Genomic epidemiology and characterisation of penicillin-sensitive Staphylococcus aureus isolates from invasive bloodstream infections in China: an increasing prevalence and higher diversity in genetic typing be revealed

Abstract

Many countries have reported increasing rates of penicillin-susceptible methicillin-sensitive Staphylococcus aureus (MSSA-PEN S ). To date, there is relatively little known about the current situation and molecular characteristics of MSSA-PEN S in China. In this study, we carried out a laboratory-based multi-region retrospective study to investigate the genomic epidemiology and characterisation of MSSA-PEN S isolated from invasive bloodstream infections (BSIs) across 17 provinces. The prevalence of MSSA-PEN S isolates increased significantly over the 6-year period, with the proportion increasing from 3.51% in 2014–8.80% in 2019, an average relative increase of 22.14% per year (95% confidence interval 9.67%-34.61%, P for trend <0.001), suggesting that China is experiencing a resurgence of MSSA-PEN S . Phylogenetic analysis showed a higher strain diversity occurred; the most frequent clonal complexes (CCs) identified were CC188 (17.14%), CC398 (15.71%) and CC5 (15.71%). Over half of MSSA-PEN S strains were pan-susceptible, with erythromycin the most frequent resistance observed. Moreover, 25 isolates were identified as immune evasion cluster negative, including CC15, CC188 and CC1, and 6 strains encoded the Panton-Valentine leucocidin gene. Importantly, virulence assays showed that MSSA-PEN S exhibited a level of virulence comparable to that of penicillin-resistant MSSA (MSSA-PEN R ), indicating that more-sensitive strains should not be mistaken for lacking aggressiveness in vivo . Furthermore, 11 of these isolates were confirmed as blaZ positive but phenotype sensitive, with different amino acid changes in blaZ . Our data support the recommendation to clinicians regarding the usage of penicillin in invasive BSIs caused by MSSA-PEN S , which might create a novel opportunity for better antimicrobial stewardship in the future.

Current molecular approach for diagnosis of MRSA: a meta-narrative review

“…The dataset includes 20 different authors from Asia (n = 13), Africa (n = 5), Europe (n = 1) and America (n = 1). A total of 20 studies were included in this synthesis: seven studies employed polymerase chain reaction (PCR) for diagnosing MRSA ( 6 , 9 , 10 , 12 , 13 , 19 , 22 ), one study employed deoxyribonucleic acid (DNA) Microarray ( 7 ), two studies used DNA sequencing ( 2 , 14 ), Xpert MRSA/SA BC assay (n = 2) ( 8 , 17 ), matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF; n = 2) ( 11 , 18 ), multilocus sequence typing (MLST; n = 4) ( 15 , 20 , 23 , 24 ), GENECUBE (n = 1) ( 21 ) and staphylococcal cassette chromosome mec (SCC mec ) typing (n = 1) ( 16 ). Figure 1 is the diagrammatic flow of the study selection and list of techniques appraised in this review.…”

“…It allows a bulk number of nucleic acid sequences in a mixture to be tested and analyzed. The study by Jin and colleagues ( 2 , 14 ) used StaphyType DNA microarray (Abbott [Alere Technologies GmbH], Jena, Germany) and the INTER-ARRAY Genotyping Kit S. aureus (Inter-Array GmbH, Bad Langensalza, Germany) for the detection of MRSA. The study by Senok and colleagues (2021) also reported that DNA microarray exhibited 100% specificity and sensitivity ( 7 ).…”

“…Antimicrobial resistance (AMR) is defined as changes in bacteria that result in the drug being used for its treatment becoming inefficacious ( 1 ). Staphylococcus aureus is an opportunistic pathogen with a tremendous capacity to adapt to human hosts and healthcare environments, causing detrimental effects to healthcare-associated infections such as bloodstream infections ( 2 ). AMR is reported as the world’s biggest 21st-century health threat, and the World Health Organization (WHO) is calling for immediate action.…”

Distribution and Current State of Molecular Genetic Characterization in Pathogenic Free-Living Amoebae

“…On the other hand, genomic epidemiology is also applied to understand other types of diseases, mainly those caused by Escherichia coli [ 153 , 154 ], Shigella spp. [ 155 ], Klebsiella pneumoniae [ 156 ], Corynebacterium diphtheriae [ 157 ], Staphylococcus aureus [ 154 , 158 ], Enterococcus faecalis [ 154 ], and Mycobacterium tuberculosis [ 159 ]. Although this discipline is more developed in bacteria and now in viruses, we can find extensive reports on emerging fungal pathogens [ 160 , 161 , 162 , 163 , 164 ] describing antifungal resistance mechanisms or shared synteny among geographically diverse species.…”

Distribution and Current State of Molecular Genetic Characterization in Pathogenic Free-Living Amoebae

“…On the other hand, genomic epidemiology is also applied to understand other types of diseases, mainly those caused by Escherichia coli [146,147] , Shigella spp. [148], Klebsiella pneumoniae [149], Corynebacterium diphtheriae [150], Staphylococcus aureus [147,151], Enterococcus faecalis [147] and Mycobacterium tuberculosis [152]. Although this discipline is more developed in bacteria and now in viruses, we can find extensive reports on emerging fungal pathogens [153][154][155][156][157] describing antifungal resistance mechanisms or shared synteny among geographically diverse species.…”