Exploring the evolution and epidemiology of European CC1-MRSA-IV: tracking a multidrug-resistant community-associated meticillin-resistant Staphylococcus aureus clone

Abstract

This study investigated the evolution and epidemiology of the community-associated and multidrug-resistant Staphylococcus aureus clone European CC1-MRSA-IV. Whole-genome sequences were obtained for 194 European CC1-MRSA-IV isolates (189 of human and 5 of animal origin) from 12 countries, and 10 meticillin-susceptible precursors (from North-Eastern Romania; all of human origin) of the clone. Phylogenetic analysis was performed using a maximum-likelihood approach, a time-measured phylogeny was reconstructed using Bayesian analysis, and in silico microarray genotyping was performed to identify resistance, virulence-associated and SCCmec (staphylococcal cassette chromosome mec) genes. Isolates were typically sequence type 1 (190/204) and spa type t127 (183/204). Bayesian analysis indicated that European CC1-MRSA-IV emerged in approximately 1995 before undergoing rapid expansion in the late 1990s and 2000s, while spreading throughout Europe and into the Middle East. Phylogenetic analysis revealed an unstructured meticillin-resistant S. aureus (MRSA) population, lacking significant geographical or temporal clusters. The MRSA were genotypically multidrug-resistant, consistently encoded seh, and intermittently (34/194) encoded an undisrupted hlb gene with concomitant absence of the lysogenic phage-encoded genes sak and scn. All MRSA also harboured a characteristic ~5350 nt insertion in SCCmec adjacent to orfX. Detailed demographic data from Denmark showed that there, the clone is typically (25/35) found in the community, and often (10/35) among individuals with links to South-Eastern Europe. This study elucidated the evolution and epidemiology of European CC1-MRSA-IV, which emerged from a meticillin-susceptible lineage prevalent in North-Eastern Romania before disseminating rapidly throughout Europe.

Beyond CC398: Characterisation of Other Tetracycline and Methicillin-Resistant Staphylococcus aureus Genetic Lineages Circulating in Spanish Hospitals

“…This PVL-negative clone, like USA400, is not usually associated with multidrug resistance profiles [ 25 ]; however, it typically carries blaZ and ermC antimicrobial resistance genes, and other virulence genes, including scn [ 26 ]. More recently, another PVL-negative MRSA-CC1 clone (different from the WA-MRSA-1) was identified in humans in Ireland with an alarming MDR profile and mupirocin resistance as a common feature [ 27 ]; this clone has been referred to as the European CC1-MRSA-IV clone [ 28 ]. These three MRSA CC1 clones share the feature that all of them present with SCC mec type IV, despite the fact that other MRSA CC1 clones can present SCC mec type V [ 24 ], mostly among swine-related isolates [ 20 ].…”

Methicillin-Resistant Staphylococcus aureus (MRSA) and Other Methicillin-Resistant Staphylococci and Mammaliicoccus (MRNaS) Associated with Animals and Food Products in Arab Countries: A Review

“…CC1 and CC5 have been recognized as both HA- and CA-MRSA but have also been isolated from pork and pigs [ 77 ]. These CCs are highly prevalent in humans in Europe and the Middle East [ 78 , 79 ]. MRSA CC22 has been reported from cattle in Egypt [ 59 ] and is considered HA-MRSA.…”

Molecular Diagnosis, Antimicrobial Resistance Profiles and Disease Patterns of Gram-Positive Pathogens Recovered from Clinical Infections in Major Ha’il Hospitals

“…Fortunately, the introduction, in recent years, of automated multiplex molecular systems for rapid and specific point-of-care detection is being proved useful for the newly emerging and re-emerging subtypes in different hosts. These systems provide a unified approach in global efforts to trace the emergence and spread of MRSA lineages in different regions [13]. Specific detection and treatment lowers increased use, or abuse, of antibiotics, the biological cost of which on bacteria contribute to the evolution of more adapted lineages capable of global expansions.…”