Prevalence and characterisation of Staphylococcus aureus causing community‐acquired skin and soft tissue infections on Java and Bali, Indonesia

Abstract

Abstractobjectives To define the role of Staphylococcus aureus in community settings among patients with skin and soft tissue infections (SSTI) in Indonesia.methods Staphylococcus aureus were cultured from anterior nares, throat and wounds of 567 ambulatory patients presenting with SSTI. The mecA gene and genes encoding Panton-Valentine leukocidin (PVL; lukF-PV and lukS-PV) and exfoliative toxin (ET; eta and etb) were determined by PCR. Clonal relatedness among methicillin-resistant S. aureus (MRSA) and PVL-positive S. aureus was analysed using multilocus variable-number tandem-repeat analysis (MLVA) typing, and multilocus sequence typing (MLST) for a subset of isolates. Staphylococcal cassette chromosome mec (SCCmec) was determined for all MRSA isolates. Moreover, determinants for S. aureus SSTI, and PVL/ET-positive vs PVL/ET-negative S. aureus were assessed.results Staphylococcus aureus were isolated from SSTI wounds of 257 (45.3%) patients, eight (3.1%) of these were MRSA. Genes encoding PVL and ETs were detected in 21.8% and 17.5% of methicillin-susceptible S. aureus (MSSA), respectively. PVL-positive MRSA was not detected. Nasopharyngeal S. aureus carriage was an independent determinant for S. aureus SSTI (odds ratio [OR] 1.8). Primary skin infection (OR 5.4) and previous antibiotic therapy (OR 3.5) were associated with PVL-positive MSSA. Primary skin infection (OR 2.2) was the only factor associated with ETpositive MSSA. MLVA typing revealed two more prevalent MSSA clusters. One ST1-MRSA-SCCmec type IV isolate and a cluster of ST239-MRSA-SCCmec type III were found.conclusions Community-acquired SSTI in Indonesia was frequently caused by PVL-positive MSSA, and the hospital-associated ST239-MRSA may have spread from the hospital into the community.keywords exfoliative toxin, Indonesia, methicillin-resistant Staphylococcus aureus, Panton-Valentine leukocidin, skin and soft tissue infections, Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus tracking spread among health-care workers and hospitalized patients in critical wards at a university hospital, Tehran, Iran

“…With the advent of molecular typing methods, epidemiologists can easily investigate outbreaks of infectious diseases, tracing the transmission of pathogens, and elucidate evolutionary relationships between microorganisms. Several genotyping methods such as amplified fragment length polymorphism [8] , [9] , multiple locus variable-number tandem repeat analysis [8] , [10] , [11] , multilocus sequence typing [12] , [13] , and pulsed-field gel electrophoresis (PFGE) [10] , [14] , [15] , [16] have been successfully applied for epidemiological investigations of MRSA infections worldwide. Of these methods, PFGE is still considered the reference standard fingerprinting method for monitoring and tracking MRSA dissemination in the hospital environment [17] .…”

<p>Community-Acquired Methicillin-Resistant <em>Staphylococcus aureus</em> ST59 in a Chinese Adult with Meningitis: A Case Report from China</p>

“…CA-MRSA infection usually manifests as cellulitis or abscesses, whereas HA-MRSA often causes pneumonia and sepsis. 10 In contrast to HA-MRSA clones that carry SCCmec type I, II or III, 11 CA-MRSA lineages have been characterized by the presence of small-sized SCCmec types IV and V and of genes encoding Panton-Valentine leukocidin (PVL) in many cases. 12 At present, there are five dominant CA-MRSA lineages, ST1-IV, ST8-IV, ST30-IV, ST59-IV/V, and ST80-IV, and each is prevalent in different geographical locations.…”

The pH-dependence of lipid-mediated antimicrobial peptide resistance in a model staphylococcal plasma membrane: A two-for-one mechanism of epithelial defence circumvention

“…With the emergence of clinical MRSA isolates which exhibit higher rates of LPG synthesis with consequently greater resistance to therapeutic lipopeptides (Chen, et al 2018), the profile of lipid-mediated bacterial intrinsic resistance mechanisms is rising. This is important because MRSA strains such as the ST239 TW upon which the model systems in this study are based, are showing a tendency toward increased transmission and proliferation (Edgeworth, et al 2007, Santosaningsih, et al 2018. In theory these strains may be primed by their fitness with respect to surviving skin acidity, via increased LPG biosynthesis, thus proving better adapted to resist both innate defensive and therapeutic lipopeptides/peptides.…”