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Di Gregorio S, Vielma J, Haim MS, Rago L, Campos J, Kekre M, Abrudan M, Famiglietti Á, Canigia LF, Rubinstein G, Helena von Specht M, Herrera M, Aro C, Galas M, Yarhui NB, Figueiredo A, Lincopan N, Falcon M, Guillén R, Camou T, Varela G, Aanensen DM, Argimón S, Mollerach M. Genomic epidemiology of Staphylococcus aureus isolated from bloodstream infections in South America during 2019 supports regional surveillance. Microb Genom 2023; 9. [PMID: 37227244 DOI: 10.1099/mgen.0.001020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Staphylococcus aureus remains one of the leading causes of infections worldwide and a common cause of bacteraemia. However, studies documenting the epidemiology of S. aureus in South America using genomics are scarce. We hereby report on the largest genomic epidemiology study to date of both methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) in South America, conducted by the StaphNET-SA network. We characterised 404 genomes recovered from a prospective observational study of S. aureus bacteraemia in 58 hospitals from Argentina, Bolivia, Brazil, Paraguay and Uruguay between April and October 2019. We show that a minority of S. aureus isolates are phenotypically multi-drug resistant (5.2%), but more than a quarter are resistant to macrolide-lincosamide-streptogramin B (MLSb). MSSA were more genetically diverse than MRSA. Lower rates of associated antimicrobial resistance in community-associated(CA)-MRSA versus hospital-associated (HA)-MRSA were found in association with three S. aureus genotypes dominating the MRSA population: CC30-MRSA-IVc-t019-lukS/F-PV+, CC5-MRSA-IV-t002-lukS/F-PV- and CC8-MRSA-IVc-t008-lukS/F-PV+-COMER+. These are historically from a CA origin, carry on average fewer antimicrobial resistance determinants, and often lack key virulence genes. Surprisingly, CC398-MSSA-t1451-lukS/F-PV- related to the CC398 human-associated lineage is widely disseminated throughout the region, and is described here for the first time as the most prevalent MSSA lineage in South America. Moreover, CC398 strains carrying ermT (largely responsible for the MLSb resistance rates of MSSA strains: inducible iMLSb phenotype) and sh_fabI (related to triclosan resistance) were recovered from both CA and HA origin. The frequency of MRSA and MSSA lineages differed between countries but the most prevalent S. aureus genotypes are high-risk clones widely distributed in the South American region without a clear country-specific phylogeographical structure. Therefore, our findings underline the need for continuous genomic surveillance by regional networks such as StaphNET-SA. This article contains data hosted by Microreact.
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Affiliation(s)
- Sabrina Di Gregorio
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Jesús Vielma
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
| | - María Sol Haim
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Unidad Operativa Centro Nacional de Genómica y Bioinformática, ANLIS Dr. Carlos G. Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucía Rago
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Josefina Campos
- Unidad Operativa Centro Nacional de Genómica y Bioinformática, ANLIS Dr. Carlos G. Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mihir Kekre
- Present address: Tropic Biosciences Ltd, Norwich Research Park, Norwich, UK
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK
| | - Monica Abrudan
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK
| | - Ángela Famiglietti
- Laboratorio de Bacteriología Clínica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | | | | | - Martha Helena von Specht
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Químicas y Naturales, Universidad Nacional de Misiones, Posadas, Argentina
| | - Melina Herrera
- Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Entre Ríos, Argentina
| | - Carolina Aro
- Hospital de Niños Dr. Orlando Alassia, Santa Fé, Argentina
| | - Marcelo Galas
- Pan American Health Organization, Washington, DC, USA
| | | | - Agnes Figueiredo
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Patologia, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil
| | - Nilton Lincopan
- Institute of Biomedical Sciences, Department of Microbiology, Universidade de São Paulo, Sao Pablo, Brazil
| | - Miryan Falcon
- Dpto. Bacteriología y Micología, Sección Antimicrobianos, Laboratorio Central de Salud Pública, Asunción, Paraguay
- Present address: Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Rosa Guillén
- Instituto de Investigaciones en Ciencias de la Salud, Facultad de Ciencias Químicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Teresa Camou
- Unidad de Bacteriología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo, Uruguay
| | - Gustavo Varela
- Cátedra de Bacteriología y Virología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - David M Aanensen
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK
| | - Silvia Argimón
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK
| | - Marta Mollerach
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
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Faiella A, Gebbia A, Villa E, Waskiewicz J, Magli A, Avuzzi B, Garibaldi E, Cante D, Girelli G, Gatti M, Ferella L, Noris Chiorda B, Rago L, Ferrari P, Bresolin A, Piva C, Badenchini F, Rancati T, Valdagni R, Vavassori V, Munoz F, Sanguineti G, Di Muzio N, Fiorino C, Cozzarini C. PD-0414 Trend over time of patient-reported QoL domains after pelvic nodal irradiation for prostate cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02849-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gebbia A, Munoz F, Magli A, Cante D, Garibaldi E, Noris Chiorda B, Girelli G, Villa E, Faiella A, Waskiewicz J, Avuzzi B, Pastorino A, Moretti E, Rago L, Bresolin A, Bianconi C, Badenchini F, Rancati T, Valdagni R, Vavassori V, Gatti M, Sanguineti G, Di Muzio N, Fiorino C, Cozzarini C. PD-0415 Pelvic RT in prostate cancer: late intestinal toxicity is modulated by severity of acute symptoms. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Olivieri M, Cozzarini C, Magli A, Cante D, Noris Chiorda B, Munoz F, Faiella A, Olivetta E, Signor M, Piva C, Avuzzi B, Ferella L, Pastorino A, Garibaldi E, Gatti M, Rago L, Statuto T, Broggi S, Fodor A, Deantoni C, Rancati T, Sanguineti G, Valdagni R, Di Muzio N, Fiorino C. OC-0457 Modeling outcome after salvage post-prostatectomy radiotherapy: impact of pelvic nodes irradiation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02593-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Di Gregorio S, Haim MS, Vielma Vallenilla J, Cohen V, Rago L, Gulone L, Aanensen DM, Argimón S, Mollerach M. Genomic Epidemiology of CC30 Methicillin-Resistant Staphylococcus aureus Strains from Argentina Reveals Four Major Clades with Distinctive Genetic Features. mSphere 2021; 6:e01297-20. [PMID: 33692199 PMCID: PMC8546718 DOI: 10.1128/msphere.01297-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/10/2021] [Indexed: 11/20/2022] Open
Abstract
Staphylococcus aureus clonal complex 30 (CC30) has given rise to epidemics worldwide and is one of the most prevalent lineages in Argentina, represented by sequence type 30 methicillin-resistant S. aureus SCCmec type IV (ST30-MRSA-IV). ST30-MRSA-IV has displaced previous prevalent clones in the country and demonstrated increased virulence. Despite the burden of infections caused by ST30-MRSA-IV both in hospitals and in communities in Argentina, no detailed genome-based characterization of this clone is available to date. In this study, we used whole-genome sequencing (WGS) to evaluate the genetic diversity, population structure, and genomic characteristics of 190 CC30-MRSA strains circulating in Argentina between 2004 and 2015. Phylogenetic analysis revealed the existence of 4 major clades: ARG-1 (CC30-MRSA-IVc-spa t012), ARG-2 (ST30-MRSA-IVc-spa t021 related), ARG-3 (ST30-MRSA-IVh/j-spa t021 and related), and ARG-4 (CC30-MRSA-IVc-spa t019 and related). The clades were characterized by different distributions of antimicrobial resistance determinants, virulence genes, and mobile genetic elements (MGEs). While ARG-1 and ARG-4 were related to global epidemic MRSA-16 (EMRSA-16) and South West Pacific (SWP) clones, respectively, ARG-3 was phylogenetically distinct from previously defined CC30 epidemic clones. ARG-4, the most prevalent and geographically disseminated in the collection (N = 164), was characterized by specific MGEs and chromosomal mutations that might have contributed to its virulence and success. To our knowledge, this is the first genomic epidemiology study of CC30-MRSA in Argentina, which will serve as baseline genomic data going forward to inform public health measures for infection prevention and control.IMPORTANCE The rise in prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is of public health concern. In Argentina, several studies documented a shift in the epidemiology of CA-MRSA since 2009, with clonal complex 30 (CC30) and, in particular, sequence type 30 MRSA SCCmec type IV (ST30-MRSA-IV) replacing other clones both in communities and in hospitals and possibly displaying increased virulence. By sequencing the whole genomes of 190 CC30 MRSA isolates recovered from Argentina between 2005 and 2015, we showed that they represented a diverse population composed of 4 major clades. The predominant clade evolved from the South West Pacific clone but has acquired a distinct repertoire of mobile genetic elements, virulence genes, and chromosomal mutations that might play a role in its success. Our work is the first extensive genomic study of CC30 S. aureus in Argentina and will contribute not only to the development of genomic surveillance in the region but also to our understanding of the global epidemiology of this pathogen.
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Affiliation(s)
- Sabrina Di Gregorio
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina
| | - María Sol Haim
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Jesús Vielma Vallenilla
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina
| | - Victoria Cohen
- The Centre for Genomic Pathogen Surveillance (CGPS), Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Lucía Rago
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina
| | - Lucía Gulone
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - David M Aanensen
- The Centre for Genomic Pathogen Surveillance (CGPS), Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Silvia Argimón
- The Centre for Genomic Pathogen Surveillance (CGPS), Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Marta Mollerach
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Iacoviello L, Di Castelnuovo A, De Curtis A, Costanzo S, Arcari A, Centritto F, De Lucia F, Di Stefano I, di Giuseppe R, Magnacca S, Pampuch A, Persichillo M, Plescia E, Rago L, Silvestri C, Vohnout B, Zito F, de Gaetano G, Donati M. FIBRIN D-DIMERS IS ASSOCIATED WITH PREVALENT CARDIOVASCULAR EVENTS IN THE MOLI-SANI STUDY. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb01829.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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