Genetic diversity of methicillin-resistant Staphylococcus aureus in a tertiary hospital in The Netherlands between 2002 and 2006

Nulens, Eric; Stobberingh, Ellen E.; Smeets, Ed; Dessel, Helke A. van; Welling, Maaike; Sebastian, Silvie; Tiel, Frank H. van; Beisser, Patrick S.; Deurenberg, Ruud H.

doi:10.1007/s10096-008-0686-0

Cited by 13 publications

(8 citation statements)

References 53 publications

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“…As previously described in Europe, PVL genes were detected in strains with different genetic backgrounds (9,28,30,35,36). However, the epidemiology in Bilbao appeared unusual.…”

supporting

confidence: 55%

Molecular Epidemiology of Panton-Valentine Leukocidin-Positive Staphylococcus aureus in Spain: Emergence of the USA300 Clone in an Autochthonous Population

et al. 2011

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“…As previously described in Europe, PVL genes were detected in strains with different genetic backgrounds (9,28,30,35,36). However, the epidemiology in Bilbao appeared unusual.…”

supporting

confidence: 55%

Molecular Epidemiology of Panton-Valentine Leukocidin-Positive Staphylococcus aureus in Spain: Emergence of the USA300 Clone in an Autochthonous Population

et al. 2011

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“…The MSSA and MRSA clones belonging to CC5, CC8, CC22, CC30, and CC45 are pandemic lineages (3,4,9,12,17,19,20,24). MSSA strains were highly diverse and rather equally distributed across such lineages.…”

Section: Discussionmentioning

confidence: 99%

“…No isolate was characterized as one of the emerging clones observed in neighboring European countries, such as ST22-IV, ST45-IV, ST125-IV, and ST225-I (1,10,14,20).…”

Section: Discussionmentioning

confidence: 99%

Variable-Number Tandem Repeat Analysis and Multilocus Sequence Typing Data Confirm the Epidemiological Changes Observed with Staphylococcus aureus Strains Isolated from Bloodstream Infections

et al. 2009

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Since 2000, our geographical region in France systematically surveys bloodstream infections (BSI) due to Staphylococcus aureus. This survey involves 39 health care institutions (HCIs) encompassing 6,888 short-stay beds and was performed during two 3-month periods during 2007 and 2008. The study periods of this survey identified 292 S. aureus isolates causing BSI. Extensive molecular characterization, including genotyping as well as toxin, agr, and staphylococcal cassette chromosome content determinations, allowed us to describe epidemiological evolution in comparison to that discussed in our previous study. Our main epidemiological observation shows that the incidence of BSI remained constant but that methicillin (meticillin)-resistant S. aureus strains with a wider variety of genetic backgrounds now harbor pyl, as has already been reported in different European countries. We noticed stable numbers of BSI episodes involving community-acquired methicillin-sensitive S. aureus (MSSA), whereas a drastic increase in the number of strains harboring the tst gene was recorded. The increase in the number of tst gene-harboring strains is related to known hospitalacquired MSSA isolates and appears related to epidemic episodes in specific HCIs. Monitoring the increase in prevalence of specific strains helps us understand where the standard precautions are not satisfactorily applied or do not efficiently prevent the spread of epidemic MSSA strains in these HCIs. The recent increases in incidence of these strains call for particular vigilance to avoid the spread of potentially virulent MSSA strains harboring the tst gene and for continuance of this strategy of BSI surveillance.Reporting of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) is often mandatory, and reduction of BSI rates is a performance target (2,15,16,19,22,23). Since 2000, a prospective, longitudinal survey of BSI has been under way at a regional level in France. Results obtained during the first 7 years of surveillance have been reported (26,27). After sustained and decreasing incidence rates of S. aureus BSI attributed to successful infection control efforts in participating health care institutions (HCIs), we reported in 2006 a sudden increase in incidence that involved two populations of S. aureus strains: one of methicillin-sensitive S. aureus (MSSA) strains and one of MRSA isolates.First, an increasing incidence of BSI was observed due to MSSA strains, including (i) strains associated with epidemic phenomena in HCIs and (ii) a genetically homogeneous population of tst-positive MSSA isolates, mostly associated with community-acquired (CA) BSI, suggesting clonal spread at a regional level.Second, we observed the emergence of BSI associated with genetically diverse nonmultiresistant staphylococcal cassette chromosome mec type IV (SCCmec IV) MRSA strains (named NORSA) that could not be related to any local outbreak in the participating HCIs.We report here data collected in 2007 and 2008 using exactly the same study design. Agai...

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“…Eighty-seven strains from the Harmony collection (1) were provided by Alex van Belkum. Twenty-five methicillin-resistant S. aureus (MRSA) carriage strains were isolated in the Maastricht University Medical Center (MUMC) in The Netherlands between 2002 and 2006 and comprise five strains each from MLST CC5, CC8, CC22, CC30, and CC45 (29). Fifty methicillin-sensitive S. aureus (MSSA) nasal carriage strains were isolated from patients attending their general practitioner in The Netherlands during 2005 and comprise five strains each from MLST CC5, CC7, CC8, CC12, CC15, CC22, CC25, CC30, CC45, and CC51 (6).…”

Section: Methodsmentioning

confidence: 99%

Improved Multiple-Locus Variable-Number Tandem-Repeat Assay for Staphylococcus aureus Genotyping, Providing a Highly Informative Technique Together with Strong Phylogenetic Value

et al. 2009

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We describe an improved multiple-locus variable-number tandem-repeat (VNTR) analysis (MLVA) scheme for genotyping Staphylococcus aureus. We compare its performance to those of multilocus sequence typing (MLST) and spa typing in a survey of 309 strains. This collection includes 87 epidemic methicillin-resistant S. Staphylococcus aureus is a pathogen of worldwide clinical significance. For this reason, it is the subject of intensive investigations in terms of virulence and drug resistance phenotypes and, also, population genetics. Although the latter is not of significant use for short-term patient care, it is essential for understanding the emergence and spread of new phenotypes. For instance, it was initially considered most likely that methicillin (meticillin)-resistant variants were appearing only rarely through the acquisition of a mobile DNA region designated staphylococcal cassette chromosome mec (SCCmec) and that these variants were spreading efficiently worldwide (34). However, the most recent population genetics investigations suggested instead that SCCmec was acquired hundreds of times independently worldwide and that, as a rule, the geographic spread of these resistant strains was limited (28,36). This knowledge could be produced in the past 10 years due to sequence-based approaches, mainly multilocus sequence typing (MLST) analysis, in which approximately 3 kb of coding genome sequence (or 1/1,000 of the whole genome) are scanned for polymorphism. MLST has allowed the creation of shared and high-quality databases which can be easily queried over the Internet, and this has proved to be highly valuable (7). However, as the sequences used in MLST schemes evolve slowly and are highly conserved, the resolution provided by MLST is too low for the investigation of recent evolution and, above all, for short-term epidemiological studies. The sequencing of much larger portions of the genome to increase resolution can only be used in dedicated research projects analyzing a limited number of strains (28). Presently, pulsed-field gel electrophoresis (PFGE) remains the most discriminatory technique for S. aureus typing, but it allows the constitution of shared databases only at the national level and is not appropriate for population studies (1, 35). There is, consequently, still a need for a technology as discriminatory as PFGE and as portable as MLST at a low cost.Tandemly repeated sequences provide a very valuable source of polymorphism. Multilocus variable-number tandemrepeat (VNTR) analysis (MLVA) is now used in genotyping several bacterial species (26,48). MLVA typing relies upon a basic and widespread methodology, the measurement of the length of DNA fragments. It is not a "pattern"-producing method, even when run on agarose gels. The genotype, in the form of a string of numbers corresponding to the number of repeats at each locus, is highly portable and can be readily incorporated in large databases (13).

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Genetic diversity of methicillin-resistant Staphylococcus aureus in a tertiary hospital in The Netherlands between 2002 and 2006

Cited by 13 publications

References 53 publications

Molecular Epidemiology of Panton-Valentine Leukocidin-Positive Staphylococcus aureus in Spain: Emergence of the USA300 Clone in an Autochthonous Population

Molecular Epidemiology of Panton-Valentine Leukocidin-Positive Staphylococcus aureus in Spain: Emergence of the USA300 Clone in an Autochthonous Population

Variable-Number Tandem Repeat Analysis and Multilocus Sequence Typing Data Confirm the Epidemiological Changes Observed with Staphylococcus aureus Strains Isolated from Bloodstream Infections

Improved Multiple-Locus Variable-Number Tandem-Repeat Assay for Staphylococcus aureus Genotyping, Providing a Highly Informative Technique Together with Strong Phylogenetic Value

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