Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Hospitalized Patients in Eastern Heilongjiang Province, China

Abstract

Background Recently, owing to antibiotic resistance, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization among intensive care unit (ICU) patients has increased rapidly. So far, there are few studies on active screening of MRSA. The purpose of the current study was to verify the effectiveness of active screening and analyze the molecular epidemiological characteristics of MRSA in the region. Methods We collected 30 samples of the MRSA strains from a tertiary hospital in the Eastern Heilongjiang Province. Among them, 7 were retrieved through nasal vestibular swabs at the emergency ICU and 23 were obtained from clinical specimens. Additionally, relevant patient medical information was examined retrospectively and molecular epidemiology and risk factor analysis for MRSA were performed. Results Molecular epidemiology studies revealed that all strains of bacteria carried the mecA resistance gene. The Panton Valentine leukocidin (PVL), for instance, was detected at a rate of 13.33% (4/30). The Staphylococcus aureus protein A (spa) types, found amongst our samples, were mainly t324, t437, t034, etc., and we discovered a new spa type t19702. We also revealed 3 types of SCCmec, namely, SCCmec type II, SCCmec type IVa, and SCCmec type V, with the most prevalent clonotypes being ST72 and ST59. In addition, we also found 7 new ST types, namely, ST6567, ST6568, ST6569, ST6570, ST6571, ST6572, and ST6573. Using risk factor analysis, we also demonstrated that long, invasive procedures used in the ICU, such as tracheal intubation and ventilator usage, along with patients with cerebral infarction and other embolism are more susceptible to developing MRSA colonization and further infections. Conclusion We recommend the infection control department within hospitals to actively screen for MRSA and perform risk factor analysis in order to establish accurate preventive measures for controlling MRSA spread.

Comparative Genomic Analysis Provides Insights into the Evolution and Genetic Diversity of Community-Genotype Sequence Type 72 Staphylococcus aureus Isolates

“…The community-genotype S. aureus ST72 lineage, which is predominant in South Korea ( 13 ), has emerged and gradually increased in hospital settings, similar to other hospital-genotype isolates, such as ST5 and ST239 in Asia. Although ST72 isolates have rarely been reported in other countries ( 18 – 20 ), the 107 ST72 isolates analyzed in this study covered 18 countries on five different continents and were isolated between 2003 and 2019. The most frequently observed isolates were from the United States ( n = 42), where isolation of ST72 isolates has not been previously reported, followed by China ( n = 24), which has reported only sporadic isolation of ST72 isolates ( 19 ).…”

“…Although ST72 isolates have rarely been reported in other countries ( 18 – 20 ), the 107 ST72 isolates analyzed in this study covered 18 countries on five different continents and were isolated between 2003 and 2019. The most frequently observed isolates were from the United States ( n = 42), where isolation of ST72 isolates has not been previously reported, followed by China ( n = 24), which has reported only sporadic isolation of ST72 isolates ( 19 ). Notably, ST72 is the trilocus variant of ST8, while ST8 is the most epidemic clone in the United States.…”

“…Moreover, although ST72 is relatively susceptible to non-β-lactams, several isolates have undergone rapid evolution of antimicrobial resistance, and some have been identified as vancomycin-intermediate isolates ( 17 , 18 ). Although isolation of ST72 isolates has been reported sporadically in other countries such as China ( 19 ), Japan ( 18 ), and Spain ( 20 ), no previous study has provided detailed information on the genomic features of the ST72 lineage on a global scale.…”

Molecular characterization of typing and subtyping of Staphylococcal cassette chromosome SCCmec types I to V in methicillin-resistant Staphylococcus aureus from clinical isolates from COVID-19 patients

“…Type I, II and III are large in size and are commonly found health care-associated MRSA (HA-MRSA) whereas Type IV and V are relatively smaller in size and are prevalent in community acquired MRSA (CA-MRSA) along with Panton Valentine Leukocidin (PVL) as a specific marker ( 3 , 4 , 10 ). Due to the smaller size, Type IV and V SSC mec variants can be easily transferred the methicillin-sensitive strains of S. aureus [MSSA] ( 6 ).…”

Relationship between mortality and molecular epidemiology of methicillin-resistant Staphylococcus aureus bacteremia

“…This epidemiological change is a major threat to public health. Therefore, detailed molecular epidemiological characterization, as suggested, could provide important information for combating MRSA infections, as well as for monitoring its trends and epidemiological pattern in Japanese hospitals [13]. Thus, the number of deaths due to MRSA bloodstream infections in Japan decreased from 5,924 in 2011 to 4,224 in 2017 [14].…”