Markers of epidemiological success of methicillin-resistant Staphylococcus aureus isolates in European populations

Baede, Valérie O.; Gupta, Arya; Knight, Gwenan M.; Schouls, Leo M.; Laing, Ken; Tavakol, Mehri; Barray, Anaïs; Vlas, Sake J. de; Vos, Anneke S. de; Hendrickx, Antoni P. A.; Khan, Madeeha; Kretzschmar, Mirjam; Wamel, Willem J. B. van; Lina, Gérard; Vandenesch, François; Vos, Margreet C.; Witney, Adam A.; Rasigade, Jean‐Philippe; Lindsay, Jodi A.

doi:10.1016/j.cmi.2023.05.015

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…All isolates of our most prevalent ST225-II and ST2883-II carried resistance genes against erythromycin and exhibited phenotypic resistance. Macrolide, ciprofloxacin, and mupirocin resistance phenotypes were described as biomarkers of epidemiological success in a recent study by Baede et al, whereas gentamicin resistance was associated with sporadicity [ 33 ]. These observations are consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Whole genome sequencing and molecular epidemiology of methicillin-resistant Staphylococcus aureus isolated from patients with bacteraemia in Slovenia

Dermota,

Šturm,

Triglav

et al. 2024

Eur J Clin Microbiol Infect Dis

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Purpose Data on the molecular epidemiology of methicillin-resistant Staphylococcus aureus isolates from patients with bacteraemia in Slovenia are lacking. The aim of this study was to phenotypically and genotypically investigate 82 MRSA strains isolated from patients with bloodstream infections in central Slovenia between 2019 and 2022. Methods Whole-genome sequencing of selected strains was performed to characterize the strains based on sequence typing, antimicrobial resistance, toxin, and virulence factors genes. Results Most MRSA carried SCCmec II (63.4%), followed by SCCmec IV (34.1%) and SCCmec V (2.5%). A high proportion of strains belonging to the ST225 lineage (45.1%) was observed, followed by ST97 (18.3%), ST2883 (15.9%), ST22 (9.8%), ST5 (3.7%), and the ST1, ST398 and ST45 lineages (2.4% each). Sixteen different spa types were identified, predominantly ST225-t003 (31.7%), ST97-t359 (15.9%), and ST2883-t4336 (14.6%). None of the strains carried Panton-Valentine leukocidin, exfoliative toxins, or toxic shock toxin. All MRSA strains were susceptible to linezolid, rifampicin, vancomycin, teicoplanin, and trimethoprim-sulfamethoxazole. MRSA strains were resistant to erythromycin, clindamycin, tetracycline and gentamicin, with a frequency of 74.4%, 74.4%, 8.5%, and 1.2%, respectively. Conclusion This study demonstrates that bacteraemia in central Slovenia is caused by diverse MRSA lineages. Identification of newly emerged lineages should be followed in the future to detect changes in the molecular epidemiology of MRSA in our country.

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Section: Discussionmentioning

confidence: 99%

Whole genome sequencing and molecular epidemiology of methicillin-resistant Staphylococcus aureus isolated from patients with bacteraemia in Slovenia

Dermota,

Šturm,

Triglav

et al. 2024

Eur J Clin Microbiol Infect Dis

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“…In the United Kingdom, MRSA exhibited higher resistance proportions to fluoroquinolones, erythromycin, gentamicin, moxifloxacin, tobramycin and methicillin. However, the resistance rate to tetracycline was relatively low ( Baede et al, 2023 ). The finding of this study confirmed that MRSA in Chinese county-level hospitals had a higher resistance rate to ERY, but were more sensitive to LNZ and VAN.…”

Section: Discussionmentioning

confidence: 99%

Genomic characterization and outbreak investigations of methicillin-resistant Staphylococcus aureus in a county-level hospital in China

Huang,

Zhu,

Yan

et al. 2024

Front. Microbiol.

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Methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen contributing to healthcare-associated infections, which can result in multiple sites infections. The epidemiological characteristics of MRSA exhibit variability among distinct regions and healthcare facilities. The aim of this study was to investigate the molecular epidemiology and nosocomial outbreak characteristics of MRSA in a county-level hospital in China. A total of 130 non-repetitive MRSA strains were collected from December 2020 to November 2021. Whole-genome sequencing (WGS) was performed to identify antimicrobial resistance and virulence factors. Phylogenetic analysis was conducted to ascertain genetic diversity and phylogenetic relationships. Independent transmission scenarios were determined by the phylogeny derived from single nucleotide polymorphisms (SNPs) within the core genome. All the MRSA isolates were collected from the intensive care unit (30.00%, 39/130), the department of otorhinolaryngology (10.00%, 13/130) and the department of burn unit (9.23%, 12/130). The clinical samples mainly included phlegm (53.85%, 70/130), purulent fluid (24.62%, 32/130), and secretions (8.46%, 11/130). The resistance rates to erythromycin, clindamycin and ciprofloxacin were 75.38, 40.00, and 39.23%, respectively. All the isolates belonged to 11 clonal complexes (CCs), with the major prevalent types were CC5, CC59, and CC398, accounting for 30.00% (39/130), 29.23% (38/130), and 16.92% (22/130), respectively. Twenty sequence types (STs) were identified, and ST59 (25.38%, 33/130) was the dominant lineage, followed by ST5 (23.84%, 31/130) and ST398 (16.92%, 22/130). Three different SCCmec types were investigated, most of isolates were type IV (33.85%, 44/130), followed by type II (27.69%, 36/130) and type III (0.77%, 1/130). The common clonal structures included CC5-ST5-t2460-SCCmec IIa, CC59-ST59-t437-SCCmec IV and CC398-ST398-t034-SCCmec (−), with rates of 16.92% (22/130), 14.62% (19/130), and 13.84% (18/130), respectively. Only 12 panton-valentine leucocidin (PVL) positive strains were identified. Two independent clonal outbreaks were detected, one consisting of 22 PVL-negative strains belongs to CC5-ST5-t2460-SCCmec IIa and the other consisting of 8 PVL-negative strains belongs to CC5-ST5-t311-SCCmec IIa. Overall, our study indicated that the CC5 lineage emerged as the predominant epidemic clone of MRSA, responsible for nosocomial outbreaks and transmission within a county-level hospital in China, highlighting the necessity to strengthen infection control measures for MRSA in such healthcare facilities.

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“…ST225-IIa and ST5-IIa isolates were all resistant to erythromycin and ciprofloxacin, which has been identified as a marker for the success of different MRSA clones in France, the Netherlands, and the United Kingdom. MRSA incidence was found to correlate with the total consumption of these antibiotics in the community ( 17 ). In Slovenia, consumption, measured in DDDs per 1,000 inhabitants per day, is right between France and the Netherlands ( 33 ) and both parameters, MRSA incidence from blood cultures and consumption of quinolones and macrolides in community, have been stable for the last 10 years ( 18 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

“…Generally, it is not well understood which group of isolates or their combinations are the most informative to better understand MRSA epidemiology. Furthermore, without a unified sampling system, the comparison of data and identification of the drivers of success of different clones are not possible ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

Different sampling strategies for optimal detection of the overall genetic diversity of methicillin-resistant Staphylococcus aureus

Zohar Cretnik,

Maric,

Rupnik

et al. 2024

Microbiol Spectr

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Surveillance schemes for methicillin-resistant Staphylococcus aureus (MRSA) are widely established at the national and international levels. Due to the simple standardization of the protocol, mainly isolates from bloodstream infections are used. However, the limitations of this simple surveillance system are well described. We conducted a comprehensive analysis of MRSA isolates in a large Slovenian region over 5 years to identify the optimal sample group for assessing the overall MRSA diversity. At the same time, this study provides to date non-available molecular characterization of Slovenian MRSA isolates. A total of 306 MRSA isolates from various sources were sequenced and phenotypically tested for resistance. The isolates exhibited significant molecular diversity, encompassing 30 multi locus sequence type (MLST) sequence types (STs), 39 ST-SCC mec genetic lineages, 49 spa types, and 29 antibiotic resistance profiles. Furthermore, the isolate pool comprised 57 resistance genes, representing 22 resistance mechanisms, and 96 virulence genes. While bloodstream isolates, commonly used in surveillance, provided insights into frequently detected clones, they overlooked majority of clones and important virulence and resistance genes. Blood culture isolates detected 21.3% spa types, 24.1% resistance phenotypes, and 28.2% MLST-SCC mec profiles. In contrast, strains from soft tissues demonstrated superior genomic diversity capture, with 65.3% spa types, 58.6% resistance phenotypes, and 71.8% MLST-SCC mec profiles. These strains also encompassed 100.0% of virulence and 82.5% of resistance genes, making them better candidates for inclusion in surveillance programs. This study highlights the limitations of relying solely on bloodstream isolates in MRSA surveillance and suggests incorporating strains from soft tissues to obtain a more comprehensive understanding of the epidemiology of MRSA. IMPORTANCE In this study, we investigated the diversity of methicillin-resistant Staphylococcus aureus (MRSA), a bacterium that can cause infections that are difficult to treat due to its resistance to antimicrobial agents. Currently, surveillance programs for MRSA mainly rely on isolates from bloodstream infections, employing a standardized protocol. However, this study highlights the limitations of this approach and introduces a more comprehensive method. The main goal was to determine which group of samples is best suited to understand the overall diversity of MRSA and to provide, for the first time, molecular characterization of Slovenian MRSA isolates. Our results suggest that including MRSA strains from soft tissue infections rather than just blood infections provides a more accurate and comprehensive view of bacterial diversity and characteristics. This insight is valuable for improving the effectiveness of surveillance programs and for developing strategies to better manage MRSA infections.

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Markers of epidemiological success of methicillin-resistant Staphylococcus aureus isolates in European populations

Cited by 6 publications

References 22 publications

Whole genome sequencing and molecular epidemiology of methicillin-resistant Staphylococcus aureus isolated from patients with bacteraemia in Slovenia

Whole genome sequencing and molecular epidemiology of methicillin-resistant Staphylococcus aureus isolated from patients with bacteraemia in Slovenia

Genomic characterization and outbreak investigations of methicillin-resistant Staphylococcus aureus in a county-level hospital in China

Different sampling strategies for optimal detection of the overall genetic diversity of methicillin-resistant Staphylococcus aureus

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