Characterisation of S. aureus/MRSA CC1153 and review of mobile genetic elements carrying the fusidic acid resistance gene fusC

Abstract

While many data on molecular epidemiology of MRSA are available for North America, Western Europe and Australia, much less is known on the distribution of MRSA clones elsewhere. Here, we describe a poorly known lineage from the Middle East, CC1153, to which several strains from humans and livestock belong. Isolates were characterised using DNA microarrays and one isolate from the United Arab Emirates was sequenced using Nanopore technology. CC1153 carries agr II and capsule type 5 genes. Enterotoxin genes are rarely present, but PVL is common. Associated spa types include t504, t903 and t13507. PVL-positive CC1153-MSSA were found in Egyptian cattle suffering from mastitis. It was also identified among humans with skin and soft tissue infections in Saudi Arabia, France and Germany. CC1153-MRSA were mainly observed in Arabian Gulf countries. Some isolates presented with a previously unknown SCCmec/SCCfus chimeric element in which a mec B complex was found together with the fusidic acid resistance gene fusC and accompanying genes including ccrA/B-1 recombinase genes. Other isolates carried SCCmec V elements that usually also included fusC. Distribution and emergence of CC1153-MRSA show the necessity of molecular characterization of MRSA that are resistant to fusidic acid. These strains pose a public health threat as they combine resistance to beta-lactams used in hospitals as well as to fusidic acid used in the community. Because of the high prevalence of fusC-positive MRSA in the Middle East, sequences and descriptions of SCC elements harbouring fusC and/or mecA are reviewed. When comparing fusC and its surrounding regions from the CC1153 strain to available published sequences, it became obvious that there are four fusC alleles and five distinct types of fusC gene complexes reminiscent to the mec complexes in SCCmec elements. Likewise, they are associated with different sets of ccrA/B recombinase genes and additional payload that might include entire mec complexes or SCCmec elements.

Sequence Analysis of Novel Staphylococcus aureus Lineages from Wild and Captive Macaques

“…ST7750 and ST7754 clustered with CC772 and CC913, which are clinically important, emerging human lineages from the Indian subcontinent and the Middle East, respectively. ST7692 appeared to be closely related to CC1153, a clonal complex to which MSSA from South-East Asia as well as MRSA from the Middle East belong [ 39 ]. The macaque ST2990 isolate was nearly identical with a previously sequenced human isolate of ST2990 from Indonesia (GenBank VCMW; [ 31 ]).…”

Lateral Flow Immunoassay for the Detection of Panton-Valentine Leukocidin in Staphylococcus aureus From Skin and Soft Tissue Infections in the United Arab Emirates

“…However, an antimicrobial coverage to mitigate against a potential threat of complications occurs commonly thus contributing to antibiotic misuse. The widespread utilization of beta lactams and fusidic acid in SSTI is a likely contributory factor to the emergence of resistance to these antibiotics resulting in the high occurrence of MRSA strains with SCC mec + SCC fusC composite elements in the Arabian Gulf region ( Senok et al., 2020a ; Monecke et al., 2021 ). The continued evolution and upward trend of MRSA in the region has been linked to strains harboring these composite elements ( Senok et al., 2020a ; Monecke et al., 2021 ).…”

“…The widespread utilization of beta lactams and fusidic acid in SSTI is a likely contributory factor to the emergence of resistance to these antibiotics resulting in the high occurrence of MRSA strains with SCC mec + SCC fusC composite elements in the Arabian Gulf region ( Senok et al., 2020a ; Monecke et al., 2021 ). The continued evolution and upward trend of MRSA in the region has been linked to strains harboring these composite elements ( Senok et al., 2020a ; Monecke et al., 2021 ). Hence, the high prevalence of MRSA isolates associated with SSTI, as well as the rate of detection of isolates harboring pvl and fusC genes is worrisome.…”

“…Given the high number of people from these countries working in the region, its occurrence is not surprising, and indeed, it has been observed in many studies from the region ( Monecke et al., 2012a ; Udo et al., 2014 ; Boswihi et al., 2016 ; Senok et al., 2020b ). CC1153-MRSA-[V/VT+ fusC ] (PVL+) and CC1153-MRSA-PseudoSCC mec [class B+ fusC + ccrAB1 ] (PVL+) are both strains that are known to occur mainly in Gulf countries ( Monecke et al., 2021 ).…”

Description of Staphylococcal Strains from Straw-Coloured Fruit Bat (Eidolon helvum) and Diamond Firetail (Stagonopleura guttata) and a Review of their Phylogenetic Relationships to Other Staphylococci

“…We selected a panel of 154 core genome markers for tree construction using SplitsTree ( Monecke et al., 2021 ). These genes and genome sequences used for visualisation ( Figure 1 ) are listed in Supplemental File 6 .…”