens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Sandra Van Puyvelde
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium,Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Anders Rhod Larsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium,*Correspondence: Surbhi Malhotra-Kumar,
| |
Collapse
|
5
|
Rodrigues RA, Pizauro LJL, Varani ADM, de Almeida CC, Silva SR, Cardozo MV, MacInnes JI, Kropinski AM, Melo PDC, Ávila FA. Comparative genomics study of Staphylococcus aureus isolated from cattle and humans reveals virulence patterns exclusively associated with bovine clinical mastitis strains. Front Microbiol 2022; 13:1033675. [PMID: 36419431 PMCID: PMC9676464 DOI: 10.3389/fmicb.2022.1033675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/17/2022] [Indexed: 12/08/2023] Open
Abstract
Staphylococcus aureus causes nosocomial and intramammary infections in humans and cattle, respectively. A large number of virulence factors are thought to play important roles in the pathogenesis of this bacterium. Currently, genome-wide and data-analysis studies are being used to better understand its epidemiology. In this study, we conducted a genome wide comparison and phylogenomic analyses of S. aureus to find specific virulence patterns associated with clinical and subclinical mastitis strains in cattle and compare them with those of human origin. The presence/absence of key virulence factors such as adhesin, biofilm, antimicrobial resistance, and toxin genes, as well as the phylogeny and sequence type of the isolates were evaluated. A total of 248 genomes (27 clinical mastitis, 43 subclinical mastitis, 21 milk, 53 skin-related abscesses, 49 skin infections, and 55 pus from cellulitis) isolated from 32 countries were evaluated. We found that the cflA, fnbA, ebpS, spa, sdrC, coa, emp, vWF, atl, sasH, sasA, and sasF adhesion genes, as well as the aur, hglA, hglB, and hglC toxin genes were highly associated in clinical mastitis strains. The strains had diverse genetic origins (72 protein A and 48 sequence types with ST97, ST8 and ST152 being frequent in isolates from clinical mastitis, abscess, and skin infection, respectively). Further, our phylogenomic analyses suggested that zoonotic and/or zooanthroponotic transmission may have occurred. These findings contribute to a better understanding of S. aureus epidemiology and the relationships between adhesion mechanisms, biofilm formation, antimicrobial resistance, and toxins and could aid in the development of improved vaccines and strain genotyping methods.
Collapse
Affiliation(s)
- Romário Alves Rodrigues
- Department of Reproduction Pathology and One Health, Faculty of Agricultural and Veterinary Sciences, São Paulo State University, Jaboticabal, São Paulo, Brazil
| | - Lucas José Luduverio Pizauro
- Department of Agricultural and Environmental Sciences, Santa Cruz State University, Ilhéus, Bahia, Brazil
- Department of Agricultural and Environmental Biotechnology, Faculty of Agricultural and Veterinary Sciences, São Paulo State University, Jaboticabal, São Paulo, Brazil
| | - Alessandro de Mello Varani
- Department of Agricultural and Environmental Biotechnology, Faculty of Agricultural and Veterinary Sciences, São Paulo State University, Jaboticabal, São Paulo, Brazil
| | - Camila Chioda de Almeida
- Department of Reproduction Pathology and One Health, Faculty of Agricultural and Veterinary Sciences, São Paulo State University, Jaboticabal, São Paulo, Brazil
| | - Saura Rodrigues Silva
- Department of Agricultural and Environmental Biotechnology, Faculty of Agricultural and Veterinary Sciences, São Paulo State University, Jaboticabal, São Paulo, Brazil
| | - Marita Vedovelli Cardozo
- Laboratory of Microorganism Physiology, Minas Gerais State University, Passos, Minas Gerais, Brazil
| | - Janet I. MacInnes
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Andrew M. Kropinski
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- Department of Food Science, University of Guelph, Guelph, ON, Canada
| | - Poliana de Castro Melo
- Department of Agricultural and Environmental Sciences, Santa Cruz State University, Ilhéus, Bahia, Brazil
| | - Fernando Antonio Ávila
- Department of Reproduction Pathology and One Health, Faculty of Agricultural and Veterinary Sciences, São Paulo State University, Jaboticabal, São Paulo, Brazil
| |
Collapse
|
6
|
Araujo-Alves AV, Kraychete GB, Gilmore MS, Barros EM, Giambiagi-deMarval M. shsA: A novel orthologous of sasX/sesI virulence genes is detected in Staphylococcus haemolyticus Brazilian strains. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 97:105189. [PMID: 34920103 DOI: 10.1016/j.meegid.2021.105189] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/06/2021] [Accepted: 12/12/2021] [Indexed: 06/14/2023]
Abstract
The surface protein SasX, has a key role in methicillin-resistant Staphylococcus aureus (MRSA) colonization and pathogenesis, and has been associated with the epidemic success of some MRSA clones. To date, only one SasX homologous protein, named SesI, has been described in Staphylococcus epidermidis. In this work, we analyze the occurrence of the sasX gene and its genetic environment in Staphylococcus haemolyticus S. haemolyticus clinical strains (n = 62) were screened for the presence of the sasX gene and its carrier, the prophage Φ SPβ-like. A deep characterization was done in one strain (MD43), through which we determined the complete nucleotide sequence for the S. haemolitycus sasX-like gene. Whole genome sequencing of strain MD43 was performed, and the gene, termed here because of its unique attributes, shsA, was mapped to the Φ SPβ-like prophage sequence. The shsA gene was detected in 33 out of 62 strains showing an average identity of 92 and 96% with the sasX and sesI genes and at the amino acid level, 88% identity with SasX and 92% identity with SesI. The ~124Kb Φ SPβ-like prophage sequence showed a largely intact prophage compared to its counterpart in S. epidermidis strain RP62A, including the sesI insertion site. In conclusion, we identified a new sasX ortholog in S. haemolyticus (shsA). Its horizontal spread from this reservoir could represent an emergent threat in healthcare facilities since so far, no S. aureus sasX+ strains have been reported in Brazil.
Collapse
Affiliation(s)
- Amanda V Araujo-Alves
- Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gabriela B Kraychete
- Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Michael S Gilmore
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02114, USA; Infectious Disease and Microbiome Program, Broad Institute, Cambridge, MA 02142, USA
| | - Elaine M Barros
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
| | - Marcia Giambiagi-deMarval
- Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil..
| |
Collapse
|
7
|
Esener N, Maciel-Guerra A, Giebel K, Lea D, Green MJ, Bradley AJ, Dottorini T. Mass spectrometry and machine learning for the accurate diagnosis of benzylpenicillin and multidrug resistance of Staphylococcus aureus in bovine mastitis. PLoS Comput Biol 2021; 17:e1009108. [PMID: 34115749 PMCID: PMC8221797 DOI: 10.1371/journal.pcbi.1009108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/23/2021] [Accepted: 05/22/2021] [Indexed: 01/16/2023] Open
Abstract
Staphylococcus aureus is a serious human and animal pathogen threat exhibiting extraordinary capacity for acquiring new antibiotic resistance traits in the pathogen population worldwide. The development of fast, affordable and effective diagnostic solutions capable of discriminating between antibiotic-resistant and susceptible S. aureus strains would be of huge benefit for effective disease detection and treatment. Here we develop a diagnostics solution that uses Matrix-Assisted Laser Desorption/Ionisation-Time of Flight Mass Spectrometry (MALDI-TOF) and machine learning, to identify signature profiles of antibiotic resistance to either multidrug or benzylpenicillin in S. aureus isolates. Using ten different supervised learning techniques, we have analysed a set of 82 S. aureus isolates collected from 67 cows diagnosed with bovine mastitis across 24 farms. For the multidrug phenotyping analysis, LDA, linear SVM, RBF SVM, logistic regression, naïve Bayes, MLP neural network and QDA had Cohen's kappa values over 85.00%. For the benzylpenicillin phenotyping analysis, RBF SVM, MLP neural network, naïve Bayes, logistic regression, linear SVM, QDA, LDA, and random forests had Cohen's kappa values over 85.00%. For the benzylpenicillin the diagnostic systems achieved up to (mean result ± standard deviation over 30 runs on the test set): accuracy = 97.54% ± 1.91%, sensitivity = 99.93% ± 0.25%, specificity = 95.04% ± 3.83%, and Cohen's kappa = 95.04% ± 3.83%. Moreover, the diagnostic platform complemented by a protein-protein network and 3D structural protein information framework allowed the identification of five molecular determinants underlying the susceptible and resistant profiles. Four proteins were able to classify multidrug-resistant and susceptible strains with 96.81% ± 0.43% accuracy. Five proteins, including the previous four, were able to classify benzylpenicillin resistant and susceptible strains with 97.54% ± 1.91% accuracy. Our approach may open up new avenues for the development of a fast, affordable and effective day-to-day diagnostic solution, which would offer new opportunities for targeting resistant bacteria.
Collapse
MESH Headings
- Animals
- Bacterial Proteins/chemistry
- Cattle
- Computational Biology
- Diagnosis, Computer-Assisted/methods
- Diagnosis, Computer-Assisted/statistics & numerical data
- Diagnosis, Computer-Assisted/veterinary
- Drug Resistance, Multiple, Bacterial
- Female
- Humans
- Mastitis, Bovine/diagnosis
- Mastitis, Bovine/drug therapy
- Mastitis, Bovine/microbiology
- Methicillin-Resistant Staphylococcus aureus/chemistry
- Methicillin-Resistant Staphylococcus aureus/drug effects
- Methicillin-Resistant Staphylococcus aureus/isolation & purification
- Microbial Sensitivity Tests
- Models, Molecular
- Penicillin G/pharmacology
- Protein Interaction Maps
- Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
- Staphylococcal Infections/diagnosis
- Staphylococcal Infections/drug therapy
- Staphylococcal Infections/veterinary
- Staphylococcus aureus/chemistry
- Staphylococcus aureus/drug effects
- Staphylococcus aureus/isolation & purification
- Supervised Machine Learning
- United Kingdom
Collapse
Affiliation(s)
- Necati Esener
- University of Nottingham, School of Veterinary Medicine and Science, Sutton Bonington, United Kingdom
| | - Alexandre Maciel-Guerra
- University of Nottingham School of Computer Science, Jubilee Campus, Nottingham, United Kingdom
| | | | - Daniel Lea
- Digital Research Service, University of Nottingham, Sutton Bonington, United Kingdom
| | - Martin J. Green
- University of Nottingham, School of Veterinary Medicine and Science, Sutton Bonington, United Kingdom
| | - Andrew J. Bradley
- University of Nottingham, School of Veterinary Medicine and Science, Sutton Bonington, United Kingdom
- Quality Milk Management Services ltd, Easton, United Kingdom
| | - Tania Dottorini
- University of Nottingham, School of Veterinary Medicine and Science, Sutton Bonington, United Kingdom
| |
Collapse
|
8
|
Kwok KO, Chan E, Chung PH, Tang A, Wei WI, Zhu C, Riley S, Ip M. Prevalence and associated factors for carriage of Enterobacteriaceae producing ESBLs or carbapenemase and methicillin-resistant Staphylococcus aureus in Hong Kong community. J Infect 2020; 81:242-247. [PMID: 32447008 DOI: 10.1016/j.jinf.2020.05.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 04/07/2020] [Accepted: 05/17/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES We conducted a cross-sectional study in Hong Kong community to estimate the carriage prevalence, associated factors and genotypes of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E), methicillin-resistant Staphylococcus aureus (MRSA) and carbapenemase-producing Enterobacteriaceae (CPE). METHODS Seemingly healthy subjects were asked to provide nasal, handprint and stool samples from March to April 2017. Isolates were characterized by molecular methods. We used multivariable logistic regression models within a generalized estimating equation framework to identify risk factors for ESBL-E carriage. Characteristics of MRSA/CPE carriage were summarized. RESULTS The prevalence of ESBL-E, MRSA and CPE were 52.8% (104/197), 2.5% (5/197) and 0.5% (1/197) respectively. Most ESBL-E isolates were E. coli (85.6%; 113/132). Most ESBL genes belonged to blaCTX-M-G9 (68.9%) and blaTEM (53.0%) types. Self-reported antibiotic consumption (≥2 courses) in the past six months was associated with ESBL-E carriage (adjusted odds ratio: 4.71-5.47). CONCLUSIONS Abundance of ESBL-E in the community are causes of concern, and antibiotic use is associated with its carriage. Presence of MRSA and CPE in community members without clear healthcare exposure hints on a change in their epidemiology. This study establishes a baseline to formulate infection control policies and future studies in combating antimicrobial resistance.
Collapse
Affiliation(s)
- Kin-On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Research Institute of The Chinese University of Hong Kong, Shenzhen, China.
| | - Emily Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Pui-Hong Chung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Arthur Tang
- Department of Software, Sungkyunkwan University, Seoul, Republic of Korea
| | - Wan-In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Chendi Zhu
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Steven Riley
- MRC Centre for Outbreak Analysis and Modelling, Department for Infectious Disease Epidemiology, Imperial College London, United Kingdom
| | - Margaret Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
9
|
Fu Y, Xiong M, Li X, Zhou J, Xiao X, Fang F, Cheng X, Le Y, Li Y. Molecular Characteristics, Antimicrobial Resistance and Virulence Gene Profiles of Staphylococcus aureus Isolates from Wuhan, Central China. Infect Drug Resist 2020; 13:2063-2072. [PMID: 32669859 PMCID: PMC7335743 DOI: 10.2147/idr.s249988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to investigate the molecular characteristics, antimicrobial resistance and virulence genes profiles of S. aureus isolates from Wuhan, central China. MATERIALS AND METHODS A total of 302 non-duplicate S. aureus isolates were collected successively during January-December 2018 and subjected to multi-locus sequence typing (MLST), staphylococcal protein A (spa) typing and Panton-Valentine leucocidin (PVL) and staphylococcal enterotoxin A, B, C, D, E, G, H and I (sea, seb, sec, sed, see, seg, seh and sei) detection. All methicillin-resistant S. aureus (MRSA) isolates were additionally subjected to staphylococcal chromosomal cassette mec(SCCmec) typing. RESULTS Of the 302 S. aureus isolates, 131 were categorised as MRSA, yielding a rate 1.4 times the average rate in China during 2018 (43.4% vs 30.9%). Thirty-one sequence types (STs) and 82 spa types were identified. The most prevalent clones were ST5-t2460 (10.9%), ST239-t030 (9.3%), ST188-t189 (7.9%) and ST59-t437 (6.3%). Notably, the continued prevalence of ST239-t030 in Wuhan differs from other areas in China. SCCmec types and subtypes I, II, III, IVa and V were present in 0.8%, 36.6%, 26.0%, 20.6% and 8.4% of MRSA isolates. A comprehensive analysis identified ST5-t2460-SCCmec II (25.2%,), ST239-t030-SCCmec III (19.8%) and ST59-t437-SCCmec IVa (7.6%) as the major clones among MRSA isolates. The genes pvl, sea, seb, sec, sed, see, seg, seh and sei were detected at respective frequencies of 11.9%, 42.1%, 49.7%, 45.0%, 20.9%, 33.8%, 60.5%, 25.8% and 66.9%. CONCLUSION ST239-t030 remains one of the most prevalent clones in S. aureus isolates from Wuhan, leading us to conclude that S. aureus isolates from Wuhan possess unique molecular characteristics. The S. aureus isolates also exhibit unique antimicrobial resistance profiles and harbour relatively high numbers of enterotoxin virulence genes, compared with other reports from China.
Collapse
Affiliation(s)
- Yu Fu
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Mengyuan Xiong
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Xuehan Li
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Junying Zhou
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Xiao Xiao
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Fang Fang
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Xiaohuan Cheng
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Yingbang Le
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Yirong Li
- Department of Clinical Laboratory, Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| |
Collapse
|
10
|
A comparative genomic analysis between methicillin-resistant Staphylococcus aureus strains of hospital acquired and community infections in Yunnan province of China. BMC Infect Dis 2020; 20:137. [PMID: 32054452 PMCID: PMC7020539 DOI: 10.1186/s12879-020-4866-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 02/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Currently, Staphylococcus aureus is one of the most important pathogens worldwide, especially for methicillin-resistant S. aureus (MRSA) infection. However, few reports referred to patients' MRSA infections in Yunnan province, southwest China. METHODS In this study, we selected representative MRSA strains from patients' systemic surveillance in Yunnan province of China, performed the genomic sequencing and compared their features, together with some food derived strains. RESULTS Among sixty selective isolates, forty strains were isolated from patients, and twenty isolated from food. Among the patients' strains, sixteen were recognized as community-acquired (CA), compared with 24 for hospital-acquired (HA). ST6-t701, ST59-t437 and ST239-t030 were the three major genotype profiles. ST6-t701 was predominated in food strains, while ST59-t437 and ST239-t030 were the primary clones in patients. The clinical features between CA and HA-MRSA of patients were statistical different. Compared the antibiotic resistant results between patients and food indicated that higher antibiotic resistant rates were found in patients' strains. Totally, the average genome sizes of 60 isolates were 2.79 ± 0.05 Mbp, with GC content 33% and 84.50 ± 0.20% of coding rate. The core genomes of these isolates were 1593 genes. Phylogenetic analysis based on pan-genome and SNP of strains showed that five clustering groups were generated. Clustering ST239-t030 contained all the HA-MRSA cases in this study; clustering ST6-t701 referred to food and CA-MRSA infections in community; clustering ST59-t437 showed the heterogeneity for provoking different clinical diseases in both community and hospital. Phylogenetic tree, incorporating 24 isolates from different regions, indicated ST239-t030 strains in this study were more closely related to T0131 isolate from Tianjin, China, belonged to 'Turkish clade' from Eastern Europe; two groups of ST59-t437 clones of MRSA in Yunnan province were generated, belonged to the 'Asian-Pacific' clone (AP) and 'Taiwan' clone (TW) respectively. CONCLUSIONS ST239-t030, ST59-t437 and ST6-t701 were the three major MRSA clones in Yunnan province of China. ST239-t030 clonal Yunnan isolates demonstrated the local endemic of clone establishment for a number of years, whereas ST59-t437 strains revealed the multi-origins of this clone. In general, genomic study on epidemic clones of MRSA in southwest China provided the features and evolution of this pathogen.
Collapse
|
11
|
Yuan W, Liu J, Zhan Y, Wang L, Jiang Y, Zhang Y, Sun N, Hou N. Molecular typing revealed the emergence of pvl-positive sequence type 22 methicillin-susceptible Staphylococcus aureus in Urumqi, Northwestern China. Infect Drug Resist 2019; 12:1719-1728. [PMID: 31354320 PMCID: PMC6590632 DOI: 10.2147/idr.s202906] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/21/2019] [Indexed: 02/04/2023] Open
Abstract
Background Staphylococcus aureus is among the most common causes of health care- and community-associated infections worldwide. The distributions of different S. aureus clones change over time and also vary geographically. The purpose of this study was to determine the molecular type and antimicrobial resistance profiles of clinical S. aureus strains isolated in Urumqi, Northwestern China. Methods A total of 605 clinical S. aureus isolates were collected from Xinjiang Military General Hospital, in Urumqi. Protein A-encoding (spa) typing, multilocus sequence typing, staphylococcal chromosomal cassette mec typing, Panton-Valentine leucocidin (pvl) gene detection, and antimicrobial resistance profiling were performed. Results Among these strains, 271 isolates (44.7%) were methicillin-resistant S. aureus (MRSA) and 334 (55.3%) were methicillin-susceptible S. aureus (MSSA). The MRSA strains consisted of 22 spa types and 14 sequence types (STs). ST239-MRSA-III-t030 (73.1%, 198/271) and ST59-MRSA-IV-t437 (11.8%, 32/271) were the most common, and ST22-MRSA-IV-t309 was the rarest (2.02%, 6/271). The MSSA strains consisted of 93 spa types and 29 STs. ST22, ST121, ST398, ST5, ST7, ST188, and ST15 were the main MSSA STs, and ST22-MSSA-t309 was most common (26.0%, 87/334). The pvl gene was present in 20.3% of all S.aureus strains, and 80.8% (88/99) of ST22-MSSA strains harbored the pvl gene. A total of 85.7% pvl-positive ST22-MSSA strains were spa t309 (85/99), and 87.5% of pvl-positive ST22-MSSA strains were from abscesses or wounds (skin and soft tissue infections). All ST239-MRSA strains were resistant to gentamicin (GEN), levofloxacin (LEV), ciprofloxacin (CIP), moxifloxacin (MXF), rifampicin (RIF), and tetracycline (TET). Among the ST59-MRSA strains, over 70.0% were resistant to erythromycin (ERY), clindamycin (CLI), and TET. ST22-MSSA remained susceptible to most antibiotics, but was resistant to PEN (97.0%), ERY (57.6%), and CLI (15.2%). Conclusion Our major results indicated that the antimicrobial resistance profiles and pvl genes of S. aureus isolates from Urumqi were closely associated with clonal lineage. ST239-MRSA-III-t030 and pvl-positive ST22-MSSA-t309 were the most common clones in this region of Northwestern China.
Collapse
Affiliation(s)
- Wenchang Yuan
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China.,Department of Clinical Laboratory, General Hospital of Xinjiang Military Region, Urumqi 830001, People's Republic of China
| | - Jianhua Liu
- Department of Clinical Laboratory, General Hospital of Xinjiang Military Region, Urumqi 830001, People's Republic of China.,Department of Intensive Care Unit, the Fourth Hospital of Changsha, Changsha 410006, People's Republic of China
| | - Youchao Zhan
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China
| | - Li Wang
- Department of Clinical Laboratory, General Hospital of Xinjiang Military Region, Urumqi 830001, People's Republic of China
| | - Yanqiong Jiang
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China
| | - Yanling Zhang
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China
| | - Ning Sun
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China.,State Key Laboratory of Chemical Biology and Drug Discovery, and Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, People's Republic of China
| | - Ning Hou
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China.,School of Pharmaceutical Sciences, Guangzhou Medical University, Guangzhou 511436, People's Republic of China
| |
Collapse
|
12
|
De Backer S, Xavier B, Vanjari L, Coppens J, Lammens C, Vemu L, Carevic B, Hryniewicz W, Jorens P, Kumar-Singh S, Lee A, Harbarth S, Schrenzel J, Tacconelli E, Goossens H, Malhotra-Kumar S. Remarkable geographical variations between India and Europe in carriage of the staphylococcal surface protein-encoding sasX/sesI and in the population structure of methicillin-resistant Staphylococcus aureus belonging to clonal complex 8. Clin Microbiol Infect 2019; 25:628.e1-628.e7. [DOI: 10.1016/j.cmi.2018.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/10/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
|
13
|
Botelho AMN, Cerqueira e Costa MO, Moustafa AM, Beltrame CO, Ferreira FA, Côrtes MF, Costa BSS, Silva DNS, Bandeira PT, Lima NCB, Souza RC, de Almeida LGP, Vasconcelos ATR, Narechania A, Ryan C, O’Brien K, Kolokotronis SO, Planet PJ, Nicolás MF, Figueiredo AMS. Local Diversification of Methicillin- Resistant Staphylococcus aureus ST239 in South America After Its Rapid Worldwide Dissemination. Front Microbiol 2019; 10:82. [PMID: 30873127 PMCID: PMC6400870 DOI: 10.3389/fmicb.2019.00082] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 01/16/2019] [Indexed: 12/18/2022] Open
Abstract
The global spread of specific clones of methicillin-resistant Staphylococcus aureus (MRSA) has become a major public health problem, and understanding the dynamics of geographical spread requires worldwide surveillance. Over the past 20 years, the ST239 lineage of MRSA has been recognized as an emerging clone across the globe, with detailed studies focusing on isolates from Europe and Asia. Less is known about this lineage in South America, and, particularly, Brazil where it was the predominant lineage of MRSA in the early 1990s to 2000s. To gain a better understanding about the introduction and spread of ST239 MRSA in Brazil we undertook a comparative phylogenomic analysis of ST239 genomes, adding seven completed, closed Brazilian genomes. Brazilian ST239 isolates grouped in a subtree with those from South American, and Western, romance-language-speaking, European countries, here designated the South American clade. After an initial worldwide radiation in the 1960s and 1970s, we estimate that ST239 began to spread in South America and Brazil in approximately 1988. This clone demonstrates specific genomic changes that are suggestive of local divergence and adaptational change including agrC single-nucleotide polymorphisms variants, and a distinct pattern of virulence-associated genes (mainly the presence of the chp and the absence of sea and sasX). A survey of a geographically and chronologically diverse set of 100 Brazilian ST239 isolates identified this virulence genotype as the predominant pattern in Brazil, and uncovered an unexpectedly high prevalence of agr-dysfunction (30%). ST239 isolates from Brazil also appear to have undergone transposon (IS256) insertions in or near global regulatory genes (agr and mgr) that likely led to rapid reprogramming of bacterial traits. In general, the overall pattern observed in phylogenomic analyses of ST239 is of a rapid initial global radiation, with subsequent local spread and adaptation in multiple different geographic locations. Most ST239 isolates harbor the ardA gene, which we show here to have in vivo anti-restriction activity. We hypothesize that this gene may have improved the ability of this lineage to acquire multiple resistance genes and distinct virulence-associated genes in each local context. The allopatric divergence pattern of ST239 also may suggest strong selective pressures for specific traits in different geographical locations.
Collapse
Affiliation(s)
- Ana Maria Nunes Botelho
- Laboratório de Biologia Molecular de Bactérias, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ahmed M. Moustafa
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, United States
| | - Cristiana Ossaille Beltrame
- Laboratório de Biologia Molecular de Bactérias, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fabienne Antunes Ferreira
- Laboratório de Biologia Molecular de Bactérias, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marina Farrel Côrtes
- Laboratório de Biologia Molecular de Bactérias, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruno Souza Scramignon Costa
- Laboratório de Biologia Molecular de Bactérias, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Deborah Nascimento Santos Silva
- Laboratório de Biologia Molecular de Bactérias, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula Terra Bandeira
- Laboratório de Biologia Molecular de Bactérias, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Rangel Celso Souza
- Laboratório Nacional de Computação Científica, Petrópolis, Rio de Janeiro, Brazil
| | | | | | - Apurva Narechania
- Sackler Institute for Comparative Genomics, American Museum of Natural History, New York, NY, United States
| | - Chanelle Ryan
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, United States
| | - Kelsey O’Brien
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, United States
| | - Sergios-Orestis Kolokotronis
- Sackler Institute for Comparative Genomics, American Museum of Natural History, New York, NY, United States
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Paul J. Planet
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, United States
- Sackler Institute for Comparative Genomics, American Museum of Natural History, New York, NY, United States
| | | | - Agnes Marie Sá Figueiredo
- Laboratório de Biologia Molecular de Bactérias, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
14
|
Monecke S, Slickers P, Gawlik D, Müller E, Reissig A, Ruppelt-Lorz A, Akpaka PE, Bandt D, Bes M, Boswihi SS, Coleman DC, Coombs GW, Dorneanu OS, Gostev VV, Ip M, Jamil B, Jatzwauk L, Narvaez M, Roberts R, Senok A, Shore AC, Sidorenko SV, Skakni L, Somily AM, Syed MA, Thürmer A, Udo EE, Vremerǎ T, Zurita J, Ehricht R. Molecular Typing of ST239-MRSA-III From Diverse Geographic Locations and the Evolution of the SCC mec III Element During Its Intercontinental Spread. Front Microbiol 2018; 9:1436. [PMID: 30087657 PMCID: PMC6066798 DOI: 10.3389/fmicb.2018.01436] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/11/2018] [Indexed: 11/13/2022] Open
Abstract
ST239-MRSA-III is probably the oldest truly pandemic MRSA strain, circulating in many countries since the 1970s. It is still frequently isolated in some parts of the world although it has been replaced by other MRSA strains in, e.g., most of Europe. Previous genotyping work (Harris et al., 2010; Castillo-Ramírez et al., 2012) suggested a split in geographically defined clades. In the present study, a collection of 184 ST239-MRSA-III isolates, mainly from countries not covered by the previous studies were characterized using two DNA microarrays (i) targeting an extensive range of typing markers, virulence and resistance genes and (ii) a SCCmec subtyping array. Thirty additional isolates underwent whole-genome sequencing (WGS) and, together with published WGS data for 215 ST239-MRSA-III isolates, were analyzed using in-silico analysis for comparison with the microarray data and with special regard to variation within SCCmec elements. This permitted the assignment of isolates and sequences to 39 different SCCmec III subtypes, and to three major and several minor clades. One clade, characterized by the integration of a transposon into nsaB and by the loss of fnbB and splE was detected among isolates from Turkey, Romania and other Eastern European countries, Russia, Pakistan, and (mainly Northern) China. Another clade, harboring sasX/sesI is widespread in South-East Asia including China/Hong Kong, and surprisingly also in Trinidad & Tobago. A third, related, but sasX/sesI-negative clade occurs not only in Latin America but also in Russia and in the Middle East from where it apparently originated and from where it also was transferred to Ireland. Minor clades exist or existed in Western Europe and Greece, in Portugal, in Australia and New Zealand as well as in the Middle East. Isolates from countries where this strain is not epidemic (such as Germany) frequently are associated with foreign travel and/or hospitalization abroad. The wide dissemination of this strain and the fact that it was able to cause a hospital-borne pandemic that lasted nearly 50 years emphasizes the need for stringent infection prevention and control and admission screening.
Collapse
Affiliation(s)
- Stefan Monecke
- Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany.,Medical Faculty "Carl Gustav Carus", Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Dresden, Germany
| | - Peter Slickers
- Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| | - Darius Gawlik
- Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| | - Elke Müller
- Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| | - Annett Reissig
- Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| | - Antje Ruppelt-Lorz
- Medical Faculty "Carl Gustav Carus", Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Dresden, Germany
| | - Patrick E Akpaka
- Department of Paraclinical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Dirk Bandt
- Instituts für Labordiagnostik, Mikrobiologie und Krankenhaushygiene, Oberlausitz-Kliniken, Bautzen, Germany
| | - Michele Bes
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Samar S Boswihi
- Microbiology Department, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - David C Coleman
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Geoffrey W Coombs
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA, Australia
| | - Olivia S Dorneanu
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine & Pharmacy "Grigore T Popa", Iaşi, Romania
| | - Vladimir V Gostev
- Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russia
| | - Margaret Ip
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Bushra Jamil
- Department of Biosciences, COMSATS Institute of Information Technology, Islamabad, Pakistan.,Department of Biogenetics, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Lutz Jatzwauk
- Department of Hospital Infection Control, Dresden University Hospital, Dresden, Germany
| | - Marco Narvaez
- Department of Hospital Infection Control, Dresden University Hospital, Dresden, Germany
| | - Rashida Roberts
- Department of Paraclinical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Abiola Senok
- Department of Basic Medical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Anna C Shore
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Sergey V Sidorenko
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Leila Skakni
- Molecular Pathology Laboratory, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ali M Somily
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Muhammad Ali Syed
- Department of Microbiology, University of Haripur, Haripur, Pakistan
| | - Alexander Thürmer
- Medical Faculty "Carl Gustav Carus", Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Dresden, Germany
| | - Edet E Udo
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Teodora Vremerǎ
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine & Pharmacy "Grigore T Popa", Iaşi, Romania
| | - Jeannete Zurita
- Facultad de Medicina, Pontificia Universidad Catolica del Ecuador, Quito, Ecuador.,Zurita & Zurita Laboratorios, Unidad de Investigaciones en Biomedicina, Quito, Ecuador
| | - Ralf Ehricht
- Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| |
Collapse
|
15
|
Improved Subtyping of Staphylococcus aureus Clonal Complex 8 Strains Based on Whole-Genome Phylogenetic Analysis. mSphere 2018; 3:3/3/e00464-17. [PMID: 29720527 PMCID: PMC5932376 DOI: 10.1128/msphere.00464-17] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/12/2017] [Indexed: 12/12/2022] Open
Abstract
Staphylococcus aureus is a major human pathogen worldwide in both community and health care settings. Surveillance for S. aureus strains is important to our understanding of their spread and to informing infection prevention and control. Confusion surrounding the strain nomenclature of one of the most prevalent lineages of S. aureus, clonal complex 8 (CC8), and the imprecision of current tools for typing S. aureus make surveillance and source tracing difficult and sometimes misleading. In this study, we clarify the CC8 strain designations and propose a new typing scheme for CC8 isolates that is rapid and easy to use. This typing scheme is based on relatively stable genomic markers, and we demonstrate its superiority over traditional typing techniques. This scheme has the potential to greatly improve epidemiological investigations of S. aureus. Strains of Staphylococcus aureus in clonal complex 8 (CC8), including USA300, USA500, and the Iberian clone, are prevalent pathogens in the United States, both inside and outside health care settings. Methods for typing CC8 strains are becoming obsolete as the strains evolve and diversify, and whole-genome sequencing has shown that some strain types fall into multiple sublineages within CC8. In this study, we attempt to clarify the strain nomenclature of CC8, classifying the major strain types based on whole-genome sequence phylogenetics using both methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) genomes. We show that isolates of the Archaic and Iberian clones from decades ago make up the most basal clade of the main CC8 lineages and that at least one successful lineage of CC8, made up mostly of MSSA, diverged before the other well-known strain types USA500 and USA300. We also show that the USA500 type includes two clades separated by the previously described “Canadian epidemic MRSA” strain CMRSA9, that one clade containing USA500 also contains the USA300 clade, and that the USA300-0114 strain type is not a monophyletic group. Additionally, we present a rapid, simple CC8 strain-typing scheme using real-time PCR assays that target single nucleotide polymorphisms (SNPs) derived from our CC8 phylogeny and show the significant benefit of using more stable genomic markers based on evolutionary lineages over traditional S. aureus typing techniques. This more accurate and accessible S. aureus typing system may improve surveillance and better inform the epidemiology of this very important pathogen. IMPORTANCEStaphylococcus aureus is a major human pathogen worldwide in both community and health care settings. Surveillance for S. aureus strains is important to our understanding of their spread and to informing infection prevention and control. Confusion surrounding the strain nomenclature of one of the most prevalent lineages of S. aureus, clonal complex 8 (CC8), and the imprecision of current tools for typing S. aureus make surveillance and source tracing difficult and sometimes misleading. In this study, we clarify the CC8 strain designations and propose a new typing scheme for CC8 isolates that is rapid and easy to use. This typing scheme is based on relatively stable genomic markers, and we demonstrate its superiority over traditional typing techniques. This scheme has the potential to greatly improve epidemiological investigations of S. aureus.
Collapse
|
16
|
Nakaminami H, Ito T, Han X, Ito A, Matsuo M, Uehara Y, Baba T, Hiramatsu K, Noguchi N. First report of sasX-positive methicillin-resistant Staphylococcus aureus in Japan. FEMS Microbiol Lett 2017; 364:4067809. [DOI: 10.1093/femsle/fnx171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 08/04/2017] [Indexed: 11/13/2022] Open
|
17
|
Li L, Ye L, Yu L, Zhou C, Meng H. Characterization of Extended Spectrum Β-Lactamase ProducingEnterobacteriaand Methicillin-ResistantStaphylococcus aureusIsolated from Raw Pork and Cooked Pork Products in South China. J Food Sci 2016; 81:M1773-7. [DOI: 10.1111/1750-3841.13346] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/13/2016] [Accepted: 04/27/2016] [Indexed: 01/12/2023]
Affiliation(s)
- Lili Li
- College of Light Industry and Food Sciences; South China Univ. of Technology; Guangzhou 510640 Guangdong People's Republic of China
| | - Lei Ye
- China and Research Inst. of Food Safety and Nutrition; Jinan Univ; Guangzhou 510632 Guangdong People's Republic of China
| | - Li Yu
- College of Light Industry and Food Sciences; South China Univ. of Technology; Guangzhou 510640 Guangdong People's Republic of China
| | - Chenqing Zhou
- College of Light Industry and Food Sciences; South China Univ. of Technology; Guangzhou 510640 Guangdong People's Republic of China
| | - Hecheng Meng
- College of Light Industry and Food Sciences; South China Univ. of Technology; Guangzhou 510640 Guangdong People's Republic of China
| |
Collapse
|
18
|
Gutiérrez D, Rodríguez-Rubio L, García P, Billington C, Premarante A, Rodríguez A, Martínez B. Phage sensitivity and prophage carriage in Staphylococcus aureus isolated from foods in Spain and New Zealand. Int J Food Microbiol 2016; 230:16-20. [PMID: 27111797 DOI: 10.1016/j.ijfoodmicro.2016.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/14/2016] [Accepted: 04/13/2016] [Indexed: 01/08/2023]
Abstract
Bacteriophages (phages) are a promising tool for the biocontrol of pathogenic bacteria, including those contaminating food products and causing infectious diseases. However, the success of phage preparations is limited by the host ranges of their constituent phages. The phage resistance/sensitivity profile of eighty seven Staphylococcus aureus strains isolated in Spain and New Zealand from dairy, meat and seafood sources was determined for six phages (Φ11, K, ΦH5, ΦA72, CAPSa1 and CAPSa3). Most of the S. aureus strains were sensitive to phage K (Myoviridae) and CAPSa1 (Siphoviridae) regardless of their origin. There was a higher sensitivity of New Zealand S. aureus strains to phages isolated from both Spain (ΦH5 and ΦA72) and New Zealand (CAPSa1 and CAPSa3). Spanish phages had a higher infectivity on S. aureus strains of Spanish dairy origin, while Spanish strains isolated from other environments were more sensitive to New Zealand phages. Lysogeny was more prevalent in Spanish S. aureus compared to New Zealand strains. A multiplex PCR reaction, which detected ΦH5 and ΦA72 sequences, indicated a high prevalence of these prophages in Spanish S. aureus strains, but were infrequently detected in New Zealand strains. Overall, the correlation between phage resistance and lysogeny in S. aureus strains was found to be weak.
Collapse
Affiliation(s)
- Diana Gutiérrez
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC). Paseo Río Linares s/n, 33300 Villaviciosa, Asturias, Spain
| | - Lorena Rodríguez-Rubio
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC). Paseo Río Linares s/n, 33300 Villaviciosa, Asturias, Spain
| | - Pilar García
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC). Paseo Río Linares s/n, 33300 Villaviciosa, Asturias, Spain
| | - Craig Billington
- Food, Water and Environmental Microbiology Group, Institute of Environmental Science and Research, Christchurch Science Centre, Christchurch 8041, New Zealand
| | - Aruni Premarante
- Food, Water and Environmental Microbiology Group, Institute of Environmental Science and Research, Christchurch Science Centre, Christchurch 8041, New Zealand
| | - Ana Rodríguez
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC). Paseo Río Linares s/n, 33300 Villaviciosa, Asturias, Spain
| | - Beatriz Martínez
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC). Paseo Río Linares s/n, 33300 Villaviciosa, Asturias, Spain.
| |
Collapse
|
19
|
Kong Z, Zhao P, Liu H, Yu X, Qin Y, Su Z, Wang S, Xu H, Chen J. Whole-Genome Sequencing for the Investigation of a Hospital Outbreak of MRSA in China. PLoS One 2016; 11:e0149844. [PMID: 26950298 PMCID: PMC4780730 DOI: 10.1371/journal.pone.0149844] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 02/05/2016] [Indexed: 11/19/2022] Open
Abstract
Staphylococcus aureus is a globally disseminated drug-resistant bacterial species. It remains a leading cause of hospital-acquired infection, primarily among immunocompromised patients. In 2012, the Affiliated People’s Hospital of Jiangsu University experienced a putative outbreak of methicillin-resistant S. aureus (MRSA) that affected 12 patients in the Neurosurgery Department. In this study, whole-genome sequencing (WGS) was used to gain insight into the epidemiology of the outbreak caused by MRSA, and traditional bacterial genotyping approaches were also applied to provide supportive evidence for WGS. We sequenced the DNA from 6 isolates associated with the outbreak. Phylogenetic analysis was constructed by comparing single-nucleotide polymorphisms (SNPs) in the core genome of 6 isolates in the present study and another 3 referenced isolates from GenBank. Of the 6 MRSA sequences in the current study, 5 belonged to the same group, clustering with T0131, while the other one clustered closely with TW20. All of the isolates were identified as ST239-SCCmecIII clones. Whole-genome analysis revealed that four of the outbreak isolates were more tightly clustered into a group and SA13002 together with SA13009 were distinct from the outbreak strains, which were considered non-outbreak strains. Based on the sequencing results, the antibiotic-resistance gene status (present or absent) was almost perfectly concordant with the results of phenotypic susceptibility testing. Various toxin genes were also analyzed successfully. Our analysis demonstrates that using traditional molecular methods and WGS can facilitate the identification of outbreaks and help to control nosocomial transmission.
Collapse
Affiliation(s)
- Zhenzhen Kong
- Department of Clinical Laboratory, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, China
- Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China
| | - Peipei Zhao
- Department of Clinical Laboratory, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, China
- Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China
| | - Haibing Liu
- Department of Clinical Laboratory, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, China
- Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China
| | - Xiang Yu
- Department of Neurosurgery, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, PR China
| | - Yanyan Qin
- Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China
| | - Zhaoliang Su
- Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China
| | - Shengjun Wang
- Department of Clinical Laboratory, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, China
| | - Huaxi Xu
- Department of Immunology, Institute of Laboratory Medicine, Jiangsu University, Zhenjiang, China
| | - Jianguo Chen
- Department of Clinical Laboratory, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, China
- * E-mail:
| |
Collapse
|
20
|
Shang W, Hu Q, Yuan W, Cheng H, Yang J, Hu Z, Yuan J, Zhang X, Peng H, Yang Y, Hu X, Li M, Zhu J, Rao X. Comparative Fitness and Determinants for the Characteristic Drug Resistance of ST239-MRSA-III-t030 and ST239-MRSA-III-t037 Strains Isolated in China. Microb Drug Resist 2015; 22:185-92. [PMID: 26565599 DOI: 10.1089/mdr.2015.0226] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Sequence type (ST) 239 with SCCmec type III methicillin-resistant Staphylococcus aureus (ST239-MRSA-III) is the most predominant multidrug-resistant clone in China. The subclone ST239-MRSA-III-t037 has been gradually replaced with ST239-MRSA-III-t030 since 2000. Subclones are characterized by drug resistance profiles. However, the mechanisms of the clonal dynamics and determinants of distinct drug resistance remain poorly understood. In the present study, 12 ST239-MRSA-III-t030 and 12 ST239-MRSA-III-t037 strains were collected from Chongqing, Guangzhou, and Shanghai; these strains were selected and investigated in terms of t030/t037 strain pairs. Independent growth curve assay revealed that the ST239-MRSA-III-t030 strains grew more rapidly, with significantly shorter doubling times, than the ST239-MRSA-III-t037 strains (p < 0.001). The ST239-MRSA-III-t037 strains exhibited slightly to moderately higher (3-13%) fitness cost than the ST239-MRSA-III-t030 strains in a competition assay in vitro. The ST239-MRSA-III-t037 strains yielded lower bacterial loads in the kidneys of the infected mice than the ST239-MRSA-III-t030 rivals in a coinfection assay (p < 0.05). The ST239-MRSA-III-t030 strains were resistant to rifampicin but susceptible to trimethoprim/sulfamethoxazole (SXT). In contrast, the ST239-MRSA-III-t037 strains were susceptible to rifampicin but resistant to SXT. The genetic determinants of the resistance to rifampicin and SXT in the MRSA strains were determined. Our results suggest that the relatively low fitness cost and characteristic drug resistance phenotype can help explain the current predominance of these ST239-MRSA-III-t030 strains in Chinese hospitals.
Collapse
Affiliation(s)
- Weilong Shang
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Qiwen Hu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Wenchang Yuan
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China .,2 Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA , Urumqi, China
| | - Hang Cheng
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Jie Yang
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Zhen Hu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Jizhen Yuan
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Xiaopeng Zhang
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Huagang Peng
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Yancheng Yang
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Xiaomei Hu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Ming Li
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Junmin Zhu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Xiancai Rao
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| |
Collapse
|
21
|
Healthcare- and Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) and Fatal Pneumonia with Pediatric Deaths in Krasnoyarsk, Siberian Russia: Unique MRSA's Multiple Virulence Factors, Genome, and Stepwise Evolution. PLoS One 2015; 10:e0128017. [PMID: 26047024 PMCID: PMC4457420 DOI: 10.1371/journal.pone.0128017] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 04/21/2015] [Indexed: 12/25/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a common multidrug-resistant (MDR) pathogen. We herein discussed MRSA and its infections in Krasnoyarsk, Siberian Russia between 2007 and 2011. The incidence of MRSA in 3,662 subjects was 22.0% and 2.9% for healthcare- and community-associated MRSA (HA- and CA-MRSA), respectively. The 15-day mortality rates for MRSA hospital- and community-acquired pneumonia (HAP and CAP) were 6.5% and 50%, respectively. MRSA CAP cases included pediatric deaths; of the MRSA pneumonia episodes available, ≥27.3% were associated with bacteremia. Most cases of HA-MRSA examined exhibited ST239/spa3(t037)/SCCmecIII.1.1.2 (designated as ST239Kras), while all CA-MRSA cases examined were ST8/spa1(t008)/SCCmecIV.3.1.1(IVc) (designated as ST8Kras). ST239Kras and ST8Kras strongly expressed cytolytic peptide (phenol-soluble modulin α, PSMα; and δ-hemolysin, Hld) genes, similar to CA-MRSA. ST239Kras pneumonia may have been attributed to a unique set of multiple virulence factors (MVFs): toxic shock syndrome toxin-1 (TSST-1), elevated PSMα/Hld expression, α-hemolysin, the staphylococcal enterotoxin SEK/SEQ, the immune evasion factor SCIN/SAK, and collagen adhesin. Regarding ST8Kras, SEA was included in MVFs, some of which were common to ST239Kras. The ST239Kras (strain OC3) genome contained: a completely unique phage, φSa7-like (W), with no att repetition; S. aureus pathogenicity island SaPI2R, the first TSST-1 gene-positive (tst+) SaPI in the ST239 lineage; and a super copy of IS256 (≥22 copies/genome). ST239Kras carried the Brazilian SCCmecIII.1.1.2 and United Kingdom-type tst. ST239Kras and ST8Kras were MDR, with the same levofloxacin resistance mutations; small, but transmissible chloramphenicol resistance plasmids spread widely enough to not be ignored. These results suggest that novel MDR and MVF+ HA- and CA-MRSA (ST239Kras and ST8Kras) emerged in Siberian Russia (Krasnoyarsk) associated with fatal pneumonia, and also with ST239Kras, a new (Siberian Russian) clade of the ST239 lineage, which was created through stepwise evolution during its potential transmission route of Brazil-Europe-Russia/Krasnoyarsk, thereby selective advantages from unique MVFs and the MDR.
Collapse
|