Characterisation of community-acquired <i>Staphylococcus aureus</i> causing skin and soft tissue infections in a children's hospital in Shanghai, China

Wang, Xing; Shen, Yanyun; Huang, Wei-Chun; Zhou, Yun

doi:10.1017/s0950268819002127

Cited by 19 publications

(21 citation statements)

References 26 publications

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“…In consistent with some previous studies, 7 , 8 most of the OS-MRSA isolates investigated in this study belonged to SCCmec IV type, which was closely correlated with prevalent CA-MRSA strains, including ST59, ST15 and ST25 genotypes. 7 , 23 In contrast to a recent report from China, no dominant clone was found among 14 OS-MRSA isolates in this study and only ST22-t309 clone accounted for 14.29% (2/14). At the same time, ST22 was also reported to be a predominant clone among community-acquired infections.…”

Section: Discussioncontrasting

confidence: 99%

Clonal Diversity, Low-Level and Heterogeneous Oxacillin Resistance of Oxacillin Sensitive MRSA

Liu

Zhang²,

et al. 2021

IDR

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Purpose This study investigates the phenotypic and genotypic resistance features of OS-MRSA clinical isolates and their distinctive sensitivities to oxacillin. Methods 1200 clinical isolates of Staphylococcus aureus were enrolled in this study. Automated antibiotics susceptibility tests on VITEK-2 and BD Phoenix-100 TM , cefoxitin disc diffusion method, oxacillin broth microdilution method, mecA , and mecC gene detection were performed to identify OS-MRSA. MLST, PFGE, SCCmec, and spa typing methods were employed to determine genotypes of OS-MRSA isolates. Heterogeneous resistance of OS-MRSA isolates was detected using the population analysis profiling method, and PBP2a latex agglutination assay was used to detect the expression of PBP2a protein for 14 OS-MRSA isolates and their highly resistant subpopulations. Results A total of 14 OS-MRSA isolates (1.17%, 14/1200) were identified, and all of the isolates were confirmed to be positive with the mecA gene and negative with the mecC gene. All of the 14 OS-MRSA isolates were identified as MSSA by VITEK-2, BD Phonenix-100, and oxacillin broth microdilution methods, while 21.43% (3/14) isolates were determined to be MRSA by the cefoxitin disk diffusion method. Genotypes of the 14 OS-MRSA isolates were diverse, and no dominant clones were identified. The prevalence of pvl gene among 14 OS-MRSA isolates was high up to 64.29% (9/14). All of the isolates showed heterogeneous resistance to oxacillin, while frequencies of the oxacillin-resistant subpopulations ranged from 10 −9 to 10 −5 and differed significantly among different isolates. Conclusion The overall prevalence of OS-MRSA was relatively lower, but lower oxacillin MICs, low testing sensitivity of routine antibiotics susceptibility testing methods and weak PBP2a protein expression were observed in this study. 14 OS-MRSA showed diverse genotypes and universal heterogeneous resistance, and inaccurate laboratory identification and improper antimicrobial usage may promote the induction of highly resistant subpopulations and lead to treatment failure.

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Section: Discussioncontrasting

confidence: 99%

Clonal Diversity, Low-Level and Heterogeneous Oxacillin Resistance of Oxacillin Sensitive MRSA

Liu

Zhang²,

et al. 2021

IDR

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“…Meanwhile, similar to a previous Chinese study [35], we found SCCmec IV was the most dominant type in all isolates. Researchers [36] suggested the reason is that the combination of smaller size and lower cost on fitness may make SCCmec type IV the selectively favored element for transfer among all S. aureus isolates.…”

Section: Discussionsupporting

confidence: 90%

Association between agr group, genetic background, virulence factors and disease types of Staphylococcus aureus isolated from Chinese children

Yan¹,

Qian²,

Yao³

et al. 2020

Preprint

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Background Staphylococcus aureus (S. aureus) accessory gene regulator (agr) system plays a critical role in staphylococcal pathogenesis. Our study aimed to investigate the relationship between agr group, the genetic background, virulence genes and disease types distribution of S. aureus isolated from different clinical sources among Chinese children.Methods S. aureus strains were isolated from Beijing Children’s hospital from October 2017 to October 2019. Isolates were typed by multilocus sequence typing (MLST), staphylococcal protein A (spa), agr, and staphylococcal cassette chromosome mec (SCCmec) typing (for methicillin-resistant S. aureus [MRSA] isolates). Furthermore, all isolates were tested for the presence of 19 selected virulence genes.Results A total of 191 non-repetitive S. aureus clinical isolates were collected and the agr type I was the most prevalent (84.8%). S. aureus isolates were divided into 33 sequence types (STs), 20 clonal complexes (CCs) and 59 spa types, ST59 (39.8%) and t437 (37.7%) were the predominant types. CC59, CC25, CC22, CC951, CC8, and CC398 isolates possessed agr group I; CC15 isolates harbored agr group II; CC30 strains were characterized as agr group III, and CC121 harbored agr group IV. Of the 19 virulence genes, the tst gene was more prevalent among agr group III compared to other groups (p = 0.006); eta and etb genes were more prevalent among agr group IV than other groups (p = 0.003 and 0.001, respectively); nearly all strains that harbored the lukS/F-PV gene (98.3%) belonged to agr group I (p = 0.004); the frequencies of bbp and ebpS genes belonged to agr group I were statistically lower than that of other groups (p < 0.001). Among 161 diagnoses, the frequency of strains from cellulitis patient harbored agr group III was higher than that of other groups (p = 0.046), and one strain isolated from staphylococcal scalded skin syndrome (SSSS) patient, which was identified as agr type IV (p = 0.021).Conclusions The results indicated that the S. aureus agr type was linked to the genetic background. Besides, a possible relationship between the agr group, several virulence determinants, and specific disease types was observed.

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“…It is important to monitor the change in the distribution of SCC mec elements because in other countries, in particular the US, MRSA SCC mec –IV isolates reach 28%, China 61%, South Africa 48% and Japan 52.3%. 50–53 , 55 PVL is one of the main virulence factors that complicate the clinical features and the therapeutic approach, since prolonged treatment of MRSA infections, producing this toxin, with VAN can lead to therapeutic failure, so it is necessary to use combinations, such as LZD and CLI, to inhibit the production of PVL. 57 , 58 …”

Section: Discussionmentioning

confidence: 99%

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

Vazquez-Rosas¹,

Mérida-Vieyra²,

Aparicio-Ozores³

et al. 2021

IDR

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Purpose Staphylococcus aureus is one of the main causative agents of hospital-acquired (HA) infections. In Mexico, information about the characteristics of clinical S. aureus isolates is limited. Our aim was to characterize S. aureus strains obtained from blood cultures of paediatric patients treated in a tertiary care hospital. Materials and Methods We analysed 249 S. aureus isolates over the period from 2006 to 2019, and their resistance profiles were determined. The isolates were classified into methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA). Staphylococcal cassettes chromosome mec (SCC mec ) were detected. Virulence genes ( cna, clfA, clfB, eta, etb, fnbA, fnbB, hla, pvl, sec, and tsst ) were amplified, and their clonal relationships were established by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and clonal complex (CC) typing. We reviewed one hundred medical files to collect clinical information. Results Thirty-eight percent of the isolates were MRSA and showed an expanded profile of resistance to other non-beta-lactam antibiotics, while MSSA strains presented a reduced resistance profile. SCC mec- II was the most frequent element (86.3%). Eight virulence factors were detected in MSSA and six in MRSA. The pvl gene was detected in four MRSA-SCC mec- IV isolates ( P ≤0.0001). MRSA isolates were distributed among 14 clones and were classified into 15 sequence types (ST); the most frequent was ST1011 (17%). The most common CC in MRSA was CC5 (69%, P ≤0.0001), and in MSSA, it was CC30 (30%, P ≤0.0001). Eighty-seven percent of MRSA isolates were HA-MRSA, and 13% were community-acquired MRSA (CA-MRSA). Of 21 HA-MRSA isolates, 17 had SCC mec -II, while two CA-MRSA isolates had SCC mec -IV. Of MSSA isolates, 77% were derived from HA infections and 23% from CA infections. Conclusion MSSA isolates had more virulence factors. MRSA isolates were resistant to more non-beta-lactam antibiotics, and those with SCC mec -IV expressed a greater variety of virulence factors. Most S. aureus isolates belonged to CC5.

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Characterisation of community-acquired Staphylococcus aureus causing skin and soft tissue infections in a children's hospital in Shanghai, China

Cited by 19 publications

References 26 publications

Clonal Diversity, Low-Level and Heterogeneous Oxacillin Resistance of Oxacillin Sensitive MRSA

Clonal Diversity, Low-Level and Heterogeneous Oxacillin Resistance of Oxacillin Sensitive MRSA

Association between agr group, genetic background, virulence factors and disease types of Staphylococcus aureus isolated from Chinese children

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

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