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Bourles A, Tristan A, Vandenesch F, Bes M, Laurent F, Ranc AG, Kainiu M, Gourinat AC, Biron A, Cazarola C, Goarant C, Colot J. A fusidic acid-resistant (PVL+) clone is associated with the increase in methicillin-resistant Staphylococcus aureus in New Caledonia. J Glob Antimicrob Resist 2022; 30:363-369. [PMID: 35835352 DOI: 10.1016/j.jgar.2022.07.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/04/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Since 2014, Staphylococcus aureus methicillin resistance is rapidly increasing in New Caledonia and is associated with potential serious clinical repercussions. In the present study, we investigated the epidemiology of Methicillin-Resistant S. aureus (MRSA) in New Caledonia and the possible emergence of a particular clonal strain. METHODS An overview of the distribution of MRSA in New Caledonia in 2019 is presented. We collected and analysed 171 clinical MRSA isolates from New Caledonia medical laboratories during August and September 2019. Among this collection, 49 representative isolates were analyzed by the French National Reference Center for Staphylococci using StaphyType DNA microarray allowing genetic characterization of the isolates. RESULTS Among the 1144 S. aureus isolated over the year 2019, 442 isolates (39%) were resistant to methicillin and 62% of these isolates were resistant to fusidic acid (FA). During the inclusion period, FA resistance rate was similar (60%). Genetic characterization evidenced CC6 as the predominant clonal complex (70%) with 26 isolates (53%) identified as CC6-MRSA-[IV+fus] (PVL+). CONCLUSIONS These findings demonstrated a low diversity of MRSA in New Caledonia with the dominance of a clonal complex not reported previously. The frequent fusidic acid (FA) resistance in MRSA was associated with a high prevalence of fusC, suggesting that FA misuse contributed to driving the selection of this clone. Our findings suggest the recommendation to stop the topical use of FA to control the emergence of this severe MRSA clone and decrease the rate of MRSA in New Caledonia.
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Key Words
- CC, Clonal complex
- CHN, Centre Hospitalier du Nord
- CHPF, Centre Hospitalier de la Polynésie Française
- CHT, Centre Hospitalier Territorial
- CWMH, Colonial War Memorial Hospital
- DASS-NC, Direction des Affaires Sanitaires et Sociales de Nouvelle-Calédonie
- EMRSA, Epidemic Methicillin-Resistant Staphylococcus aureus
- FA, Fusidic Acid
- HA-MRSA, Hospital-Acquired Methicillin-Resistant Staphylococcus aureus
- MIC, Minimum Inhibitory Concentration
- MRSA, Methicillin-Resistant Staphylococcus aureus
- MSSA, Methicillin-susceptible Staphylococcus aureus
- Methicillin-Resistant S. aureus, Fusidic acid resistance, New Caledonia, Panton Valentin Leukocidin, Community Acquired-MRSA Abbreviations CA-MRSA, Community-Acquired Methicillin-Resistant Staphylococcus aureus
- PBP2a, Penicillin-Binding Protein 2a
- PICTs, Pacific Island Countries and Territories
- PVL, Panton–Valentine Leukocidin
- SCCmec, Staphylococcal cassette chromosome mec
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Affiliation(s)
- Alexandre Bourles
- Institut Pasteur de Nouvelle-Calédonie, Institut Pasteur International Network, Medical and Environmental Bacteriology Group - Bacteriology Unit, Noumea, New Caledonia
| | - Anne Tristan
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - François Vandenesch
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Michèle Bes
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Laurent
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Anne-Gaëlle Ranc
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Malia Kainiu
- Institut Pasteur de Nouvelle-Calédonie, Institut Pasteur International Network, Medical and Environmental Bacteriology Group - Bacteriology Unit, Noumea, New Caledonia
| | - Ann-Claire Gourinat
- Centre Hospitalier Territorial Gaston-Bourret, Laboratoire de Biologie Médicale, Dumbea-sur-mer, New Caledonia
| | - Antoine Biron
- Centre Hospitalier Territorial Gaston-Bourret, Laboratoire de Biologie Médicale, Dumbea-sur-mer, New Caledonia
| | - Cécile Cazarola
- Centre Hospitalier Territorial Gaston-Bourret, Laboratoire de Biologie Médicale, Dumbea-sur-mer, New Caledonia
| | - Cyrille Goarant
- Institut Pasteur de Nouvelle-Calédonie, Institut Pasteur International Network, Medical and Environmental Bacteriology Group - Bacteriology Unit, Noumea, New Caledonia
| | - Julien Colot
- Institut Pasteur de Nouvelle-Calédonie, Institut Pasteur International Network, Medical and Environmental Bacteriology Group - Bacteriology Unit, Noumea, New Caledonia; Centre Hospitalier Territorial Gaston-Bourret, Laboratoire de Biologie Médicale, Dumbea-sur-mer, New Caledonia.
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