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Kholaseh S, Derakhshan S, Abedini M. A comparative study on antibiotic resistance and virulence properties of Staphylococcus aureus isolated from hospitalized patients and hospital environment. Am J Infect Control 2022:S0196-6553(22)00868-9. [PMID: 36566986 DOI: 10.1016/j.ajic.2022.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND We compared the characteristics of clinical Staphylococcus aureus and S. aureus isolated from environmental surfaces in 3 hospitals. METHODS Clinical S. aureus isolates were collected from hospitalized patients. Environmental surfaces were sampled from the rooms of patients infected with S. aureus. After identifying rooms with the target organism, 3-5 high-touch surfaces in patient care areas were sampled using swabs before room cleaning by environmental services. S. aureus isolates were subjected to genotyping, antimicrobial susceptibility testing, and virulence determinant screening. The isolates were analyzed for integron content and sequences of variable region amplification products. RESULTS There were epidemiologically unrelated 79 clinical and 62 environmental S. aureus isolates. Overall, 11.4% of clinical and 59.7% of environmental isolates were methicillin-resistant. The environmental and clinical S. aureus exhibited very different virulence profiles: 79% of the environmental isolates were negative for virulence genes compared to 2.5% of clinical isolates (P < .001). Environmental isolates were more resistant to antibiotics compared to clinical isolates. Class 1 integrons were only detected in 7 of 62 environmental isolates, of which 3 isolates had integrons with cysteine synthase cassette, 1 had aadA1, and 1 had an unknown cassette. CONCLUSION These data indicate the different characteristics between environmental and clinical S. aureus, which may reflect different reservoirs from which the 2 groups acquired the strains.
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Affiliation(s)
- Sareh Kholaseh
- Student Research Committee, Kurdistan University of Medical Sciences, Kurdistan, Sanandaj, Iran
| | - Safoura Derakhshan
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Kurdistan, Sanandaj, Iran; Lung Diseases and Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Kurdistan, Sanandaj, Iran.
| | - Masoumeh Abedini
- Department of Infectious Diseases, Kurdistan University of Medical Sciences, Kurdistan, Sanandaj, Iran
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Hsu BM, Chen JS, Lin IC, Hsu GJ, Koner S, Hussain B, Huang SW, Tsai HC. Molecular and Anti-Microbial Resistance (AMR) Profiling of Methicillin-Resistant Staphylococcus aureus (MRSA) from Hospital and Long-Term Care Facilities (LTCF) Environment. Antibiotics (Basel) 2021; 10:antibiotics10060748. [PMID: 34205552 PMCID: PMC8235027 DOI: 10.3390/antibiotics10060748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022] Open
Abstract
To provide evidence of the cross-contamination of emerging pathogenic microbes in a local network between long-term care facilities (LTCFs) and hospitals, this study emphasizes the molecular typing, the prevalence of virulence genes, and the antibiotic resistance pattern of methicillin-resistant Staphylococcus aureus. MRSA isolates were characterized from 246 samples collected from LTCFs, medical tubes of LTCF residents, and hospital environments of two cities, Chiayi and Changhua. Species identification, molecular characterization, and drug resistance analysis were performed. Hospital environments had a higher MRSA detection rate than that of LTCF environments, where moist samples are a hotspot of MRSA habitats, including tube samples from LTCF residents. All MRSA isolates in this study carried the exfoliative toxin eta gene (100%). The majority of MRSA isolates were resistant to erythromycin (76.7%), gentamicin (60%), and ciprofloxacin (55%). The percentage of multidrug-resistant MRSA isolates was approximately 50%. The enterobacterial repetitive intergenic consensus polymerase chain reaction results showed that 18 MRSA isolates belonged to a specific cluster. This implied that genetically similar isolates were spread between hospitals and LTCFs in Changhua city. This study highlights the threat to the health of LTCFs’ residents posed by hospital contact with MRSA.
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Affiliation(s)
- Bing-Mu Hsu
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi County 621, Taiwan; (B.-M.H.); (S.K.); (B.H.)
- Center for Innovative on Aging Society, National Chung Cheng University, Chiayi County 621, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, Kaohsiung City 824, Taiwan;
| | - I-Ching Lin
- Department of Family Medicine, Asia University Hospital, Taichung City 413, Taiwan;
- Department of Kinesiology, Health and Leisure, Chienkuo Technology University, Chenghua County 500, Taiwan
| | - Gwo-Jong Hsu
- Division of Infectious Diseases, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi City 600, Taiwan;
| | - Suprokash Koner
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi County 621, Taiwan; (B.-M.H.); (S.K.); (B.H.)
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi County 621, Taiwan
| | - Bashir Hussain
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi County 621, Taiwan; (B.-M.H.); (S.K.); (B.H.)
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi County 621, Taiwan
| | - Shih-Wei Huang
- Center for Environmental Toxin and Emerging Contaminant Research, Cheng Shiu University, Kaohsiung City 830, Taiwan;
- Super Micro Research and Technology Center, Cheng Shiu University, Kaohsiung City 830, Taiwan
| | - Hsin-Chi Tsai
- Department of Psychiatry, School of Medicine, Tzu Chi University, Hualien County 970, Taiwan
- Department of Psychiatry, Tzu-Chi General Hospital, Hualien County 970, Taiwan
- Correspondence: ; Tel.: +88-638-561-825
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Thai Son N, Thu Huong VT, Kim Lien VT, Quynh Nga DT, Hai Au TT, Thu Hang PT, Nguyet Minh HT, Binh TQ. Antimicrobial Resistance Profile and Molecular Characteristics of Staphylococcus aureus Isolates from Hospitalized Adults in Three Regions of Vietnam. Jpn J Infect Dis 2019; 73:193-200. [PMID: 31875603 DOI: 10.7883/yoken.jjid.2019.239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate antimicrobial resistance profile, multidrug resistance (MDR), and molecular characteristics of pathogenic Staphylococcus aureus isolates from hospitalized Vietnamese adults. Two hundred and twenty-three pathogenic S. aureus isolates were obtained from the hospitals located in 3 regions of Vietnam. The minimum inhibitory concentrations were determined to detect the antibiotic susceptibility of the isolates. The molecular characteristics of S. aureus isolates were investigated through antibiotic-resistant genes analysis, staphylococcal cassette chromosome mec typing, pulsed-field gel electrophoresis, and multilocus sequence typing. Substantial differences among the 3 regions were found in the prevalence rates of methicillin-resistant S. aureus (north: 48.6%, central: 58.7%, south: 78.9%) and MDR (north: 65.8%, central: 79.7%, and south: 84.2%). The prevalence rates of the genes tetK/M, aacA/aphD, ermA/B/C, and mecA increased substantially from north to south. ST188-SCCmecIV and ST239-SCCmecII isolates were most commonly found in the 2 largest clusters. ST188 predominance was observed in the largest cluster in methicillin-resistant and methicillin-sensitive S. aureus isolates, including SCCmecIII and SCCmecIVa, in fatal cases. Our results revealed a high occurrence of MDR and possible north-south trend in antibiotic resistance profile, MDR patterns, and frequency of antibiotic-conferring genes among S. aureus isolates. ST188 predominance raises concerns about the global importance of host-adapted ST188 in East Asian populations.
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Affiliation(s)
- Nguyen Thai Son
- Department of Medical Microbiology, Vietnam Military Medical University
| | | | | | | | | | | | | | - Tran Quang Binh
- National Institute of Hygiene and Epidemiology.,Dinh Tien Hoang Institute of Medicine, High Tech Business Incubator Center
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4
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Kateete DP, Bwanga F, Seni J, Mayanja R, Kigozi E, Mujuni B, Ashaba FK, Baluku H, Najjuka CF, Källander K, Rutebemberwa E, Asiimwe BB, Joloba ML. CA-MRSA and HA-MRSA coexist in community and hospital settings in Uganda. Antimicrob Resist Infect Control 2019; 8:94. [PMID: 31171965 PMCID: PMC6547506 DOI: 10.1186/s13756-019-0551-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/28/2019] [Indexed: 01/17/2023] Open
Abstract
Background Methicillin resistant Staphylococcus aureus (MRSA) strains were once confined to hospitals however, in the last 20 years MRSA infections have emerged in the community in people with no prior exposure to hospitals. Strains causing such infections were novel and referred to as community-associated MRSA (CA-MRSA). The aim of this study was to determine the MRSA carriage rate in children in eastern Uganda, and to investigate coexistence between CA-MRSA and hospital-associated (HA-MRSA). Methods Between February and October 2011, nasopharyngeal samples (one per child) from 742 healthy children under 5 years in rural eastern Uganda were processed for isolation of MRSA, which was identified based on inhibition zone diameter of ≤19 mm on 30 μg cefoxitin disk. SCCmec and spa typing were performed for MRSA isolates. Results A total of 140 S. aureus isolates (18.9%, 140/742) were recovered from the children of which 5.7% (42/742) were MRSA. Almost all (95.2%, 40/42) MRSA isolates were multidrug resistant (MDR). The most prevalent SCCmec elements were types IV (40.5%, 17/42) and I (38.1%, 16/42). The overall frequency of SCCmec types IV and V combined, hence CA-MRSA, was 50% (21/42). Likewise, the overall frequency of SCCmec types I, II and III combined, hence HA-MRSA, was 50% (21/42). Spa types t002, t037, t064, t4353 and t12939 were detected and the most frequent were t064 (19%, 8/42) and t037 (12%, 5/42). Conclusion The MRSA carriage rate in children in eastern Uganda is high (5.7%) and comparable to estimates for Mulago Hospital in Kampala city. Importantly, HA-MRSA (mainly of spa type t037) and CA-MRSA (mainly of spa type t064) coexist in children in the community in eastern Uganda, and due to high proportion of MDR detected, outpatient treatment of MRSA infection in eastern Uganda might be difficult. Electronic supplementary material The online version of this article (10.1186/s13756-019-0551-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David Patrick Kateete
- 1Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Freddie Bwanga
- 1Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jeremiah Seni
- 2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.,3Catholic University of Health and Allied Sciences - Bugando, Mwanza, Tanzania
| | - Raymond Mayanja
- 1Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.,4Makerere University Walter Reed Project, Kampala, Uganda
| | - Edgar Kigozi
- 1Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Brian Mujuni
- 1Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fred K Ashaba
- 1Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Hannington Baluku
- 2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Christine F Najjuka
- 2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Karin Källander
- 5Malaria Consortium, London, UK.,6Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Benon B Asiimwe
- 2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Moses L Joloba
- 1Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda.,2Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
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Abd El-Hamid MI, Bendary MM, Merwad AMA, Elsohaby I, Mohammad Ghaith D, Alshareef WA. What is behind phylogenetic analysis of hospital-, community- and livestock-associated methicillin-resistant Staphylococcus aureus? Transbound Emerg Dis 2019; 66:1506-1517. [PMID: 30892827 DOI: 10.1111/tbed.13170] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 03/01/2019] [Accepted: 03/09/2019] [Indexed: 11/30/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has been shown to be the predominant life-threatening pathogen in Egypt. MRSA is a major cause of severe healthcare-associated (HA) infections. During the last decades, the incidence of community-associated (CA) MRSA infections has a complex epidemiology arising from the circulation of different strains in the general population. Moreover, livestock-associated (LA) MRSA emerged recently becomes an emerging threat to public health. Therefore, it is important to illuminate the differences between CA-, HA- and LA-MRSA to shed light on their genetic diversity and evolution. This study presents the first data on analysing the correlation between CA-, LA- and HA-MRSA using antibiogram typing, molecular characteristics and antimicrobial resistance and virulence genes' profiles. Overall, HA-MRSA strains tended to be multidrug resistant and less virulent than both LA- and CA-MRSA strains. Importantly, CA-MRSA strains had a high homology with each of HA- and LA-MRSA. However, no similarity was observed between HA- and LA-MRSA. Our findings suggest that the epidemiological changes in genetic behaviour between HA- and LA-MRSA are due to the presence of CA-MRSA confirming that CA-MRSA has created a public health crisis worldwide.
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Affiliation(s)
- M I Abd El-Hamid
- Department of Microbiology, Faculty of Veterinary Medicine, Zagazig University, Sharkia Governorate, Egypt
| | - M M Bendary
- Department of Microbiology and Immunology, Faculty of Pharmacy, Port Said University, Port Said Governorate, Egypt
| | - A M A Merwad
- Department of Zoonoses, Faculty of Veterinary Medicine, Zagazig University, Sharkia Governorate, Egypt
| | - I Elsohaby
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada.,Department of Animal Medicine, Division of Infectious Diseases, Faculty of Veterinary Medicine, Zagazig University, Sharkia Governorate, Egypt
| | - D Mohammad Ghaith
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo City, Egypt
| | - W A Alshareef
- Department of Microbiology and Immunology, Faculty of Pharmacy, October 6 University, 6 October Governorate, Egypt
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Liang Y, Tu C, Tan C, El-Sayed Ahmed MAEG, Dai M, Xia Y, Liu Y, Zhong LL, Shen C, Chen G, Tian GB, Liu J, Zheng X. Antimicrobial resistance, virulence genes profiling and molecular relatedness of methicillin-resistant Staphylococcus aureus strains isolated from hospitalized patients in Guangdong Province, China. Infect Drug Resist 2019; 12:447-459. [PMID: 30881052 PMCID: PMC6394240 DOI: 10.2147/idr.s192611] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose The main objective of this study was to decipher the prevalence, antimicrobial resistance, major virulence genes and the molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolated from different clinical sources in southern China. Materials and methods The present study was performed on 187 non-duplicate S. aureus clinical isolates collected from three tertiary hospitals in Guangdong Province, China, 2010–2016. Antimicrobial susceptibility testing was performed by the disk diffusion method and by measuring the minimum inhibitory concentration. Screening for resistance and virulence genes was performed. Clonal relatedness was determined using various molecular typing methods such as multilocus sequence typing, spa and staphylococcal chromosomal cassette mec (SCCmec) typing. Whole genome sequencing was performed for three selected isolates. Results Out of 187 isolates, 103 (55%) were identified as MRSA. The highest prevalence rate was found among the skin and soft tissue infection (SSTI) samples (58/103), followed by sputum samples (25/103), blood stream infection samples (15/103) and others (5/103). Antimicrobial susceptibility results revealed high resistance rates for erythromycin (64.1%), clindamycin (48.5%), gentamicin (36.9%) and ciprofloxacin (33.98%). All isolates were susceptible to vancomycin. Resistance genes and mutation detected were as follows: aac(6’)-aph(2”) (24.3%), dfrG (10.7%), rpoB (21.4%), cfr (0%), fexA (1.94%), gyrA (35.92%), gyrB (0.97%), grlA (20.4%), grlB (10.68%), ermA (21.4%), ermB (18.44%), ermC (21.4%) and lnuA (18.44%). Profiling of virulence genes revealed the following: sea (11.7%), seb (21.4%), sec (0.97%), sed (0.97%), hla (86.41%), hlb (17.48%), hlg (10.68%), hld (53.4%), Tsst-1 (3.9%) and pvl (27.2%). Clonal relatedness showed that ST239-SCCmecA III-t37 clone was the most prevalent clone. Conclusion Our study elucidated the prevalence, antibiotic resistance, pathogenicity and molecular characteristics of MRSA isolated from various clinical sources in Guangdong, China. We found that the infectious rate of MRSA was higher among SSTI than other sources. The most predominant genotype was ST239-SCCmecA III-t37 clone, indicating that ST239-t30 clone which was previously predominant had been replaced by a new clone.
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Affiliation(s)
- Yingjian Liang
- Department of Respiratory Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China, ;
| | - Changli Tu
- Department of Respiratory Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China, ;
| | - Cuiyan Tan
- Department of Respiratory Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China, ;
| | - Mohamed Abd El-Gawad El-Sayed Ahmed
- Department of Immunology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Diseases Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China.,Department of Microbiology and Immunology, Faculty of Pharmacy, Misr University for Science and Technology (MUST), 6th of October City, Egypt
| | - Min Dai
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, China
| | - Yong Xia
- Department of Clinical Laboratory Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yan Liu
- Clinical laboratory, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Lan-Lan Zhong
- Department of Immunology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Diseases Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
| | - Cong Shen
- Department of Immunology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Diseases Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
| | - Guanping Chen
- Department of Immunology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Diseases Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
| | - Guo-Bao Tian
- Department of Immunology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Diseases Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
| | - Jing Liu
- Department of Respiratory Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China, ;
| | - Xiaobin Zheng
- Department of Respiratory Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China, ;
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Tang YT, Cao R, Xiao N, Li ZS, Wang R, Zou JM, Pei J. Molecular epidemiology and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus isolates in Xiangyang, China. J Glob Antimicrob Resist 2017; 12:31-36. [PMID: 28887291 DOI: 10.1016/j.jgar.2017.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 07/22/2017] [Accepted: 08/29/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Methicillin-resistant Staphylococcus aureus (MRSA) is a public health problem worldwide. This study aimed to investigate the antimicrobial susceptibility and molecular epidemiological characteristics of MRSA strains in Xiangyang, China, during 2012-2014. METHODS Eighty non-duplicate S. aureus isolates from clinical specimens were collected from four tertiary hospitals. MRSA strains were identified and were tested for antibacterial susceptibility. Staphylococcal cassette chromosome mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and staphylococcal protein A (spa) typing were performed to explore molecular characteristics. RESULTS Among the 80 S. aureus isolates, 43 MRSA (53.8%) were detected. MRSA strains exhibited resistance against non-β-lactam antibiotics to varying degrees. SCCmec type III was the predominant type (39/43; 90.7%), and the remainder were SCCmec type IVa (4/43; 9.3%). Thirteen MLST types were found, mainly ST239 (12/43; 27.9%) and ST59 (7/43; 16.3%). Fifteen spa types were found, mainly t437 (13/43; 30.2%) and t030 (6/43; 14.0%). PFGE grouped the 43 MRSA isolates into five types. SCCmecIII-ST239-t030/t632 and SCCmecIII-ST59/ST338-t437 were the dominant epidemic clones in this region. ST239-t030/t632/t037 was the epidemic clone with the most serious drug resistance. CONCLUSIONS This region presented a high MRSA rate and the MRSA isolates demonstrated strong antimicrobial resistance. The existence of four strains of community-acquired MRSA (SCCmec type IVa) indicated the dissemination of MRSA strains from the community to hospitals. The epidemic situation and drug resistance of MRSA should be regularly monitored. Effective measures should be adopted to prevent and control the occurrence of infection in hospitals.
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Affiliation(s)
- Yi-Tong Tang
- Medical College of Hubei University of Arts and Science, 296 Long Zhong Road, Xiangyang, China.
| | - Rui Cao
- Maternal and Child Health Care Hospital of Dongguan, Dongguan, China
| | - Na Xiao
- Medical College of Hubei University of Arts and Science, 296 Long Zhong Road, Xiangyang, China
| | - Zhi-Shan Li
- Medical College of Hubei University of Arts and Science, 296 Long Zhong Road, Xiangyang, China; The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
| | - Rong Wang
- The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Jiu-Ming Zou
- The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Jiao Pei
- The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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Xie X, Bao Y, Ouyang N, Dai X, Pan K, Chen B, Deng Y, Wu X, Xu F, Li H, Huang S. Molecular epidemiology and characteristic of virulence gene of community-acquired and hospital-acquired methicillin-resistant Staphylococcus aureus isolates in Sun Yat-sen Memorial hospital, Guangzhou, Southern China. BMC Infect Dis 2016; 16:339. [PMID: 27450316 PMCID: PMC4957337 DOI: 10.1186/s12879-016-1684-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of both hospital and community infections globally. It’s important to illuminate the differences between community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA), but there have been confusions on the definition, especially for the MRSA isolates identified within 48 h of admission. This study aimed to determine the molecular characteristics and virulence genes profile of CA and HA-MRSA isolates identified less than 48 h after hospital admission in our region. Methods A total 62 MRSA isolates identified within 48 h after admission and the clinical data were collected. Antimicrobial susceptibility test (AST) of collected isolates were performed according to the guidelines of Clinical and Laboratory Standards Institute (CLSI) 2015, and staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE) and virulence gene profiling were performed to explore the molecular diversity. Results SCCmec III and sequence type (ST) 239 were the most prevalent SCCmec type and ST in both CA and HA-MRSA groups. HA-MRSA group had higher prevalence of SCCmec III (87.2 %) and ST239 (79.5 %) compared with CA-MRSA (60.9 and 43.4 %, both P < 0.001), while the frequency of SCCmec IV (26.0 %) and ST59 (21.7 %) were higher in CA-MRSA than its counterpart (P < 0.001 and P = 0.003). MRSA-ST239-III was the predominant type in this study (61.3 %, 38/62), especially in HA-MRSA group (76.9 %, 30/39). However, CA-MRSA strains exhibited more diversity in genotypes in this study. Meanwhile, CA-MRSA tended to have lower resistant percentage to non-β-lactams antibiotics but more virulence genes carriage, especially the staphylococcal enterotoxins (SE) genes. Notably, seb gene was only detected in CA-MRSA isolates (52.2 %), likely a significant marker for CA-MRSA isolates. Panton-Valentine leukocidin gene (PVL) was highly detected in both groups, while appeared no significantly different between CA-MRSA (47.8 %) and HA-MRSA (43.6 %). Conclusions Our findings support a difference in the molecular epidemiology and virulence genes profile of CA-MRSA and HA-MRSA. Furthermore, this study indicates a possible transmission from HA-MRSA to CA-MRSA, which may cause the overlap of the definition. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1684-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoying Xie
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yunwen Bao
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Nengyong Ouyang
- Department of Gynaecology and Obstetrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Xinlu Dai
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Kunyi Pan
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Baiji Chen
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yawen Deng
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Xiquan Wu
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Fengqin Xu
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Hongyu Li
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Songyin Huang
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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