Increase of genetic diversity and clonal replacement of epidemic methicillin-resistantStaphylococcus aureusstrains in South-East Austria

Abstract

Spa-typing and microarray techniques were used to study epidemiological changes in methicillin-resistant Staphylococcus aureus (MRSA) in South-East Austria. The population structure of 327 MRSA isolated between 2002 and 2012 was investigated. MRSA was assigned to 58 different spa types and 14 different MLST CC (multilocus sequence type clonal complexes); in particular, between 2007 and 2012, an increasing diversity in MRSA clones could be observed. The most abundant clonal complex was CC5. On the respective SCCmec cassettes, the CC5 isolates differed clearly within this decade and CC5/SCCmecI, the South German MRSA, predominant in 2002, was replaced by CC5/SCCmecII, the Rhine-Hesse MRSA in 2012. Whereas in many European countries MLST CC22-MRSA (EMRSA 15, the Barnim epidemic MRSA) is predominant, this clone occurred in Austria nearly 10 years later than in neighbouring countries. CC45, the Berlin EMRSA, epidemic in Germany, was only sporadically found in South-East Austria. The Irish ST8-MRSA-II represented by spa-type t190 was frequently found in 2002 and 2007, but disappeared in 2012. Our results demonstrate clonal replacement of MRSA clones within the last years in Austria. Ongoing surveillance is warranted for detection of changes within the MRSA population.

MRSA diversity and the emergence of LA-MRSA in a large teaching hospital in Slovenia

“…The spa types found in this study are associated with all main globally distributed clonal complexes (CC5, CC8, CC22, and CC45) except CC30 (Table I) [27]. Some spa types are associated with the clonal complex CC152, reported from West European countries and previously suggested to be present in the Balkan region [35]. Two spa types, associated with ST239, were also found in Asia [35,36].…”

“…Some spa types are associated with the clonal complex CC152, reported from West European countries and previously suggested to be present in the Balkan region [35]. Two spa types, associated with ST239, were also found in Asia [35,36]. CC398 was continuously present since the year 2009.…”

“…Ireland has reported low LA-MRSA levels (0.05%) during a time period of 2010-2014 [34]. Characterization of more than 2500 MRSA isolates from an Austrian region close to UCCM found CC398 strains represented 11.11% of isolates in 2007 and 8.17% in 2012 [35]. A study across 27 European countries has identified an overall proportion of 3.9% of LA-MRSA, but in five countries (including Slovenia), the proportion was higher than 10% [11].…”

Global Evolution of Pathogenic Bacteria With Extensive Use of Fluoroquinolone Agents

“…STs suffering considerable fitness cost upon developing high-level resistance to fluoroquinolones will be replaced by STs retaining much fitness even at high MIC values in "high fluoroquinoloneconsumption areas". In line with experimental results long dominant HA-MRSA clones, especially ST30, ST8, and ST239, have been losing ground to or have been completely replaced by CC5, ST228, and ST22 strains in adult hospital wards across various continents (Mato et al, 2004;Pérez-Roth et al, 2004;Velazquez-Meza et al, 2004;Ma et al, 2006;Amorim et al, 2007;Conceição et al, 2007;Aires-de-Sousa et al, 2008;Knight et al, 2012;Espadinha et al, 2013;Lim et al, 2013;Coombs et al, 2014;Abdulgader et al, 2015;Hsu et al, 2015;Lawes et al, 2015;Zarfel et al, 2016;Chamon et al, 2017;Nikolaras et al, 2018).…”

Epidemiological characteristics of methicillin-resistant Staphylococcus aureus isolates from bloodstream cultures at University Hospital in the Czech Republic

“…Over the years, there have been changes in the dominant clone. This phenomenon has also been described in many European countries (Zarfel et al 2016).…”