#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Unconventional SCCmec types and low prevalence of the Panton-Valentine Leukocidin exotoxin in South African blood culture Staphylococcus aureus surveillance isolates, 2013-2016


Autoři: Ashika Singh-Moodley aff001;  Wilhelmina Strasheim aff001;  Ruth Mogokotleng aff001;  Husna Ismail aff001;  Olga Perovic aff001
Působiště autorů: Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa aff001;  Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa aff002
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0225726

Souhrn

Staphylococcus aureus is a healthcare-associated pathogen that can harbour multiple antimicrobial resistance determinants and express multiple virulence factors e.g. Panton-Valentine Leukocidin (PVL). Unknown staphylococcal cassette chromosome mec (SCCmec) typing patterns were previously observed among 11% (n = 52) of methicillin-resistant S. aureus (MRSA) isolates; we further investigated these as well as the proportion of PVL, encoded by lukS/F-PV, in 761 S. aureus isolates from patients with a diagnosis of pneumonia/lower respiratory tract, skin/soft tissue, bone and joint infection. S. aureus isolates from blood culture were identified and antimicrobial susceptibility testing was performed using automated systems. Conventional PCR assays were used to identify the ccr and mec gene complexes in mecA-positive isolates with an unknown SCCmec type and screen for lukS/F-PV. Epidemiological data was used to classify isolates as healthcare- or community-associated infections. Antimicrobial susceptibility profiles according to SCCmec type and PVL were reported. Of the unknown SCCmec types, isolates were interpreted as type I-like (86%, 38/44), type II-like (9%, 4/44) and type III-like (5%, 2/44). Eight isolates did not produce definitive results. Of all MRSA isolates, majority were multidrug-resistant as indicated by their non-susceptibility to most antimicrobial agents; 92% were healthcare-associated. PVL was seen in 14% of the isolates (MRSA: 25%, MSSA: 75%); 56% were classified as healthcare-associated infection. The SCCmec typing method did not definitively classify all unknown isolates into clearly defined types. It showed that majority of these isolates were not the conventional types; untypeable elements appeared to be composite SCCmec elements, consisting of multiple ccr gene complexes. Majority of the MRSA isolates were non-susceptible to most antibiotics indicating that multiple resistance genes are present in our population. Furthermore, the proportion of PVL was low and more prevalent in MSSA.

Klíčová slova:

Lower respiratory tract infections – Methicillin-resistant Staphylococcus aureus – Nosocomial infections – Polymerase chain reaction – Skeletal joints – Skin infections – Soft tissue infections – Staphylococcus aureus


Zdroje

1. Price JR, Golubchik T, Cole K, Wilson DJ, Crook DW, Thwaites GE, Bowden R, Walker AS, Peto TEA, Paul J, Llewelyn MJ. Whole-genome-sequencing shows that patient-to-patient transmission rarely accounts for acquisition of Staphylococcus aureus in an intensive care unit. Clin Infect Dis. 2014;58:609–18. doi: 10.1093/cid/cit807 24336829

2. Shore AC, Coleman DC. Staphylococcal cassette chromosome mec: recent advances and new insights. Int J Med Microbiol. 2013;303(6–7):350–9. doi: 10.1016/j.ijmm.2013.02.002 23499303

3. Saeed K, Gould I, Esposito S, Ahmad-Saeed N, Ahmed SS, Alp E, Bal AM, Bassetti M, Bonnet E, Chan M, Coombs G, Dancer SJ, David MZ, De Simone G, Dryden M, Guardabassi L, Hanitsch LG, Hijazi K, Kruger R, Lee A, Leistner R, Pagliano P, Righi E, Schneider-Barrus S, Skov RL, Tattevin P, Van Wamel W, Vos MC, Voss A. Panton–Valentine leukocidin-positive Staphylococcus aureus: a position statement from the International Society of Chemotherapy. International Journal of Antimicrobial Agents. 2018;51:16–25. doi: 10.1016/j.ijantimicag.2017.11.002 29174420

4. Gulmez D, Sancak B, Ercis S, Karakaya J, Hascelik G. Investigation of SCCmec types and Panton-Valentine leukocidin in community-acquired and nosocomial Staphylococcus aureus strains: comparing skin and soft tissue infections to the other infections. Mikrobiyol Bul. 2012;46(3):341–51. 22951646

5. Badiou C, Dumitrescu O, George N, Forbes ARN, Drougka E, Chan KS, Ramdani-Bouguessa N, Meugnier H, Bes M, Vandenesch M, Ettiene J, Hsu LY, Tazir M, Spiliopoulou I, Nimmo GR, Hulten KG, Lina G. Rapid detection of Staphylococcus aureus Panton-Valentine Leukocidin in Clinical Specimens by Enzyme-linked Immunosorbent Assay and Immunochromatographic Tests. J Clin Microbiol. 2010;48(4):1384–90. doi: 10.1128/JCM.02274-09 20129971

6. Shields BE, Tschetter AJ, Wanat KA. Staphylococcus simulans: An emerging cutaneous pathogen. JAAD Case Rep. 2016;2(6):428–9. doi: 10.1016/j.jdcr.2016.08.015 27957522

7. International Working Group on the Classification of Staphylococcal Cassette Chromosome Elements (IWG-SCC). Classification of Staphylococcal Cassette Chromosome mec (SCCmec): Guidelines for reporting novel SCCmec elements. Antimicrobial agents and Chemotherapy 53: 4961–4967. 2009;53:4961–7. doi: 10.1128/AAC.00579-09 19721075

8. Becker K, Ballhausen B, Köck R, Kriegeskorte A. Methicillin-resistance in Staphylococcus isolates: The "mec alphabet" with specific consideration of mecC, a mec homolog associated with zoonotic S. aureus lineages. International Journal of Medical Microbiology. 2014; 304:794–804. doi: 10.1016/j.ijmm.2014.06.007 25034857

9. Turlej A, Hryniewicz W, Empel J. Staphylococcal cassette chromosome mec (SCCmec) classification and typing methods: an overview. Pol J Microbiol. 2011;60(2):95–103. 21905625

10. Ito T, Hiramatsu K, Tomasz A, De Lencastre H, Oerreten V, Holden MTG, Coleman DC, Goering R, Giffard PM, Skov RL, Zhang K, Westh H, O’Brien F, Tenover FC, Oliveira DC, Boyle-Vavra S, Laurent F, Kearns AM, Kreiswirth B, Ko KS, Grundmann H, Sollid JE, John JF Jr, Daum R, Soderquist B, Buist GGuidelines for reporting novel mecA gene homologues. Antimicrobial agents and Chemotherapy 2012;56:4997–9. doi: 10.1128/AAC.01199-12 22869575

11. Baig S, Johannesen TB, Overballe-Petersen S, Larsen J, Larsen AR, Stegger M. Novel SCCmec type XIII (9A) identified in an ST152 methicillin-resistant Staphylococcus aureus. Infect Genet Evol. 2018;61:74–6. doi: 10.1016/j.meegid.2018.03.013 29567305

12. Kondo Y, Ito T, Ma XX, Watanabe S, Kreiswirth BN, Etienne J, Hiramatsu K. Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. Antimicrob Agents Chemother. 2007;51(1):264–74. doi: 10.1128/AAC.00165-06 17043114

13. Wu Z, F. L, Liu D, Xue H, Zhao X. Novel Type XII Staphylococcal Cassette Chromosome mec Harboring a New Cassette Chromosome Recombinase, CcrC2. Antimicrob Agents Chemother 2015;59(12):7597–601. doi: 10.1128/AAC.01692-15 26416872

14. Ganga R, Riederer K, Sharma M, Fakih MG, Johnson LB, Shemes S, Khatib R. Role of SCCmec type in outcome of Staphylococcus aureus bacteremia in a single medical center. J Clin Microbiol. 2009;47(3):590–5. doi: 10.1128/JCM.00397-08 19144813

15. Bal AM, Coombs GW, Holden MTG, Lindsay JA, Nimmo GR, Tattevin P, Skov RL. Genomic insights into the emergence and spread of international clones of healthcare-, community- and livestock-associated meticillin-resistant Staphylococcus aureus: Blurring of the traditional definitions. Journal of Global Antimicrobial Resistance. 2016;6:95–101. doi: 10.1016/j.jgar.2016.04.004 27530849

16. Perovic O, Iyaloo S, Kularatne R, Lowman W, Bosman N, Wadula J, Seetharam S, Duse A, Mbelle N, Bamford C, Dawood H, Mahabeer Y, Bhola P, Abrahams S, Singh-Moodley A. Prevalence and Trends of Staphylococcus aureus Bacteraemia in Hospitalized Patients in South Africa, 2010 to 2012: Laboratory-Based Surveillance Mapping of Antimicrobial Resistance and Molecular Epidemiology. PLoS One. 2015;10(12). doi: 10.1371/journal.pone.0145429 26719975

17. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing: twenty fourth informational supplement. 2017.

18. Perovic O, Singh-Moodley A, Govender NP, Kularatne R, Whitelaw A, Chibabhai V, Naicker P, Mbelle N, Lekalakala R, Quan V, Samuel C, Van Schalkwyk E, for GERMS-SA. A small proportion of community-associated methicillin-resistant Staphylococcus aureus bacteraemia, compared to healthcare-associated cases, in two South African provinces. Eur J Clin Microbiol Infect Dis. 2017;36(12):2519–32. doi: 10.1007/s10096-017-3096-3 28849285

19. Singh-Moodley A, Marais E, Perovic O. Discrepancies in the identification of methicillin resistant Staphylococcus aureus and the absence of mecC in surveillance isolates in South Africa. South African Journal of Infectious Diseases. 2015;1(1):1–3. doi: 10.1080/23120053.2015.1107256

20. Fosheim GE, Nicholson AC, Albrecht VS, Limbago BM. A Multiplex Real-time PCR Assay for Detection of Methicillin-Resistant Staphylococcus aureus and Associated Toxin Genes. J Clin Microbiol. 2011 49(8):3071–3. doi: 10.1128/JCM.00795-11 21697325

21. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, Harbarth S, Hindler JF, Kahlmeter G, Olsson-Liljequist B, Paterson DL, Rice LB, Stelling J, Struelens MJ, Vatopoulos A, Weber JT, Monnet DL. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2011 18(3):268–81. doi: 10.1111/j.1469-0691.2011.03570.x 21793988

22. Milheirico C, Oliveira DC, de Lencastre H. Update to the multiplex PCR strategy for assignment of mec element types in Staphylococcus aureus. Antimicrob Agents Chemother. 2007;51(9):3374–7. doi: 10.1128/AAC.00275-07 17576837

23. International Working Group on the Classification of Staphylococcal Cassette Chromosome Elements (IWG-SCC). Classification of Staphylococcal Chromosome mec (SCCmec): Guidelines for reporting novel SCCmec elements. Antimicrob Agents Chemother. 2009;53:4961–7. doi: 10.1128/AAC.00579-09 19721075

24. Valsesia G, Rossi M, Bertschy S, Pfyffer GE. Emergence of SCCmec type IV and SCCmec type V methicillin-resistant Staphylococcus aureus containing the Panton-Valentine leukocidin genes in a large academic teaching hospital in central Switzerland: external invaders or persisting circulators? J Clin Microbiol. 2010;48(3):720–7. doi: 10.1128/JCM.01890-09 20042625

25. David MZ, Glikman D, Crawford SE, Peng J, King KJ, Hostetler MA, Boyle-Vavara S, Daum RS. What is community-associated methicillin-resistant Staphylococcus aureus? J Infect Dis 2008;97 (9):1234–43. doi: 10.1086/533502 18422435

26. de Carvalho SP, de Almeida JB, Andrade YMFS, da Silva LSC, de Oliveira AC, Nascimento FS, Campos GB, Oliveira MV, Timenetsky J, Marques LM. Community-acquired methicillin-resistant Staphylococcus aureus carrying SCCmec type IV and V isolated from healthy children attending public daycares in northeastern Brazil. Braz J Infect Dis 2017;21(4). doi: 10.1016/j.bjid.2017.04.001 28482183

27. Moroney SM, Heller LC, Arbuckle J, Talavera M, Widen RH. Staphylococcal cassette chromosome mec and Panton-Valentine leukocidin characterization of methicillin-resistant Staphylococcus aureus clones. J Clin Microbiol. 2007;45(3):1019–21. doi: 10.1128/JCM.01706-06 17192420

28. Szczuka E, Grabska K, Trawczynski K, Bosacka K, Kaznowski A. Characterization of SCCmec types, antibiotic resistance, and toxin gene profiles of Staphylococcus aureus strains. Acta Microbiologica et Immunologica Hungarica. 2013;60:261–70. doi: 10.1556/AMicr.60.2013.3.3 24060551

29. Berglund C, Molling P, Sjoberg L, Soderquist B. Predominance of staphylococcal cassette chromosome mec (SCCmec) type IV among methicillin-resistant Staphylococcus aureus (MRSA) in a Swedish county and presence of unknown SCCmec types with Panton-Valentine leukocidin genes. Clin Microbiol Infect. 2005;11(6):447–56. doi: 10.1111/j.1469-0691.2005.01150.x 15882194

30. Ahmad N, Ruzan IN, Abd Ghani MK, Hussin A, Nawi S, Aziz MN, Maning N, Eow VL. Characteristics of community- and hospital-acquired meticillin-resistant Staphylococcus aureus strains carrying SCCmec type IV isolated in Malaysia. J Med Microbiol 2009;58(Pt 9):1213–8. doi: 10.1099/jmm.0.011353-0 19528158


Článek vyšel v časopise

PLOS One


2019 Číslo 11
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#