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Yang Y, Xie S, He F, Xu Y, Wang Z, Ihsan A, Wang X. Recent development and fighting strategies for lincosamide antibiotic resistance. Clin Microbiol Rev 2024; 37:e0016123. [PMID: 38634634 PMCID: PMC11237733 DOI: 10.1128/cmr.00161-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
SUMMARYLincosamides constitute an important class of antibiotics used against a wide range of pathogens, including methicillin-resistant Staphylococcus aureus. However, due to the misuse of lincosamide and co-selection pressure, the resistance to lincosamide has become a serious concern. It is urgently needed to carefully understand the phenomenon and mechanism of lincosamide resistance to effectively prevent and control lincosamide resistance. To date, six mobile lincosamide resistance classes, including lnu, cfr, erm, vga, lsa, and sal, have been identified. These lincosamide resistance genes are frequently found on mobile genetic elements (MGEs), such as plasmids, transposons, integrative and conjugative elements, genomic islands, and prophages. Additionally, MGEs harbor the genes that confer resistance not only to antimicrobial agents of other classes but also to metals and biocides. The ultimate purpose of discovering and summarizing bacterial resistance is to prevent, control, and combat resistance effectively. This review highlights four promising strategies, including chemical modification of antibiotics, the development of antimicrobial peptides, the initiation of bacterial self-destruct program, and antimicrobial stewardship, to fight against resistance and safeguard global health.
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Affiliation(s)
- Yingying Yang
- National Reference Laboratory of Veterinary Drug Residues (HZAU), Huazhong Agricultural University, Wuhan, Hubei, China
- MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei, China
| | - Shiyu Xie
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural University, Wuhan, Hubei, China
| | - Fangjing He
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural University, Wuhan, Hubei, China
| | - Yindi Xu
- Institute of Animal Husbandry Research, Henan Academy of Agricultural Sciences, Zhengzhou, Henan, China
| | - Zhifang Wang
- Institute of Animal Husbandry Research, Henan Academy of Agricultural Sciences, Zhengzhou, Henan, China
| | - Awais Ihsan
- Department of Biosciences, COMSATS University Islamabad, Sahiwal campus, Islamabad, Pakistan
| | - Xu Wang
- National Reference Laboratory of Veterinary Drug Residues (HZAU), Huazhong Agricultural University, Wuhan, Hubei, China
- MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei, China
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural University, Wuhan, Hubei, China
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2
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Dalmieda J, Hitchcock M, Xu J. High diversity within and low but significant genetic differentiation among geographic and temporal populations of the global Streptococcus pneumoniae. Can J Microbiol 2024; 70:226-237. [PMID: 38422492 DOI: 10.1139/cjm-2023-0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Streptococcus pneumoniae is the major cause of invasive pneumococcal disease. However, the global population structure remains largely unexplored. In this study, we investigated the spatial and temporal patterns of genetic variation of S. pneumoniae based on archived multilocus sequence typing data from PubMLST.org. Our analyses demonstrated both shared and unique distributions of sequence types (STs) and allele types among regional populations. Among the 17 915 global STs, 36 representing 15 263 isolates were broadly shared among all six continents, consistent with recent clonal dispersal and expansion of this pathogen. The analysis of molecular variance revealed that >96% genetic variations were found within individual regional populations. However, though low (<4%), statistically significant genetic differentiation among regional populations was observed. Comparisons between non-clone-corrected and clone-corrected datasets showed that localized clonal expansion contributed significantly to the observed genetic differentiations among regions. Temporal analyses of the isolates showed that implementation of pneumococcal conjugate vaccine impacted the distributions of STs, but the effect on population structure was relatively limited. Linkage disequilibrium analyses identified evidence for recombination in all continental populations; however, the inferred recombination was not random. We discussed the limitations and implications of our analyses to the global epidemiology and future vaccine developments for S. pneumoniae.
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Affiliation(s)
- Jezreel Dalmieda
- Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Megan Hitchcock
- Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada
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3
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Räz AK, Andreoni F, Boumasmoud M, Bergada-Pijuan J, Schweizer TA, Mairpady Shambat S, Hasse B, Zinkernagel AS, Brugger SD. Limited Adaptation of Staphylococcus aureus during Transition from Colonization to Invasive Infection. Microbiol Spectr 2023; 11:e0259021. [PMID: 37341598 PMCID: PMC10433843 DOI: 10.1128/spectrum.02590-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 05/24/2023] [Indexed: 06/22/2023] Open
Abstract
Staphylococcus aureus carriage is a risk factor for invasive infections. Unique genetic elements favoring the transition from colonizing to invasive phenotype have not yet been identified, and phenotypic adaptation traits are understudied. We therefore assessed phenotypic and genotypic profiles of 11 S. aureus isolate pairs sampled from colonized patients simultaneously suffering from invasive S. aureus infections. Ten out of 11 isolate pairs displayed the same spa and multilocus sequence type, suggesting colonization as an origin for the invasive infection. Systematic analysis of colonizing and invasive isolate pairs showed similar adherence, hemolysis, reproductive fitness properties, antibiotic tolerance, and virulence in a Galleria mellonella infection model, as well as minimal genetic differences. Our results provide insights into the similar phenotypes associated with limited adaptation between colonizing and invasive isolates. Disruption of the physical barriers of mucosa or skin was identified in the majority of patients, further emphasizing colonization as a major risk factor for invasive disease. IMPORTANCE S. aureus is a major pathogen of humans, causing a wide range of diseases. The difficulty to develop a vaccine and antibiotic treatment failure warrant the exploration of novel treatment strategies. Asymptomatic colonization of the human nasal passages is a major risk factor for invasive disease, and decolonization procedures have been effective in preventing invasive infections. However, the transition of S. aureus from a benign colonizer of the nasal passages to a major pathogen is not well understood, and both host and bacterial properties have been discussed as being relevant for this behavioral change. We conducted a thorough investigation of patient-derived strain pairs reflecting colonizing and invasive isolates in a given patient. Although we identified limited genetic adaptation in certain strains, as well as slight differences in adherence capacity among colonizing and invasive isolates, our work suggests that barrier breaches are a key event in the disease continuum of S. aureus.
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Affiliation(s)
- Anna K. Räz
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Federica Andreoni
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mathilde Boumasmoud
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Judith Bergada-Pijuan
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tiziano A. Schweizer
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Srikanth Mairpady Shambat
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Barbara Hasse
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Annelies S. Zinkernagel
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Silvio D. Brugger
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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4
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Gómez-Martínez J, Rocha-Gracia RDC, Bello-López E, Cevallos MA, Castañeda-Lucio M, Sáenz Y, Jiménez-Flores G, Cortés-Cortés G, López-García A, Lozano-Zarain P. Comparative Genomics of Pseudomonas aeruginosa Strains Isolated from Different Ecological Niches. Antibiotics (Basel) 2023; 12:antibiotics12050866. [PMID: 37237769 DOI: 10.3390/antibiotics12050866] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/27/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
The Pseudomonas aeruginosa genome can change to adapt to different ecological niches. We compared four genomes from a Mexican hospital and 59 genomes from GenBank from different niches, such as urine, sputum, and environmental. The ST analysis showed that high-risk STs (ST235, ST773, and ST27) were present in the genomes of the three niches from GenBank, and the STs of Mexican genomes (ST167, ST2731, and ST549) differed from the GenBank genomes. Phylogenetic analysis showed that the genomes were clustering according to their ST and not their niche. When analyzing the genomic content, we observed that environmental genomes had genes involved in adapting to the environment not found in the clinics and that their mechanisms of resistance were mutations in antibiotic resistance-related genes. In contrast, clinical genomes from GenBank had resistance genes, in mobile/mobilizable genetic elements in the chromosome, except for the Mexican genomes that carried them mostly in plasmids. This was related to the presence of CRISPR-Cas and anti-CRISPR; however, Mexican strains only had plasmids and CRISPR-Cas. blaOXA-488 (a variant of blaOXA50) with higher activity against carbapenems was more prevalent in sputum genomes. The virulome analysis showed that exoS was most prevalent in the genomes of urinary samples and exoU and pldA in sputum samples. This study provides evidence regarding the genetic variability among P. aeruginosa isolated from different niches.
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Affiliation(s)
- Jessica Gómez-Martínez
- Posgrado en Microbiología, Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico
| | - Rosa Del Carmen Rocha-Gracia
- Posgrado en Microbiología, Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico
| | - Elena Bello-López
- Programa de Genómica Evolutiva, Centro de Ciencias Genómicas, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - Miguel Angel Cevallos
- Programa de Genómica Evolutiva, Centro de Ciencias Genómicas, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - Miguel Castañeda-Lucio
- Posgrado en Microbiología, Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico
| | - Yolanda Sáenz
- Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja (CIBIR), 26006 Logroño, Spain
| | - Guadalupe Jiménez-Flores
- Laboratorio Clínico, Área de Microbiología, Hospital Regional Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Puebla 72570, Mexico
| | - Gerardo Cortés-Cortés
- Department of Microbiology and Environmental Toxicology, University of California at Santa Cruz, Santa Cruz, CA 95064, USA
| | - Alma López-García
- Posgrado en Microbiología, Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico
| | - Patricia Lozano-Zarain
- Posgrado en Microbiología, Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico
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Schechner V, Levytskyi K, Shalom O, Yalek A, Adler A. A hospital-wide outbreak of IMI-17-producing Enterobacter ludwigii in an Israeli hospital. Antimicrob Resist Infect Control 2021; 10:166. [PMID: 34844659 PMCID: PMC8630898 DOI: 10.1186/s13756-021-01036-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 11/21/2021] [Indexed: 11/11/2022] Open
Abstract
Background To describe the course and intervention of an hospital-wide IMI-Producing Enterobacter ludwigii outbreak. Methods This was an outbreak interventional study, done at a tertiary care center in Tel-Aviv, Israel. Data was collected on the course of the outbreak and the demographic and clinical characteristics of all patients involved in the outbreak. The intervention measures included patients’ cohorting, contact isolation precautions, environmental cleaning and screening of contacts. The molecular features and phylogeny of outbreak-related isolates were studied by whole-genome based analysis. Results The outbreak included 34 patients that were colonized by IMI-Producing E. ludwigii and were identified in 24 wards throughout the hospital. Colonization was identified in the first 72 h of admission in 13/34 patients (38.2%). Most patients (91.2%) were admitted from home and had relatively low level of comorbidities. The majority of them (88%) had no recent use of invasive catheters and none had previous carriage of other multi-drug resistant bacteria. All available isolates harbored the blaIMI-17 allele and belonged to Sequence-Type 385. With the exception of two isolates, all isolates were closely related with less than a 20-SNP difference between them. Conclusions This outbreak had most likely originated in the community and subsequently disseminated inside our institution. More studies are required in order to elucidate the epidemiology of IMI-Producing E. ludwigii and the possible role of environmental sources in its dissemination.
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Affiliation(s)
- Vered Schechner
- Section of Epidemiology and Preventative Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel-Aviv, Israel
| | - Katya Levytskyi
- Clinical Microbiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Ohad Shalom
- Clinical Microbiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Alexander Yalek
- Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Amos Adler
- Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel-Aviv, Israel. .,Clinical Microbiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
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Boswihi SS, Udo EE, AlFouzan W. Antibiotic resistance and typing of the methicillin-resistant Staphylococcus aureus clones in Kuwait hospitals, 2016-2017. BMC Microbiol 2020; 20:314. [PMID: 33076838 PMCID: PMC7574199 DOI: 10.1186/s12866-020-02009-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 10/12/2020] [Indexed: 12/18/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) belong to diverse genetic backgrounds that differ in antibiotic resistance. Knowledge of the local clonal composition of MRSA strains is important for patients’ management and for designing effective control and eradication methods. The aim of this study was to compare the antibiotic resistance patterns and genotypic characteristics of MRSA isolates obtained in public hospitals in Kuwait in 2016 and 2017 for changes in their resistance patterns and clonal composition. Methods A total of 4726 MRSA isolates obtained in 2016–2017 from clinical specimens in Kuwait public hospitals were characterized using antibiogram, SCCmec typing, spa typing and DNA microarray. Results The isolates expressed resistance to fusidic acid (52.9%), kanamycin (41.6%), gentamicin (32.5%) and erythromycin (36.2%). The prevalence of high-level mupirocin resistance decreased from 3.7% in 2016 to 2.4% in 2017, while the proportion of resistance to other antibiotics remained relatively stable. A total of 382 spa types were detected with eight spa types, t688 (N = 547), t304 (N = 428), t860 (N = 394), t127 (N = 306), t044 (N = 230), t311 (N = 243), t223 (N = 184) and t002 (N = 181) constituting 53.1% of the MRSA isolates in 2016–2017. Of the 3004 MRSA isolates obtained in 2016 (N = 1327) and 2017 (N = 1677) selected for DNA microarray analysis, 26 clonal complexes (CCs) were identified. Most of the isolates belonged to CC1 (N = 248), CC5 (N = 833), CC6 (N = 241), CC8 (N = 292), CC22 (N = 421), CC30 (N = 177), CC80 (N = 177) and CC97 (N = 171). The prevalence of CC5 isolates has significantly (p ≤ 0.05) increased from 294 isolates in 2016 to 539 isolates in 2017. Although CC22 increased from 196 isolates in 2016 to 225 isolates in 2017, CC1 increased from 112 isolates in 2016 to 136 isolates in 2017, CC6 increased from 103 isolates in 2016 to 138 isolates in 2017, these changes were not significant (p ≥ 0.05). Conclusion These results revealed the diversity in the genetic backgrounds of MRSA isolates and the stable maintenance of the dominant MRSA clones in Kuwait hospitals in 2016 and 2017 suggesting an on-going transmission of these clones. Novel and creative infection prevention and control measures are required to curtail further transmission. Supplementary information Supplementary information accompanies this paper at 10.1186/s12866-020-02009-w.
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Affiliation(s)
- Samar S Boswihi
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Edet E Udo
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
| | - Wadha AlFouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
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7
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Milionis A, Tripathy A, Donati M, Sharma CS, Pan F, Maniura-Weber K, Ren Q, Poulikakos D. Water-Based Scalable Methods for Self-Cleaning Antibacterial ZnO-Nanostructured Surfaces. Ind Eng Chem Res 2020; 59:14323-14333. [PMID: 32831473 PMCID: PMC7434054 DOI: 10.1021/acs.iecr.0c01998] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 11/28/2022]
Abstract
![]()
Bacterial
colonization poses significant health risks, such as
infestation of surfaces in biomedical applications and clean water
unavailability. If maintaining the surrounding water clean is a target,
developing surfaces with strong bactericidal action, which is facilitated
by bacterial access to the surface and mixing, can be a solution.
On the other hand, if sustenance of a surface free of bacteria is
the goal, developing surfaces with ultralow bacterial adhesion often
suffices. Here we report a facile, scalable, and environmentally benign
strategy that delivers customized surfaces for these challenges. For
bactericidal action, nanostructures of inherently antibacterial ZnO,
through simple immersion of zinc in hot water, are fabricated. The
resulting nanostructured surface exhibits extreme bactericidal effectiveness
(9250 cells cm–2 h–1) that eliminates
bacteria in direct contact and also remotely through the action of
reactive oxygen species. Remarkably, the remote bactericidal action
is achieved without the need for any illumination, otherwise required
in conventional approaches. As a result, ZnO nanostructures yield
outstanding water disinfection of >99.98%, in the dark, by inactivating
the bacteria within 3 h. Moreover, Zn2+ released to the
aqueous medium from the nanostructured ZnO surface have a concentration
of 0.73 ± 0.15 ppm, markedly below the legal limit for safe drinking
water (5–6 ppm). The same nanostructures, when hydrophobized
(through a water-based or fluorine-free spray process), exhibit strong
bacterial repulsion, thus substantially reducing bacterial adhesion.
Such environmentally benign and scalable methods showcase pathways
toward inhibiting surface bacterial colonization.
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Affiliation(s)
- Athanasios Milionis
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Abinash Tripathy
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Matteo Donati
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Chander Shekhar Sharma
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Fei Pan
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, 9014 St. Gallen, Switzerland
| | - Katharina Maniura-Weber
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, 9014 St. Gallen, Switzerland
| | - Qun Ren
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, 9014 St. Gallen, Switzerland
| | - Dimos Poulikakos
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
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Okorie-Kanu OJ, Anyanwu MU, Ezenduka EV, Mgbeahuruike AC, Thapaliya D, Gerbig G, Ugwuijem EE, Okorie-Kanu CO, Agbowo P, Olorunleke S, Nwanta JA, Chah KF, Smith TC. Molecular epidemiology, genetic diversity and antimicrobial resistance of Staphylococcus aureus isolated from chicken and pig carcasses, and carcass handlers. PLoS One 2020; 15:e0232913. [PMID: 32407414 PMCID: PMC7224487 DOI: 10.1371/journal.pone.0232913] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/23/2020] [Indexed: 12/18/2022] Open
Abstract
The epidemiology of Staphylococcus aureus in food animals, associated products, and their zoonotic potential in Nigeria are poorly understood. This study aimed to provide data on the prevalence, genetic characteristics and antimicrobial resistance of S. aureus isolated from chicken and pig carcasses, and persons in contact with the carcasses at slaughterhouses in Nigeria. Surface swabs were collected randomly from 600 chicken and 600 pig carcasses. Nasal swabs were collected from 45 workers in chicken slaughterhouses and 45 pig slaughterhouse workers. S. aureus isolates were analyzed by spa typing. They were also examined for presence of the Panton-Valentine Leucocidin (PVL) and mecA genes, as well as for antimicrobial resistance phenotype. Overall, 53 S. aureus isolates were recovered (28 from chicken carcasses, 17 from pig carcasses, 5 from chicken carcass handlers and 3 from pig carcass handlers). Among the isolates, 19 (35.8%) were PVL-positive and 12 (22.6%) carried the mecA gene. The 53 isolates belonged to 19 spa types. The Based Upon Repeat Pattern (BURP) algorithm separated the isolates into 2 spa-clonal complexes (spa-CC) and 9 singletons including 2 novel spa types (t18345 and t18346). The clonal complexes (CC) detected were CC1, CC5, CC8, CC15, CC88 and CC152. CC15-related isolates represented by spa type t084 (32.1%) and CC5 represented by spa type t311 (35.3%) predominated among isolates from chicken carcasses/ handlers, and pig carcasses/ handlers, respectively. Multidrug resistance exhibited by all the CC except CC8, was observed among isolates from chicken carcasses (64.3%), pig carcasses (41.2%), handlers of chicken meat (40.0%) and handlers of pork (33.3%). All the CC showed varying degrees of resistance to tetracycline while CC15 and CC5 exhibited the highest resistance to sulphamethoxazole/trimethoprim and erythromycin, respectively. The predominant antimicrobial resistance pattern observed was penicillin-tetracycline-sulphamethoxazole/trimethoprim (PEN-TET-SXT). In conclusion, food animals processed in Enugu State in Southeast Nigeria are potential vehicles for transmission of PVL-positive multiple-drug resistant S. aureus and methicillin-resistant S. aureus from farm to slaughterhouse and potentially to the human population. Public health intervention programs at pre- and post-slaughter stages should be considered in Nigerian slaughterhouses.
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Affiliation(s)
- Onyinye J. Okorie-Kanu
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
- * E-mail:
| | - Madubuike U. Anyanwu
- Microbiology Unit, Department of Veterinary Microbiology and Pathology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Ekene V. Ezenduka
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Anthony C. Mgbeahuruike
- Microbiology Unit, Department of Veterinary Microbiology and Pathology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Dipendra Thapaliya
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, Kent State University, Kent, Ohio, United States of America
| | - Gracen Gerbig
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, Kent State University, Kent, Ohio, United States of America
| | - Ejike E. Ugwuijem
- Department of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Christian O. Okorie-Kanu
- Department of Veterinary Pathology, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria
| | - Philip Agbowo
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Solomon Olorunleke
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - John A. Nwanta
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Kennedy F. Chah
- Microbiology Unit, Department of Veterinary Microbiology and Pathology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Tara C. Smith
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, Kent State University, Kent, Ohio, United States of America
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Prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA) in Saudi Arabia: A Systematic Review. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.1.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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10
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Kateete DP, Asiimwe BB, Mayanja R, Mujuni B, Bwanga F, Najjuka CF, Källander K, Rutebemberwa E. Nasopharyngeal carriage, spa types and antibiotic susceptibility profiles of Staphylococcus aureus from healthy children less than 5 years in Eastern Uganda. BMC Infect Dis 2019; 19:1023. [PMID: 31791276 PMCID: PMC6889221 DOI: 10.1186/s12879-019-4652-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/22/2019] [Indexed: 01/13/2023] Open
Abstract
Background Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and identify S. aureus lineages that cause infection in Uganda. Methods Nasopharyngeal samples from 742 healthy children less than 5 years residing in the Iganga/Mayuge Health and Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic susceptibility testing based on minimum inhibitory concentrations (MICs) was determined by the BD Phoenix™ system. Genotyping was performed by spa and SCCmec typing. Results The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All isolates were susceptible to rifampicin, vancomycin and linezolid. Moreover, all MRSA were susceptible to vancomycin, linezolid and clindamycin. Compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials –trimethoprim/sulfamethoxazole 73.3% (33/45) vs. 27.3% (27/99) [p < 0.0001]; erythromycin 75.6% (34/45) vs. 24.2% (24/99) [p < 0.0001]; chloramphenicol 60% (27/45) vs. 19.2% (19/99) [p < 0.0001]; gentamicin 55.6% (25/45) vs. 25.3% (25/99) [p = 0.0004]; and ciprofloxacin 35.6% (16/45) vs. 2% (2/99) [p < 0.0001]. Furthermore, 42 MRSA (93.3%) were multidrug resistant (MDR) and one exhibited high-level resistance to mupirocin. Overall, 61 MSSA (61.6%) were MDR, including three mupirocin and clindamycin resistant isolates. Seven spa types were detected among MRSA, of which t037 and t064 were predominant and associated with SCCmec types I and IV, respectively. Fourteen spa types were detected in MSSA which consisted mainly of t645 and t4353. Conclusions S. aureus carriage rate in healthy children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.
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Affiliation(s)
- David Patrick Kateete
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda. .,Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Benon B Asiimwe
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Raymond Mayanja
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.,Makerere University Walter Reed Project, Kampala, Uganda
| | - Brian Mujuni
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Freddie Bwanga
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Christine F Najjuka
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Karin Källander
- Malaria Consortium, London, UK.,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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11
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Nurjadi D, Fleck R, Lindner A, Schäfer J, Gertler M, Mueller A, Lagler H, Van Genderen PJJ, Caumes E, Boutin S, Kuenzli E, Gascon J, Kantele A, Grobusch MP, Heeg K, Zanger P. Import of community-associated, methicillin-resistant Staphylococcus aureus to Europe through skin and soft-tissue infection in intercontinental travellers, 2011-2016. Clin Microbiol Infect 2018; 25:739-746. [PMID: 30315958 DOI: 10.1016/j.cmi.2018.09.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Recently, following import by travel and migration, epidemic community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has caused nosocomial outbreaks in Europe, sometimes with a fatal outcome. We describe clinico-epidemiological characteristics of CA-MRSA detected by the European Network for the Surveillance of imported S. aureus (www.staphtrav.eu) from May 2011 to November 2016. METHODS Sentinel surveillance at 13 travel clinics enrolling patients with travel-associated skin and soft-tissue infection (SSTI) and analysing lesion and nose swabs at one central laboratory. RESULTS A total of 564 independent case-patients with SSTI were enrolled and had 374 (67%) S. aureus-positive lesions, of which 14% (51/374) were MRSA. The majority of CA-MRSA isolates from SSTI were Panton-Valentine leucocidin (PVL) -positive (43/51, 84%). The risk of methicillin-resistance in imported S. aureus varied by travel region (p <0.001) and was highest in Latin America (16/57, 28%, 95% CI 17.0-41.5) and lowest in Sub-Saharan Africa (4/121, 3%, 95% CI 0.9-8.3). Major epidemic clones (USA300 / USA300 Latin-American Variant, Bengal Bay, South Pacific) accounted for more than one-third (19/51, 37%) of CA-MRSA imports. CA-MRSA SSTI in returnees was complicated (31/51 multiple lesions, 61%; 22/50 recurrences, 44%), led to health-care contact (22/51 surgical drainage, 43%; 7/50 hospitalization, 14%), was transmissible (13/47 reported similar SSTI in non-travelling contacts, 28%), and associated with S. aureus nasal colonization (28 of 51 CA-MRSA cases, 55%; 24 of 28 colonized with identical spa-type in nose and lesion, 85%). CONCLUSIONS Travel-associated CA-MRSA SSTI is a transmissible condition that leads to medical consultations and colonization of the infected host.
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Affiliation(s)
- D Nurjadi
- Department of Infectious Diseases, Medical Microbiology and Hygiene, University Clinics, Heidelberg, Germany
| | - R Fleck
- Tropenklinik, Paul-Lechler-Krankenhaus, Tübingen, Germany
| | - A Lindner
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Schäfer
- Tropenklinik, Paul-Lechler-Krankenhaus, Tübingen, Germany
| | - M Gertler
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Mueller
- Klinikum Würzburg Mitte gGmbH, Missioklinik, Tropenmedizin, Würzburg, Germany
| | - H Lagler
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria; Department of Tropical Medicine, University Medical Centre Hamburg Eppendorf & Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - P J J Van Genderen
- Institute for Tropical Diseases, Harbour Hospital, Rotterdam, The Netherlands
| | - E Caumes
- Service de Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - S Boutin
- Department of Infectious Diseases, Medical Microbiology and Hygiene, University Clinics, Heidelberg, Germany
| | - E Kuenzli
- Swiss Tropical and Public Health Institute, Department Medicine, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - J Gascon
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - A Kantele
- Inflammation Centre, Division of Infectious Diseases, University of Helsinki and Helsinki University Hospital, HUS, Finland
| | - M P Grobusch
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - K Heeg
- Department of Infectious Diseases, Medical Microbiology and Hygiene, University Clinics, Heidelberg, Germany
| | - P Zanger
- Department of Infectious Diseases, Medical Microbiology and Hygiene, University Clinics, Heidelberg, Germany; Heidelberg Institute of Global Health, Unit of Epidemiology and Biostatistics, University Clinics, Heidelberg, Germany.
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12
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Asadollahi P, Farahani NN, Mirzaii M, Khoramrooz SS, van Belkum A, Asadollahi K, Dadashi M, Darban-Sarokhalil D. Distribution of the Most Prevalent Spa Types among Clinical Isolates of Methicillin-Resistant and -Susceptible Staphylococcus aureus around the World: A Review. Front Microbiol 2018; 9:163. [PMID: 29487578 PMCID: PMC5816571 DOI: 10.3389/fmicb.2018.00163] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/24/2018] [Indexed: 12/25/2022] Open
Abstract
Background:Staphylococcus aureus, a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies. Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were “Staphylococcus aureus, spa typing.” Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95% of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence. Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution.
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Affiliation(s)
- Parisa Asadollahi
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narges Nodeh Farahani
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mirzaii
- Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyed Sajjad Khoramrooz
- Department of Microbiology, Faculty of Medicine, Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Alex van Belkum
- Data Analytics Unit, bioMérieux 3, La Balme Les Grottes, France
| | - Khairollah Asadollahi
- Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.,Faculty of Medicine, Biotechnology and Medicinal Plants Researches Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Masoud Dadashi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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13
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Ma JG, An JX. Deep sternal wound infection after cardiac surgery: a comparison of three different wound infection types and an analysis of antibiotic resistance. J Thorac Dis 2018; 10:377-387. [PMID: 29600070 DOI: 10.21037/jtd.2017.12.109] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background Deep sternal wound infection (DSWI) is a severe complication following cardiac surgery. We compared epidemiology, clinical features, and microbiology of three types of DSWI and examined the antibiotic resistance in DSWI patients. Methods From 2011 to 2015, 170 adult post-cardiac surgery DSWI patients were recruited for this study and underwent the pectoralis major muscle flap transposition in our department. Results Of 170 adult patients with DSWI (mean age of 54 years), the majority (99 patients, 58.2%) had type II DSWI. The three types of DSWI patients showed significant differences in terms of gender, smoking history, chronic obstructive pulmonary disease (COPD), length of intensive care unit (ICU) stay, and hospitalization cost (P<0.05). The most common symptoms of DSWI patients were fever and wound dehiscence accompanied by purulent secretions. Types I and II DSWI were more frequently associated with hypoproteinemia and high leucocyte count (P<0.05). Microbiological diagnosis was available for 77 of 170 patients (45.3%). Of 157 pathogens detected, 87 (55.4%) species of gram negative bacilli were identified and most commonly were Pseudomonas aeruginosa (25.5%) and methicillin-susceptible Staphylococcus aureus (20.4%). However, no statistically significant microbiological differences among the three DSWI types were observed (P>0.05). Notably, P. aeruginosa isolates showed 100% resistance to cefazolin and cefuroxime. Meanwhile, the resistance rate of Acinetobacter baumannii isolates to commonly used antibiotics was greater than 70%, while resistance rates of staphylococcus to penicillin-G were 100% and to clindamycin were over 70%. No isolates were resistant to vancomycin, linezolid, and tigecycline. Conclusions Three types of DSWI exhibit differences in epidemiology and clinical features. P. aeruginosa and S. aureus are the most common pathogens in DSWI patients and antibiotic resistance is a serious concern in these patients. Therefore, prevention and treatment of DSWI should be closely tailored to clinical features, local microbiological characteristics, and resistance patterns of commonly encountered pathogens.
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Affiliation(s)
- Jia-Gui Ma
- Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China
| | - Jian-Xiong An
- Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China
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14
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Seinige D, Von Altrock A, Kehrenberg C. Genetic diversity and antibiotic susceptibility of Staphylococcus aureus isolates from wild boars. Comp Immunol Microbiol Infect Dis 2017; 54:7-12. [PMID: 28916003 DOI: 10.1016/j.cimid.2017.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/30/2017] [Accepted: 07/04/2017] [Indexed: 01/22/2023]
Abstract
We here report the occurrence of S. aureus in wild boars and characterize isolates genotypically and phenotypically in order to get knowledge about the occurrence of clonal lineages and genotypes in free-living wild animals. Forty-one S. aureus isolates obtained from 111 wild boars hunted in Lower Saxony, Germany, were investigated and compared to human and livestock isolates. The S. aureus belonged to multilocus sequence types ST1, ST7, ST30, ST133, ST425, ST804, ST890 and to the new ST3237, ST3238, ST3255 and ST3369. The livestock associated CC398-MRSA lineage, however, was not found. In addition to well-known spa types, the new types t14999, t15000, t15001 and t15002 were detected. Macrorestriction analysis revealed a variety of different SmaI fragment patterns. Most isolates were susceptible to all antimicrobials tested, including methicillin, and resistance was detected only to ampicillin, penicillin and erythromycin. PCR analysis confirmed the presence of staphylococcal enterotoxin genes (seh) in all t127-ST1 isolates. A high degree of genetic diversity was detected with many spa types and clonal lineages previously reported in humans and livestock animals.
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Affiliation(s)
- D Seinige
- Institute for Food Quality and Food Safety, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - A Von Altrock
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Services, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - C Kehrenberg
- Institute for Food Quality and Food Safety, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
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15
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Udo EE, Al-Sweih N. Dominance of community-associated methicillin-resistant Staphylococcus aureus clones in a maternity hospital. PLoS One 2017. [PMID: 28640870 PMCID: PMC5480892 DOI: 10.1371/journal.pone.0179563] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Methicillin- resistant Staphylococcus aureus (MRSA) is a major pathogen causing healthcare- and community- acquired infections. The purpose of this study was to characterize MRSA isolated at the Maternity Hospital between 2006 and 2011 for their genetic relatedness. Materials and methods The MRSA isolates were investigated using a combination of antibiogram, Staphylococcal chromosome cassette mec (SCCmec) and spa typing to determine their relatedness to MRSA isolated in other Kuwait hospitals. The isolates were also investigated for the carriage of genes for Pantone valentine Leukocidin (PVL). Results A total of 103 MRSA obtained from 64 neonates, 17 adult patients and 12 healthcare workers. The isolates were resistant to Kanamycin (46.6%), gentamicin (40.8%), trimethoprim (32%), ciprofloxacin (22.3%), fusidic acid (16.5%), tetracycline (19.4%), erythromycin (15.5%), clindamycin (15.5%), streptomycin (11.6%) high-level mupirocin (2.9%) and chloramphenicol (0.9%). Twenty (19.4%) of the isolates were multiresistant. Thirty-one (30.0%) isolates were positive for PVL. Molecular typing revealed the presence of 11 clonal complexes and 23 clones with ST5-V-t002, (N = 22), ST22-IV-t223 (N = 18), ST22-IV-t852 (N = 10), ST80-IV-t044 (N = 7), ST5-V-t688 (N = 5), ST772-V-t657 (N = 5) and ST239-III-t860 (N = 4) constituting 66.9% of the isolates. Other clones were isolated sporadically. The number of MRSA isolates increased from two in 2006 to 22 in 2011 with a peak of 43 in 2008. Conclusion The study revealed a high prevalence of community-associated MRSA Maternity hospital. The MRSA population consisted of known strains, such as ST239-III-t680, ST22-IV-t223/t852 and ST80-IV-t044, that were reported previously in Kuwait and novel strains such as ST5-V-t002, and several sporadic strains obtained for the first time in the Maternity hospital. This study has provided an initial data which will serve as a platform for future comparative studies on the distribution of MRSA clones in the Maternity hospital in Kuwait.
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Affiliation(s)
- Edet E. Udo
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
- * E-mail:
| | - Noura Al-Sweih
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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16
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Earls MR, Kinnevey PM, Brennan GI, Lazaris A, Skally M, O’Connell B, Humphreys H, Shore AC, Coleman DC. The recent emergence in hospitals of multidrug-resistant community-associated sequence type 1 and spa type t127 methicillin-resistant Staphylococcus aureus investigated by whole-genome sequencing: Implications for screening. PLoS One 2017; 12:e0175542. [PMID: 28399151 PMCID: PMC5388477 DOI: 10.1371/journal.pone.0175542] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/28/2017] [Indexed: 11/19/2022] Open
Abstract
Community-associated spa type t127/t922 methicillin-resistant Staphylococcus aureus (MRSA) prevalence increased from 1%-7% in Ireland between 2010–2015. This study tracked the spread of 89 such isolates from June 2013-June 2016. These included 78 healthcare-associated and 11 community associated-MRSA isolates from a prolonged hospital outbreak (H1) (n = 46), 16 other hospitals (n = 28), four other healthcare facilities (n = 4) and community-associated sources (n = 11). Isolates underwent antimicrobial susceptibility testing, DNA microarray profiling and whole-genome sequencing. Minimum spanning trees were generated following core-genome multilocus sequence typing and pairwise single nucleotide variation (SNV) analysis was performed. All isolates were sequence type 1 MRSA staphylococcal cassette chromosome mec type IV (ST1-MRSA-IV) and 76/89 were multidrug-resistant. Fifty isolates, including 40/46 from H1, were high-level mupirocin-resistant, carrying a conjugative 39 kb iles2-encoding plasmid. Two closely related ST1-MRSA-IV strains (I and II) and multiple sporadic strains were identified. Strain I isolates (57/89), including 43/46 H1 and all high-level mupirocin-resistant isolates, exhibited ≤80 SNVs. Two strain I isolates from separate H1 healthcare workers differed from other H1/strain I isolates by 7–47 and 12–53 SNVs, respectively, indicating healthcare worker involvement in this outbreak. Strain II isolates (19/89), including the remaining H1 isolates, exhibited ≤127 SNVs. For each strain, the pairwise SNVs exhibited by healthcare-associated and community-associated isolates indicated recent transmission of ST1-MRSA-IV within and between multiple hospitals, healthcare facilities and communities in Ireland. Given the interchange between healthcare-associated and community-associated isolates in hospitals, the risk factors that inform screening for MRSA require revision.
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Affiliation(s)
- Megan R. Earls
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College, Dublin, Ireland
| | - Peter M. Kinnevey
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College, Dublin, Ireland
| | - Gráinne I. Brennan
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College, Dublin, Ireland
- National MRSA Reference Laboratory, St. James’s Hospital, Dublin 8, Ireland
| | - Alexandros Lazaris
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College, Dublin, Ireland
| | - Mairead Skally
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
| | - Brian O’Connell
- National MRSA Reference Laboratory, St. James’s Hospital, Dublin 8, Ireland
- Department of Clinical Microbiology, School of Medicine, Trinity College Dublin, St. James’s Hospital, Dublin 8, Ireland
| | - Hilary Humphreys
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Anna C. Shore
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College, Dublin, Ireland
| | - David C. Coleman
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College, Dublin, Ireland
- * E-mail:
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Islam MZ, Espinosa-Gongora C, Damborg P, Sieber RN, Munk R, Husted L, Moodley A, Skov R, Larsen J, Guardabassi L. Horses in Denmark Are a Reservoir of Diverse Clones of Methicillin-Resistant and -Susceptible Staphylococcus aureus. Front Microbiol 2017; 8:543. [PMID: 28421046 PMCID: PMC5376617 DOI: 10.3389/fmicb.2017.00543] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/15/2017] [Indexed: 11/13/2022] Open
Abstract
Denmark is a country with high prevalence of livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) clonal complex (CC) 398 in pigs. Even though pig farming is regarded as the main source of human infection or colonization with MRSA CC398, 10-15% of the human cases appear not to be linked to pigs. Following the recent reports of MRSA CC398 in horses in other European countries and the lack of knowledge on S. aureus carriage in this animal species, we carried out a study to investigate whether horses constitute a reservoir of MRSA CC398 in Denmark, and to gain knowledge on the frequency and genetic diversity of S. aureus in horses, including both methicillin-resistant and -susceptible S. aureus (MSSA). Nasal swabs were collected from 401 horses originating from 74 farms, either at their farms or prior to admission to veterinary clinics. Following culture on selective media, species identification by MALDI-TOF MS and MRSA confirmation by standard PCR-based methods, S. aureus and MRSA were detected in 54 (13%) and 17 (4%) horses originating from 30 (40%) and 7 (9%) farms, respectively. Based on spa typing, MSSA differed genetically from MRSA isolates. The spa type prevalent among MSSA isolates was t127 (CC1), which was detected in 12 horses from 11 farms and represents the most common S. aureus clone isolated from human bacteremia cases in Denmark. Among the 17 MRSA carriers, 10 horses from three farms carried CC398 t011 harboring the immune evasion cluster (IEC), four horses from two farms carried IEC-negative CC398 t034, and three horses from two farms carried a mecC-positive MRSA lineage previously associated with wildlife and domestic ruminants (CC130 t528). Based on whole-genome phylogenetic analysis of the 14 MRSA CC398, t011 isolates belonged to the recently identified horse-adapted clone in Europe and were closely related to human t011 isolates from three Danish equine veterinarians, whereas t034 isolates belonged to pig-adapted clones. Our study confirms that horses carry an equine-specific clone of MRSA CC398 that can be transmitted to veterinary personnel, and reveals that these animals are exposed to MRSA and MSSA clones that are likely to originate from livestock and humans, respectively.
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Affiliation(s)
- Md Zohorul Islam
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of CopenhagenFrederiksberg C, Denmark.,Microbiology and Infection Control, Statens Serum InsititutCopenhagen, Denmark
| | - Carmen Espinosa-Gongora
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of CopenhagenFrederiksberg C, Denmark.,Section for Bacteriology, Pathology and Parasitology, National Veterinary Institute, Technical University of DenmarkFrederiksberg C, Denmark
| | - Peter Damborg
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of CopenhagenFrederiksberg C, Denmark
| | - Raphael N Sieber
- Microbiology and Infection Control, Statens Serum InsititutCopenhagen, Denmark
| | | | | | - Arshnee Moodley
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of CopenhagenFrederiksberg C, Denmark
| | - Robert Skov
- Microbiology and Infection Control, Statens Serum InsititutCopenhagen, Denmark
| | - Jesper Larsen
- Microbiology and Infection Control, Statens Serum InsititutCopenhagen, Denmark
| | - Luca Guardabassi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of CopenhagenFrederiksberg C, Denmark.,Department of Biomedical Sciences, Ross University School of Veterinary MedicineBasseterre, West Indies
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18
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Seidl K, Leemann M, Palheiros Marques M, Rachmühl C, Leimer N, Andreoni F, Achermann Y, Zinkernagel AS. High level methicillin resistance correlates with reduced Staphylococcus aureus endothelial cell damage. Int J Med Microbiol 2016; 307:11-20. [PMID: 27955998 DOI: 10.1016/j.ijmm.2016.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/29/2016] [Accepted: 11/27/2016] [Indexed: 11/17/2022] Open
Abstract
There has been controversy about the intrinsic virulence of methicillin-resistant Staphylococcus aureus (MRSA) as compared to methicillin-susceptible S. aureus (MSSA). To address this discrepancy, the intrinsic virulence of 42 MRSA and 40 MSSA clinical isolates was assessed by testing endothelial cell (EC) damage, a surrogate marker for virulence in blood stream infections. Since these clinical isolates represent a heterogeneous group, well characterized S. aureus laboratory strains with SCCmec loss- and gain-of-function mutations were used in addition. The clinical MRSA isolates carrying typical hospital acquired SCCmec types (I, II or III) induced significantly less damage (47.8%) as compared to isolates with other SCCmec types (62.3%, p=0.03) and MSSA isolates (64.2%, p<0.01). There was a strong inverse correlation between high-level oxacillin resistance and low EC damage induction (R2=0.4464, p<0.001). High-level oxacillin resistant strains (MIC >32μ/ml) grew significantly slower as compared to isolates with low-level resistance (p=0.047). The level of EC damage positively correlated with α- and δ-toxin production (p<0.0001 and p<0.05, respectively) but not with β-toxin production. Invasive MRSA isolates (n=21, 56.3%) were significantly less cytotoxic as compared to invasive MSSA isolates (n=20, 68.0%, p<0.05). There was no difference between EC damage induced by superficial versus invasive isolates in either MRSA or MSSA strains. Our data suggest that the intrinsic virulence of MRSA is similar or even reduced as compared to MSSA strains but is linked to the level of methicillin resistance.
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Affiliation(s)
- Kati Seidl
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Michèle Leemann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Miguel Palheiros Marques
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Carole Rachmühl
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nadja Leimer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Federica Andreoni
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Yvonne Achermann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Annelies S Zinkernagel
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Distribution of spa Types, Integrons and Associated Gene Cassettes in Staphylococcus aureus Strains Isolated From Intensive Care Units of Hospitals in Tehran, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2016. [DOI: 10.5812/archcid.38813] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Goudarzi M, Fazeli M, Goudarzi H, Azad M, Seyedjavadi SS. Spa Typing of Staphylococcus aureus Strains Isolated From Clinical Specimens of Patients With Nosocomial Infections in Tehran, Iran. Jundishapur J Microbiol 2016; 9:e35685. [PMID: 27679706 PMCID: PMC5035396 DOI: 10.5812/jjm.35685] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 06/07/2016] [Accepted: 06/14/2016] [Indexed: 12/14/2022] Open
Abstract
Background The incidence of nosocomial Staphylococcus aureus infection is increasing annually and becoming a true global challenge. The pattern of Staphylococcus aureus protein A (spa) types in different geographic regions is diverse. Objectives This study determined the prevalence of methicillin-resistant S. aureus and different spa types in S. aureus clinical isolates. Materials and Methods During a six-month period, 90 S. aureus isolates were recovered from 320 clinical specimens. The in vitro susceptibility of various S. aureus isolates to 16 antibiotic discs was assessed using the Kirby-Bauer disk diffusion method. Molecular typing was carried out with S. aureus protein A typing via polymerase chain reaction. Results The frequency of methicillin-resistant S. aureus in our study was 88.9%. Twenty-three (25.5%) isolates were positive for panton-valentine leukocidin encoding genes. S. aureus presented a high resistance rate to ampicillin (100%) and penicillin (100%). No resistance was observed to vancomycin, teicoplanin, or linezolid. The rates of resistance to the majority of antibiotics tested varied between 23.3% and 82.2%. The rate of multidrug resistance among these clinical isolates was 93.3%. The 90 S. aureus isolates were classified into five S. aureus protein A types: t037 (33.3%), t030 (22.2%), t790 (16.7%), t969 (11.1%), and t044 (7.7%). Eight (8.9%) isolates were not typable using the S. aureus protein A typing method. Conclusions We report a high methicillin-resistant S. aureus rate in our hospital. Additionally, t030 and t037 were the predominant spa-types among hospital-associated S. aureus. Our findings emphasize the need for continuous surveillance to prevent the dissemination of multidrug resistance among different S. aureus protein A types in Iran.
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Affiliation(s)
- Mehdi Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Maryam Fazeli
- WHO Collaborating Center for Reference and Research on Rabies, Pasteur Institute of Iran, Tehran, IR Iran
| | - Hossein Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mehdi Azad
- Department of Medical laboratory Sciences, School of Paramedicine, Qazvin University of Medical Sciences, Qazvin, IR Iran
| | - Sima Sadat Seyedjavadi
- Department of Medical Mycology, Pasteur Institute of Iran, Tehran, IR Iran
- Corresponding author: Sima Sadat Seyedjavadi, Department of Medical Mycology, Pasteur Institute of Iran, Tehran, IR Iran, E-mail:
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21
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Issler-Fisher AC, Fakin RM, Fisher OM, McKew G, Gazzola R, Rauch AK, Gottlieb T, Haertsch P, Guggenheim M, Giovanoli P, Maitz PKM. Microbiological findings in burn patients treated in a general versus a designated intensive care unit: Effect on length of stay. Burns 2016; 42:1805-1818. [PMID: 27372144 DOI: 10.1016/j.burns.2016.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/12/2016] [Accepted: 06/10/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Infection is one of the most common causes of mortality and morbidity in burn patients. The incidence and frequency of microbiological micro-organisms are known to vary across different models of intensive care units. To date, no study has attempted to describe the different findings in burn patients treated in an open, general intensive care unit (GICU) versus a dedicated burns intensive care unit (BICU). Only limited data is available on the effect of these microbiological micro-organisms on patients' length of stay. AIM To characterize and compare the microbiological flora and antibiotic resistance patterns encountered in two different models of burn intensive care and to determine the effect of specific microbiological types on length of intensive care unit (ICU) and overall stay. METHODS A retrospective case-control study of 209 burn patients treated in two highly specialized, Western burn referral centres between September 2009 and March 2014. RESULTS 9710 culture results were analysed, of which 2590 (26.7%) yielded positive results (1537 in the GICU and 1050 in the BICU). Gram-positive cultures were more frequently found in the GICU, whereas Gram-negative and yeast cultures were more prevalent in the BICU. The most frequently encountered micro-organisms in both units were similar and included Staphylococcus aureus, Pseudomonas aeruginosa, coagulase-negative staphylococci (CoNS) and Candida albicans. Significantly more resistant bacteria were detected in the BICU. Testing positive across all types of microbiological isolates, as well as for both Gram-positive and -negative bacteria significantly prolonged patient length of stay. This effect was even more pronounced if the micro-organisms were resistant to antimicrobial therapy. CONCLUSION There are notable differences in the microbiological isolate and antibiotic resistance patterns between burn patients treated in a GICU compared to a designated BICU. In both units, testing positive for resistant microbiological micro-organisms is significantly associated with longer hospital stay.
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Affiliation(s)
| | - Richard M Fakin
- Division of Plastic and Hand Surgery, University Hospital Zurich, Switzerland
| | - Oliver M Fisher
- St Vincent's Centre for Applied Medical Research, Sydney, Australia
| | - Genevieve McKew
- Department of Microbiology and Infectious Diseases, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia
| | - Riccardo Gazzola
- Division of Plastic and Hand Surgery, University Hospital Zurich, Switzerland
| | - Ann-Kathrin Rauch
- Division of Plastic and Hand Surgery, University Hospital Zurich, Switzerland
| | - Thomas Gottlieb
- Department of Microbiology and Infectious Diseases, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia
| | - Peter Haertsch
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia
| | - Merlin Guggenheim
- Division of Plastic and Hand Surgery, University Hospital Zurich, Switzerland
| | - Pietro Giovanoli
- Division of Plastic and Hand Surgery, University Hospital Zurich, Switzerland
| | - Peter K M Maitz
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia
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Udo EE, Boswihi SS, Al-Sweih N. High prevalence of toxic shock syndrome toxin-producing epidemic methicillin-resistant Staphylococcus aureus 15 (EMRSA-15) strains in Kuwait hospitals. New Microbes New Infect 2016; 12:24-30. [PMID: 27222714 PMCID: PMC4873690 DOI: 10.1016/j.nmni.2016.03.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 03/22/2016] [Indexed: 11/22/2022] Open
Abstract
This study characterized EMRSA-15 isolates obtained from patients in Kuwait hospitals for their genotypic relatedness, antibiotic resistance and carriage of virulence genes using pulsed-field gel electrophoresis (PFGE), coagulase serotyping, SCCmec subtyping, spa typing, multilocus sequence typing and DNA microarray. The isolates were resistant to trimethoprim (75.6%), ciprofloxacin (29.7%), erythromycin and clindamycin (24.3%), tetracycline (19.0%), and gentamicin and kanamycin (21.6%). All 37 isolates belonged to sequence type (ST) 22, coagulase type XI, three PFGE types and eight subtypes, ten spa types including t223 (51.3%), t852 (13.5%), t032 (8.1%), t790 (8.1%), t3107 (5.4%) and one each of t309, t2251, t3935, t5708 and t5983. Twenty-six isolates (70.2%) carried SCCmec IVa, eight isolates carried SCCmec IV and three isolates carried SCCmec IVh. All isolates carried agr1, cap5 and egc gene cluster (seg, sei, selm, seln, selo, and selu). tst (toxic shock syndrome toxin) was detected in 23 isolates. Eight isolates (21.6%) were positive for Panton-Valentine leukocidin (PVL). Genotypic analysis revealed that 62.1% of the isolates comprising ST22-IVa-t223 (51.3%) and ST22-IVa-t309/t2251/t3935/t5708 (10.8%) were CC22-[tst1+] UK EMRSA-15/Middle Eastern variant, 21.6% were CC22-PVL+ EMRSA-15 variant and 16.2% were CC22-UK EMRSA-15/Barnim clone. These results show that the tst1 positive-ST22-IVa-t223 (Middle Eastern variant) and the CC22-PVL+ EMRSA-15 variant were the dominant EMRSA-15 variants in Kuwait hospitals.
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Affiliation(s)
- E E Udo
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
| | - S S Boswihi
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
| | - N Al-Sweih
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
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Meyer Sauteur PM, Leimer N, Chan PK, Relly C, Seidl K, Zinkernagel AS, Berger C. Methicillin-resistant Staphylococcus aureus eradication in young infants should include the diaper area and treat housing contacts. Acta Paediatr 2015; 104:e581-4. [PMID: 26341723 DOI: 10.1111/apa.13179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/27/2015] [Accepted: 09/01/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Patrick M. Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, and Children's Research Center (CRC); University Children's Hospital of Zurich; University of Zurich; Zurich Switzerland
| | - Nadja Leimer
- Division of Infectious Diseases and Hospital Epidemiology; University Hospital and University of Zurich; University of Zurich; Zurich Switzerland
| | - Pik Ki Chan
- Division of Infectious Diseases and Hospital Epidemiology, and Children's Research Center (CRC); University Children's Hospital of Zurich; University of Zurich; Zurich Switzerland
| | - Christa Relly
- Division of Infectious Diseases and Hospital Epidemiology, and Children's Research Center (CRC); University Children's Hospital of Zurich; University of Zurich; Zurich Switzerland
| | - Kati Seidl
- Division of Infectious Diseases and Hospital Epidemiology; University Hospital and University of Zurich; University of Zurich; Zurich Switzerland
| | - Annelies S. Zinkernagel
- Division of Infectious Diseases and Hospital Epidemiology; University Hospital and University of Zurich; University of Zurich; Zurich Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, and Children's Research Center (CRC); University Children's Hospital of Zurich; University of Zurich; Zurich Switzerland
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Von Dach E, Diene SM, Fankhauser C, Schrenzel J, Harbarth S, François P. Comparative Genomics of Community-Associated Methicillin-Resistant Staphylococcus aureus Shows the Emergence of Clone ST8-USA300 in Geneva, Switzerland. J Infect Dis 2015; 213:1370-9. [PMID: 26464204 DOI: 10.1093/infdis/jiv489] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/18/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Previous investigations of community-associated methicillin-resistant Staphylococcus aureus(CA-MRSA) isolates have revealed a wide diversity of genetic backgrounds, with only sporadic occurrence of ST8-USA300, in Geneva, Switzerland. We conducted a molecular epidemiologic analysis to identify the origin of a sudden increase of ST8 PVL-positive isolates in Geneva during 2013. METHODS On the basis of prospective CA-MRSA surveillance, we collected colonizing and infecting ST8-USA300 isolates and compared them to non-ST8 CA-MRSA isolates. Whole-genome sequencing (WGS) was performed for each isolate of this collection, and discriminating molecular features were linked to patient data. RESULTS In 2013, 22 isolates with the ST8-USA300 profile were identified among 46 cases of CA-MRSA. WGS revealed 2 groups of strains that differed by the type of the SCCmec IV element encoded and whether they harbored an arginine catabolism mobile element (ACME) locus. ACME-negative strains were mainly isolated from patients traveling in or originating from South America. Single-nucleotide polymorphism positions in isolate groups were used to infer their common ancestor, determine their geographical origin, and trace their relatedness. CONCLUSIONS WGS allowed the identification of transmission events and revealed that the increased prevalence of USA300 CA-MRSA isolates resulted from multiple importation events from the Americas but not from local clonal expansion of a successful clone.
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Affiliation(s)
- Elodie Von Dach
- Infection Control Program, Geneva University Hospitals Faculty of Medicine, University of Geneva, Switzerland
| | - Seydina M Diene
- Genomic Research Laboratory, Service of Infectious Diseases, Geneva University Hospitals Faculty of Medicine, University of Geneva, Switzerland
| | - Carolina Fankhauser
- Infection Control Program, Geneva University Hospitals Faculty of Medicine, University of Geneva, Switzerland
| | - Jacques Schrenzel
- Genomic Research Laboratory, Service of Infectious Diseases, Geneva University Hospitals Faculty of Medicine, University of Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program, Geneva University Hospitals Faculty of Medicine, University of Geneva, Switzerland
| | - Patrice François
- Genomic Research Laboratory, Service of Infectious Diseases, Geneva University Hospitals Faculty of Medicine, University of Geneva, Switzerland
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