Characterization of Staphylococcus aureus Isolated from Non-Native Patients with Skin and Soft Tissue Infections in Shanghai

Abstract

Background Staphylococcus aureus is one predominant cause of skin and soft-tissue infections (SSTIs), but little information exists regarding the characterization of S. aureus from non-native patients with SSTIs in China.MethodsIn this study, we enrolled 52 non-native patients with S. aureus SSTIs, and 65 native control patients with S. aureus SSTIs in Shanghai. 52 and 65 S. aureus isolates were collected from both groups, respectively. S. aureus isolates were characterized by antimicrobial susceptibility testing, toxin gene detection, and molecular typing with sequence type, spa type, agr group and SCCmec type.ResultsMethicillin-resistant S. aureus (MRSA) was detected in 8 non-native patients and 14 native patients with SSTIs. Overall, antimicrobial susceptibilities of S. aureus isolated from non-native patients were found higher than those from native patients. CC59 (ST338 and ST59) was found in a total of 14 isolates (4 from non-native patients; 10 from native patients), 9 of which were carrying lukS/F-PV (3 from non-native patients; 6 from native patients). ST7 was found in 12 isolates and all 12 isolates were found in native patients. The livestock-associated clone ST398 was found in 11 isolates (6 from non-native patients; 5 from native patients), and 5 ST398 lukS/F-PV-positive methicillin-susceptible S. aureus (MSSA) were all discovered among non-native patients. The molecular epidemiology of S. aureus isolated from non-native patients was quite different from those from native patients. lukS/F-PV was more frequent in isolates originating from non-native patients with SSTIs compared to native patients (31 vs. 7, P <0.0001).ConclusionsCC59 was the most common clonal complex among patients with SSTIs in Shanghai. The other most common sequence types were ST7 and Livestock ST398. The molecular epidemiology of S. aureus isolated from non-native patients was quite different from those from native patients. S. aureus isolated from non-native patients was more likely to carry lukS/F-PV.

Molecular Epidemiology of Staphylococcus aureus among Patients with Skin and Soft Tissue Infections in Two Chinese Hospitals

“…In this study, 16 MRSA isolates were detected accounting for 25.8%, and it was higher than the occurrence of MRSA among S. aureus from SSTIs as we studied in Shanghai previously. [ 4 ] However, it was lower than the occurrence of MRSA among S. aureus SSTIs as reported in Canada. [ 15 ] Considering the importance of MRSA in SSTIs and its involvement associated with poor patient outcomes, vancomycin, teicoplanin, linezolid, daptomycin, tigecycline, and ceftaroline were recommended by European guidelines for the treatment of MRSA complicated SSTIs (cSSTIs).…”

“…ST398 was a livestock-associated clone and has been reported as a common but not the most common clone among patients with S. aureus SSTIs in Shanghai and Beijing, China before. [ 4 7 ] It has also been reported unexpectedly high among bone and joint infections and nasal-colonizing isolates in France. [ 17 ] The spa type t034 which was found among all ST398 S. aureus isolates was reported as a dominant type in pigs and pig farmers in Canada.…”

“…In China, CC59 was the dominant clonal complex among S. aureus , especially MRSA among the patients with SSTIs, and ST7 has become the common clone recently in methicillin-susceptible S. aureus (MSSA) SSTIs. [ 4 5 ] The livestock-associated clone ST398, which was always associated with animals and farm workers,[ 6 ] was currently found frequently with a high positive rate of lukS/F-PV among S. aureus in SSTIs patients in China. [ 4 7 ] CC8 was the most common clone among SSTIs-associated S. aureus , especially MRSA in the United States and Japan.…”

“…[ 4 5 ] The livestock-associated clone ST398, which was always associated with animals and farm workers,[ 6 ] was currently found frequently with a high positive rate of lukS/F-PV among S. aureus in SSTIs patients in China. [ 4 7 ] CC8 was the most common clone among SSTIs-associated S. aureus , especially MRSA in the United States and Japan. [ 8 9 ] Moreover, the prevalence of S. aureus colonization among SSTIs patients was high in the United States and USA300 (CC8) MRSA was often involved as reported.…”

Prevalence and Molecular Epidemiology of Staphylococcus aureus among Residents of Seven Nursing Homes in Shanghai

“…ST398 has been reported causing an outbreak of MRSA in a Dutch Nursing Home between 2010 and 2011[ 23 ]. CC398 was also recently reported as a livestock-associated clone in skin and soft-tissue infections (SSTIs) in China[ 24 , 25 ] and the spa type t034 (CC398) which was found in 3 MRSA and 7 MSSA was reported as a dominant type in pigs and pig farmers in Canada[ 26 ]. ST188 was the common genotype of methicillin-susceptible S .…”