Emergence and spread of worldwide &lt;em&gt;Staphylococcus aureus &lt;/em&gt;clones among cystic fibrosis patients

Garbacz, Katarzyna; Piechowicz, Lidia; Podkowik, Magdalena; Mroczkowska, Aneta; Empel, Joanna; Bania, Jacek

doi:10.2147/idr.s153427

Cited by 28 publications

(29 citation statements)

References 38 publications

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“…Using three geographically distinct collections of S. aureus isolated from U.S. patients with cystic fibrosis, we found that EGC toxins had similarly high prevalence. This is similar to a recent study of S. aureus isolates from Europe patients with CF, in which EGC toxins were present in ≈57% of isolates [19]. The EGC prevalence within this U.S. collection is even higher, suggesting the continued emergence of strains encoding this locus, possibly through the spread of one or more clones.…”

Section: Discussionsupporting

confidence: 90%

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High Prevalence of Staphylococcus aureus Enterotoxin Gene Cluster Superantigens in Cystic Fibrosis Clinical Isolates

Fischer

Kilgore

Singh

et al. 2019

Genes

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Background: Staphylococcus aureus is a highly prevalent respiratory pathogen in cystic fibrosis (CF). It is unclear how this organism establishes chronic infections in CF airways. We hypothesized that S. aureus isolates from patients with CF would share common virulence properties that enable chronic infection. Methods: 77 S. aureus isolates were obtained from 45 de-identified patients with CF at the University of Iowa. We assessed isolates phenotypically and used genotyping assays to determine the presence or absence of 18 superantigens (SAgs). Results: We observed phenotypic diversity among S. aureus isolates from patients with CF. Genotypic analysis for SAgs revealed 79.8% of CF clinical isolates carried all six members of the enterotoxin gene cluster (EGC). MRSA and MSSA isolates had similar prevalence of SAgs. We additionally observed that EGC SAgs were prevalent in S. aureus isolated from two geographically distinct CF centers. Conclusions: S. aureus SAgs belonging to the EGC are highly prevalent in CF clinical isolates. The greater prevalence in these SAgs in CF airway specimens compared to skin isolates suggests that these toxins confer selective advantage in the CF airway.

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Section: Discussionsupporting

confidence: 90%

“…In the European study, 5 spa types accounted for 25.6% of all S. aureus isolates. However, EGC-positive S. aureus isolates were not limited to a single clonal group [19].…”

Section: Discussionmentioning

confidence: 95%

High Prevalence of Staphylococcus aureus Enterotoxin Gene Cluster Superantigens in Cystic Fibrosis Clinical Isolates

Fischer

Kilgore

Singh

et al. 2019

Genes

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“…Furthermore, such prevalent S. aureus strains do not only belong to carriage strains (Holtfreter et al, 2016), but also to S. aureus strains that can cause severe life threatening infection (Grundmann et al, 2010). Also, in comparison to the study from Garbacz et al (2018), in which 215 S. aureus isolates from 107 CF patients from Poland were characterized by spa-typing, four of our eight prevalent spa-types were also part of the five most common spa-types of their study (t015, t084, t091, and t002). Therefore, our findings are representative for S. aureus isolates cultured also from the airways of CF patients from other countries.…”

Section: Discussionmentioning

confidence: 95%

Antibiotic Treatment and Age Are Associated With Staphylococcus aureus Carriage Profiles During Persistence in the Airways of Cystic Fibrosis Patients

et al. 2020

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Background: Staphylococcus aureus is one of the most isolated pathogens from the airways of cystic fibrosis (CF) patients. There is a lack of information about the clonal nature of S. aureus cultured from CF patients and their impact on disease. We hypothesized that patients would differ in their clinical status depending on S. aureus clonal carriage profiles during persistence. Methods: During a 21-months prospective observational multicenter study (Junge et al., 2016), 3893 S. aureus isolates (nose, oropharynx, and sputa) were cultured from 183 CF patients (16 German centers, 1 Austrian center) and subjected to spa-sequence typing to assess clonality. Data were associated to lung function, age, gender, and antibiotic treatment by multivariate regression analysis. Results: Two hundred and sixty-five different spa-types were determined with eight prevalent spa-types (isolated from more than 10 patients): t084, t091, t008, t015, t002 t012, t364, and t056. We observed different carriage profiles of spa-types during the study period: patients being positive with a prevalent spa-type, only one, a dominant or related spa-type/s. Patients with more antibiotic cycles were more likely to be positive for only one spa-type (p = 0.005), while older patients were more likely to have related (p = 0.006), or dominant spa-types (p = 0.026). Two percent of isolates were identified as methicillin-resistant S. aureus (MRSA) and evidence of transmission of clones within centers was low. Conclusion: There was a significant association of antibiotic therapy and age on S. aureus carriage profiles in CF patients indicating that antibiotic therapy prevents acquisition of new clones, while during aging of patients with persisting S. aureus, dominant clones were selected and mutations in the spa-repeat region accumulated.

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“…S. aureus utilizes an arsenal of toxins as virulence factors during infection [29]. While detecting toxin genes in S. aureus CF clinical isolates is commonly performed in epidemiology studies [44], the prevalence of toxin production in a large set of S. aureus CF clinical isolates has not been performed. Therefore, in order to assess the virulence capabilities of our S. aureus clinical isolates, we measured the production of hemolysins on blood agar plates.…”

Section: Resultsmentioning

confidence: 99%

Genotypic and phenotypic diversity ofStaphylococcus aureusfrom cystic fibrosis lung infections and their interactions withPseudomonas aeruginosa

Petit

Raghuram

et al. 2019

Preprint

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20Pseudomonas aeruginosa and Staphylococcus aureus are the most common bacteria 21 that infect the respiratory tract of individuals with the genetic disease cystic fibrosis (CF); in fact, 22S. aureus has recently overtaken P. aeruginosa to become the most common. Substantial 23 research has been performed on the epidemiology of S. aureus in CF; however, there appears 24 to be a gap in knowledge in regard to the pathogenesis of S. aureus in the context of CF lung 25 infections. Most studies have focused on a few S. aureus isolates, often exclusively laboratory 26 adapted strains, and how they are killed by P. aeruginosa. Because of this, little is known about 27 the diversity of S. aureus CF lung isolates in both virulence and interaction with P. aeruginosa. 28To begin to address this gap in knowledge, we recently sequenced 65 clinical S. aureus isolates 29 from the Emory CF Biospecimen Registry and Boston Children's Hospital, including the 30 reference isolate JE2, a USA300 strain. Here, we analyzed antibiotic resistance genotypes, 31 sequence type, clonal complex, spa type, and agr type of these isolates. We hypothesized that 32 major virulence phenotypes of S. aureus that may be associated with CF lung infections, 33 namely toxin production and mucoid phenotype, would be retained in these isolates. To test our 34 hypothesis, we plated on specific agars and found that most isolates can hemolyze both rabbit 35 and sheep blood (67.7%) and produce polysaccharide (69.2%), consistent with virulence 36 retention in CF lung isolates. We also identified three distinct phenotypic groups of S. aureus 37 based on their survival in the presence of nonmucoid P. aeruginosa laboratory strain PAO1 and 38 its mucoid derivative. Altogether, our work provides greater insight into the diversity of S. aureus 39 CF isolates, specifically the distribution of important virulence factors and their interaction with 40 P. aeruginosa, all of which have implications in patient health. 41 42 Author Summary 43Staphylococcus aureus is now the most frequently detected pathogen in the lungs of 44 individuals who have cystic fibrosis (CF), followed closely by Pseudomonas aeruginosa. When 45 these two pathogens are found to coinfect the CF lung, patients have a significantly worse 46 prognosis. While P. aeruginosa has been rigorously studied in the context of bacterial 47 pathogenesis in CF, less is known about S. aureus. Here we present an in-depth study of 64 S. 48 aureus CF clinical isolates where we investigated genetic diversity utilizing whole genome 49 sequencing, virulence phenotypes, and interactions with P. aeruginosa. We have found that S. 50 aureus isolated from the CF lung are phylogenetically diverse, most retain known virulence 51 factors, and they vary in interactions with P. aeruginosa from highly sensitive to completely 52 tolerant. Deepening our understanding of how S. aureus responds to its environment and other 53 microbes in the CF lung will enable future development of effective treatments and preventative 54 measures agains...

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Emergence and spread of worldwide <em>Staphylococcus aureus </em>clones among cystic fibrosis patients

Cited by 28 publications

References 38 publications

High Prevalence of Staphylococcus aureus Enterotoxin Gene Cluster Superantigens in Cystic Fibrosis Clinical Isolates

High Prevalence of Staphylococcus aureus Enterotoxin Gene Cluster Superantigens in Cystic Fibrosis Clinical Isolates

Antibiotic Treatment and Age Are Associated With Staphylococcus aureus Carriage Profiles During Persistence in the Airways of Cystic Fibrosis Patients

Genotypic and phenotypic diversity ofStaphylococcus aureusfrom cystic fibrosis lung infections and their interactions withPseudomonas aeruginosa

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