Molecular Characterization of Staphylococcus aureus Obtained from Blood Cultures of Paediatric Patients Treated in a Tertiary Care Hospital in Mexico

Vazquez-Rosas, Guillermo Jose; Mérida-Vieyra, Jocelin; Aparicio-Ozores, Gerardo; Lara-Hernández, Antonino; Colsa, Agustin De; Aquino-Andrade, Alejandra

doi:10.2147/idr.s302416

Cited by 6 publications

(9 citation statements)

References 59 publications

(84 reference statements)

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“…In our study, CC5 followed by CC30 and CC8 were the main CC detected which coincides with the isolates reported in the epidemiology of S. aureus infections, in Mexico (Vazquez-Rosas et al, 2021). Also, this is consistent with other authors who point out the diversity of origins of strains causing paediatric OAIs, particularly in MSSA (Kechrid et al, 2011;Yu et al, 2020;Pimentel de Araujo et al, 2022).…”

Section: Discussionsupporting

confidence: 92%

“…According to the Network for the Research and Surveillance of Drug Resistance, the frequency of methicillin-resistant S. aureus (MRSA) in Mexico has decreased from 44.5% in 2009 to 26.2% in 2018. It was more common in respiratory (21.4%), blood (16.7%) and urine (9.1%) samples ( Garza-González et al., 2019 ); however, information about S. aureus from bone samples or joint fluid in paediatric patients is limited ( Vazquez-Rosas et al., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Surveillance of osteoarticular infections caused by Staphylococcus aureus in a paediatric hospital in Mexico City

Aguilar-Gómez

Mérida-Vieyra

Isunza-Alonso

et al. 2022

Front. Cell. Infect. Microbiol.

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Staphylococcus aureus is the main aetiologic agent of osteoarticular infections (OAIs) in paediatric patients. The aim of this prospective unicenter study was to describe the phenotypic and genotypic characteristics of S. aureus isolates obtained from OAIs in paediatric patients admitted to tertiary care hospital. Through a surveillance program called OsteoCode, a multidisciplinary team was created and we identified 27 patients with OAIs caused by S. aureus from 2019 to 2021. The susceptibility profile, virulence factors, biofilm formation, pulsed-field gel electrophoresis (PFGE), clonal complex (CC) and sequence type (ST) were determined. In addition, the clinical characteristics and evolution of the patients presented six months after the diagnosis of OAIs were described. Ninety-two percent of the isolates were methicillin-sensitive S. aureus (MSSA). In methicillin-resistant S. aureus (MRSA), SCCmec-II and SCCmec-V were detected. The pvl gene was only observed in MSSA (18.5%) and was associated with highest fever (p=0.015), multiple localization (p=0.017), and soft tissue sites of infection beyond the bone (pyomyositis, pulmonary abscess) (p=0.017). Biofilm formation was detected in 55.6% of isolates. The most common CC were CC5 and CC30 which represent the most common linages for bone and joint infections worldwide. The isolates were distributed in different STs, and ST672 was predominant. MRSA were associated with a longer duration of intravenous treatment and a prolonged hospital stay (p=0.023). Recurrent infection occurred in five children and orthopaedic complications in 33.3% of patients. This is the first study that reflects the epidemiology of S. aureus in OAIs in paediatric patients in Mexico; a clear predominance of MSSA distributed in different STs was observed. Our findings highlight that a multidisciplinary team is required for the diagnosis and treatment of OAIs.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Surveillance of osteoarticular infections caused by Staphylococcus aureus in a paediatric hospital in Mexico City

Aguilar-Gómez

Mérida-Vieyra

Isunza-Alonso

et al. 2022

Front. Cell. Infect. Microbiol.

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“…Community-acquired MRSA strains often express lower levels of resistance to oxacillin and multiply faster than hospital-acquired MRSA strains with significantly shorter times which help community-acquired MRSA achieve successful colonization by enabling it to compete with the commensal bacterial flora [ 8 ]. Based on SCC mec typing, community-acquired MRSA strains are typically SCCmec IV, V, and VI, while hospital-acquired MRSA are usually SCC mec I, II, and III [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Susceptibility, Biofilm Production, and Detection of mecA Gene among Staphylococcus aureus Isolates from Different Clinical Specimens

et al. 2021

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The increasing incidence of methicillin-resistant and biofilm-forming S. aureus isolates in hospital settings is a gruesome concern today. The main objectives of this study were to determine the burden of S. aureus in clinical samples, assess their antibiotic susceptibility pattern and detect biofilm formation and mecA gene in them. A total of 1968 different clinical specimens were processed to isolate S. aureus following standard microbiological procedures. Antibiotic susceptibility test of the isolates was performed by Kirby–Bauer disc-diffusion method following CLSI guidelines. Biofilm was detected through tissue culture plate method. Methicillin-resistant S. aureus (MRSA) isolates were screened using cefoxitin (30 µg) discs and mecA gene was amplified by conventional polymerase chain reaction (PCR). Of 177 bacterial growth, the prevalence of S. aureus was 15.3% (n = 27). MRSA were 55.6% (15/27) and 44% (12/27) exhibited multidrug resistance (MDR). There was no significant association between methicillin resistance and MDR (p > 0.05). Both MRSA and MSSA were least sensitive to penicillin (100%, 75%) followed by erythromycin (86.6%, 66.6%). Most of the MRSA (93.4%) were susceptible to tetracycline. All S. aureus isolates were biofilm producers—19 (70%) were weak and only one (4%) was a strong biofilm producer. The strong biofilm-producing MSSA was resistant to most of the antibiotics except cefoxitin and clindamycin. None of the MSSA possessed mecA gene while 8 (53.3%) MRSA had it. More than half of S. aureus isolated were MRSA. High incidence of multidrug resistance along with capacity to form biofilm among clinical isolates of S.aureus is a matter of apprehension and prompt adoption of biosafety measures is suggested to curb their dissemination in the hospital environments.

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“…ST965 is a single-locus variant of ST5 that belongs to clonal complex 5 (CC5). CC5-MRSA is the most common and widespread MRSA lineage and has increasingly been isolated from China and abroad ( Chen et al, 2018 ; Perez-Montarelo et al, 2018 ; Wu et al, 2018 ; Vazquez-Rosas et al, 2021 ). Meanwhile, most VRSA isolates with typing data are categorized into the CC5 lineage, which independently acquires vanA-positive Tn1546 from enterococci ( Limbago et al, 2014 ; Challagundla et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Genetic Characteristics of Multiple Copies of Tn1546-Like Elements in ermB-Positive Methicillin-Resistant Staphylococcus aureus From Mainland China

Wang

et al. 2022

Front. Microbiol.

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ObjectiveTo determine the genetic structure of ermB-positive Tn1546-like mobile elements in methicillin-resistant Staphylococcus aureus (MRSA) from mainland China.MethodsA total of 271 erythromycin-resistant MRSA isolates were isolated from Sir Run Run Shaw Hospital (SRRSH) from 2013 to 2015. Whole-genome sequencing was performed for the ermB-positive strains, and the genetic environment of the ermB genes was analyzed. Southern hybridization analysis and transformation tests were performed to confirm the location of the ermB gene.ResultsA total of 64 isolates (64/271, 23.6%) were ermB-positive strains, with 62 strains (62/64, 96.9%) belonging to the CC59 clone. The other two strains, SR130 and SR231, belonging to CC5-ST965, both harbored 14,567 bp ermB-positive Tn1546-like elements and displayed multidrug-resistant profiles. PFGE followed by Southern blot demonstrated that the ermB genes were located on the plasmids of both SR130 and SR231, while two copies of ermB were located on the chromosome of SR231. Further sequencing demonstrated that SR231 carried one Tn1546-ermB elements in the plasmid and two identical copies integrated on the chromosome, which had 99.99% identity to the element in the plasmid of SR130. The Tn1546-ermB elements were highly similar (100% coverage, >99.9% identity) to the element Tn6636 reported in a previous study from Taiwan. The plasmids (pSR130 and pSR231) harboring ermB-positive Tn1546-like elements were also identical to the mosaic plasmid pNTUH_5066148. However, conjugation of ermB-carrying plasmids of SR130 and SR231 were failed after triple repeats.ConclusionMultiple copies of ermB-positive Tn1546-like mobile elements were found in CC5-ST965 MRSA from mainland China, showing the wide dissemination of these Enterococcus faecium-originated ermB-positive Tn1546-like elements. Molecular epidemiological study of Tn1546-like elements is essential to avoid the spreading of resistant determinants.

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Molecular Characterization of Staphylococcus aureus Obtained from Blood Cultures of Paediatric Patients Treated in a Tertiary Care Hospital in Mexico

Cited by 6 publications

References 59 publications

Surveillance of osteoarticular infections caused by Staphylococcus aureus in a paediatric hospital in Mexico City

Surveillance of osteoarticular infections caused by Staphylococcus aureus in a paediatric hospital in Mexico City

Antibiotic Susceptibility, Biofilm Production, and Detection of mecA Gene among Staphylococcus aureus Isolates from Different Clinical Specimens

Genetic Characteristics of Multiple Copies of Tn1546-Like Elements in ermB-Positive Methicillin-Resistant Staphylococcus aureus From Mainland China

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