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Di Gregorio S, Vielma J, Haim MS, Rago L, Campos J, Kekre M, Abrudan M, Famiglietti Á, Canigia LF, Rubinstein G, Helena von Specht M, Herrera M, Aro C, Galas M, Yarhui NB, Figueiredo A, Lincopan N, Falcon M, Guillén R, Camou T, Varela G, Aanensen DM, Argimón S, Mollerach M. Genomic epidemiology of Staphylococcus aureus isolated from bloodstream infections in South America during 2019 supports regional surveillance. Microb Genom 2023; 9. [PMID: 37227244 DOI: 10.1099/mgen.0.001020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Staphylococcus aureus remains one of the leading causes of infections worldwide and a common cause of bacteraemia. However, studies documenting the epidemiology of S. aureus in South America using genomics are scarce. We hereby report on the largest genomic epidemiology study to date of both methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) in South America, conducted by the StaphNET-SA network. We characterised 404 genomes recovered from a prospective observational study of S. aureus bacteraemia in 58 hospitals from Argentina, Bolivia, Brazil, Paraguay and Uruguay between April and October 2019. We show that a minority of S. aureus isolates are phenotypically multi-drug resistant (5.2%), but more than a quarter are resistant to macrolide-lincosamide-streptogramin B (MLSb). MSSA were more genetically diverse than MRSA. Lower rates of associated antimicrobial resistance in community-associated(CA)-MRSA versus hospital-associated (HA)-MRSA were found in association with three S. aureus genotypes dominating the MRSA population: CC30-MRSA-IVc-t019-lukS/F-PV+, CC5-MRSA-IV-t002-lukS/F-PV- and CC8-MRSA-IVc-t008-lukS/F-PV+-COMER+. These are historically from a CA origin, carry on average fewer antimicrobial resistance determinants, and often lack key virulence genes. Surprisingly, CC398-MSSA-t1451-lukS/F-PV- related to the CC398 human-associated lineage is widely disseminated throughout the region, and is described here for the first time as the most prevalent MSSA lineage in South America. Moreover, CC398 strains carrying ermT (largely responsible for the MLSb resistance rates of MSSA strains: inducible iMLSb phenotype) and sh_fabI (related to triclosan resistance) were recovered from both CA and HA origin. The frequency of MRSA and MSSA lineages differed between countries but the most prevalent S. aureus genotypes are high-risk clones widely distributed in the South American region without a clear country-specific phylogeographical structure. Therefore, our findings underline the need for continuous genomic surveillance by regional networks such as StaphNET-SA. This article contains data hosted by Microreact.
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Affiliation(s)
- Sabrina Di Gregorio
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Jesús Vielma
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
| | - María Sol Haim
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Unidad Operativa Centro Nacional de Genómica y Bioinformática, ANLIS Dr. Carlos G. Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucía Rago
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Josefina Campos
- Unidad Operativa Centro Nacional de Genómica y Bioinformática, ANLIS Dr. Carlos G. Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mihir Kekre
- Present address: Tropic Biosciences Ltd, Norwich Research Park, Norwich, UK
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK
| | - Monica Abrudan
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK
| | - Ángela Famiglietti
- Laboratorio de Bacteriología Clínica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | | | | | - Martha Helena von Specht
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Químicas y Naturales, Universidad Nacional de Misiones, Posadas, Argentina
| | - Melina Herrera
- Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Entre Ríos, Argentina
| | - Carolina Aro
- Hospital de Niños Dr. Orlando Alassia, Santa Fé, Argentina
| | - Marcelo Galas
- Pan American Health Organization, Washington, DC, USA
| | | | - Agnes Figueiredo
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Patologia, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil
| | - Nilton Lincopan
- Institute of Biomedical Sciences, Department of Microbiology, Universidade de São Paulo, Sao Pablo, Brazil
| | - Miryan Falcon
- Dpto. Bacteriología y Micología, Sección Antimicrobianos, Laboratorio Central de Salud Pública, Asunción, Paraguay
- Present address: Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Rosa Guillén
- Instituto de Investigaciones en Ciencias de la Salud, Facultad de Ciencias Químicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Teresa Camou
- Unidad de Bacteriología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo, Uruguay
| | - Gustavo Varela
- Cátedra de Bacteriología y Virología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - David M Aanensen
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK
| | - Silvia Argimón
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK
| | - Marta Mollerach
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
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Martínez ME, Grenón SL, López OH, Leguizamón LB, Mollerach ME, von Specht MH. [Description of 3 cases of skin and soft tissue infections caused by Streptococcus pneumoniae]. Rev Argent Microbiol 2017; 49:142-145. [PMID: 28416258 DOI: 10.1016/j.ram.2016.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/14/2016] [Accepted: 12/19/2016] [Indexed: 11/25/2022] Open
Abstract
The role of Streptococcus pneumoniae as a causative agent of skin and soft tissue infections (SSTI) is unusual and its clinical interpretation is difficult. We describe here three cases of SSTI due to S. pneumoniae in patients admitted to the Provincial Pediatric Hospital of Misiones, Argentina that were detected during 10 years of invasive disease (ID) surveillance documented in 2010, 2011 and 2015. These cases involved two girls aged 8 and 7 months old, and a two-year-old male child with diagnoses of gluteal abscess, preseptal cellulites and pyoderma respectively. All the patients were eutrophic and in good general condition on admission; one of them was seropositive for HIV. Antimicrobial susceptibility and serotypes were framed within the local epidemiology of invasive pneumococcal disease. Despite its low frequency, S. pneumoniae as an etiological agent of SSTI must be considered. Our findings revalue the role of the diagnostic laboratory and contribute to document the behavior of this pathogen.
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Affiliation(s)
- Mónica Elisabeth Martínez
- Laboratorio de Bacteriología, Hospital Provincial de Pediatría «Dr. F. Barreyro», CEDIT, CONICET, Posadas, Misiones, Argentina; Departamento de Microbiología, Facultad de Ciencias Exactas Químicas y Naturales, Universidad Nacional de Misiones, Posadas, Misiones, Argentina
| | - Sandra Liliana Grenón
- Departamento de Microbiología, Facultad de Ciencias Exactas Químicas y Naturales, Universidad Nacional de Misiones, Posadas, Misiones, Argentina
| | - Oscar Herminio López
- Sector Infectología, Hospital Provincial de Pediatría «Dr. Fernando Barreyro», Posadas, Misiones, Argentina
| | - Lorena Beatriz Leguizamón
- Laboratorio de Bacteriología, Hospital Provincial de Pediatría «Dr. F. Barreyro», CEDIT, CONICET, Posadas, Misiones, Argentina
| | - Marta Eugenia Mollerach
- Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Martha Helena von Specht
- Laboratorio de Bacteriología, Hospital Provincial de Pediatría «Dr. F. Barreyro», CEDIT, CONICET, Posadas, Misiones, Argentina; Departamento de Microbiología, Facultad de Ciencias Exactas Químicas y Naturales, Universidad Nacional de Misiones, Posadas, Misiones, Argentina.
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von Specht MH, Gardella N, Ubeda C, Grenon S, Gutkind G, Mollerach M. Community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections in a pediatric hospital in Argentina. J Infect Dev Ctries 2014; 8:1119-28. [PMID: 25212076 DOI: 10.3855/jidc.4271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 01/30/2014] [Accepted: 01/31/2014] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) emerged at the Pediatric Hospital of Misiones Province, north Argentina, in 2003 as a cause of community-acquired (CA) infections, mostly associated with skin and soft tissue infections (SSTIs). This study aimed to assess the microbiological, epidemiological, and clinical features of CA-MRSA SSTIs treated at the hospital. METHODOLOGY From 2003 through 2006, a longitudinal study on CA-MRSA SSTIs was conducted. Clinical, bacteriological, and molecular data were collected and analyzed by multiple correspondences and cluster analysis (MCCA). RESULTS A total of 138 children were enrolled; 55.8% of the children required hospitalization. The main clinical presentation was abscesses (51%). Antibiotic therapy in the previous six months was registered in 41% of the patients, and 72% of the patients had relatives with similar symptoms. Resistance to non-b-lactam antibiotics was found in less than 12% of patients. All 44 isolates carried staphylococcal cassette chromosomemec (SCCmec) type IV, and 30/44 had Panton-Valentine leucocidin (PVL) coding genes. Six pulsed-field gel electrophoresis (PFGE) patterns were detected from 17 isolates. MCCA hierarchic classification resulted in four distinctive patient classes (new variable). No relationship could be observed regarding the PVL detection, as PVL (+) isolates were detected in all classes; the same lack of significance was observed concerning the distribution of resistance to non-β-lactam antibiotics. CONCLUSIONS This study increases the understanding and knowledge about CA-MRSA skin and soft tissue infections in pediatric patients. Continuous efforts should be made to control this significant public health problem.
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