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Volume 4, Issue 2

Molecular epidemiological and pharmaceutical studies of methicillin-resistant isolated at hospitals in Kure City, Japan Open Access

Abstract

Methicillin-resistant (MRSA) is one of the major pathogens of nosocomial infections throughout the world. In the medical field, it is extremely important to this pathogen’s trends when considering infection control.

We hypothesized that clarifying the characteristics of clinically isolated MRSA would contribute to infection control and proper use of antimicrobial agents against MRSA.

The purpose of this study is to elucidate the genetic and biological characteristics of the MRSA isolates found at our hospital and to reveal changes in the spread of this pathogen in the local area where we live.

Pulse-field gel electrophoresis (PFGE) and polymerase chain reaction were used for the genetic analyses of MRSA isolates. Toxin production by each isolate was examined using toxin-specific detection systems.

During the 3 years from 2017 through 2019, over 1000 MRSA strains were isolated at our hospital. Genomic analysis of 237 of these clinical isolates by PFGE revealed 12 PFGE types (types A to L), each consisting of five or more MRSA clinical strains with over 80% genetic similarity. Examination of the SCC genotypes found that 219 of 237 isolated MRSA strains (approximately 92%) were SCC genotype II or IV and that only four of the isolates carried the Panton−Valentine leukocidin (PVL) gene. Examination of the toxin production of the isolates using staphylococcal enterotoxin detection kits found that most isolates carrying the SCC genotype II produced enterotoxin B and/or C, and that most isolates carrying the SCC genotype IV produced enterotoxin A.

The present results revealed that MRSA isolates with common properties were isolated at certain rates throughout the 3 year study period, suggesting that relatively specific MRSA clones may have settled in the local area around our hospital. We also examine the relationship between antimicrobial usage over time and changes in MRSA isolation rates.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): antibacterial agents , antibiotic resistance , AUD/DOT value , epidemiology , genome typing , MRSA , phylogeny , pulse-field gel electrophoresis , SCCmec and Staphylococcus aureus
Funding
This study was supported by the:
  • Hiroshima International University (Award research grant 2020)
    • Principle Award Recipient: AkihiroSawa
  • Japan Society for the Promotion of Science (Award 16K09194)
    • Principle Award Recipient: AkihiroSawa
© 2022 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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2022-02-25
2024-04-19
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References

  1. Tenover FC, McDougal LK, Goering RV, Killgore G, Projan SJ et al. Characterization of a strain of community-associated methicillin-resistant Staphylococcus aureus widely disseminated in the United States. J Clin Microbiol 2006; 44:108–118 [View Article] [PubMed]
     [Google Scholar]
  2. Turner NA, Sharma-Kuinkel BK, Maskarinec SA, Eichenberger EM, Shah PP et al. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nat Rev Microbiol 2019; 17:203–218 [View Article] [PubMed]
     [Google Scholar]
  3. Popovich KJ, Snitkin ES, Hota B, Green SJ, Pirani A et al. Genomic and epidemiological evidence for community origins of hospital-onset methicillin-resistant Staphylococcus aureus bloodstream infections. J Infect Dis 2017; 215:1640–1647 [View Article] [PubMed]
     [Google Scholar]
  4. Arias CA, Rincon S, Chowdhury S, Martínez E, Coronell W et al. MRSA USA300 clone and VREF--a U.S.-Colombian connection?. N Engl J Med 2008; 359:2177–2179 [View Article] [PubMed]
     [Google Scholar]
  5. Reyes J, Rincón S, Díaz L, Panesso D, Contreras GA et al. Dissemination of methicillin-resistant Staphylococcus aureus USA300 sequence type 8 lineage in Latin America. Clin Infect Dis 2009; 49:1861–1867 [View Article] [PubMed]
     [Google Scholar]
  6. Song J-H, Hsueh P-R, Chung DR, Ko KS, Kang C-I et al. Spread of methicillin-resistant Staphylococcus aureus between the community and the hospitals in Asian countries: an ANSORP study. J Antimicrob Chemother 2011; 66:1061–1069 [View Article] [PubMed]
     [Google Scholar]
  7. Chuang Y-Y, Huang Y-C. Molecular epidemiology of community-associated meticillin-resistant Staphylococcus aureus in Asia. Lancet Infect Dis 2013; 13:698–708 [View Article] [PubMed]
     [Google Scholar]
  8. Liu Y, Wang H, Du N, Shen E, Chen H et al. Molecular evidence for spread of two major methicillin-resistant Staphylococcus aureus clones with a unique geographic distribution in Chinese hospitals. Antimicrob Agents Chemother 2009; 53:512–518 [View Article] [PubMed]
     [Google Scholar]
  9. Zhao C, Liu Y, Zhao M, Liu Y, Yu Y et al. Characterization of community acquired Staphylococcus aureus associated with skin and soft tissue infection in Beijing: high prevalence of PVL+ ST398. PLoS One 2012; 7:e38577 [View Article] [PubMed]
     [Google Scholar]
  10. Ito T, Okuma K, Ma XX, Yuzawa H, Hiramatsu K. Insights on antibiotic resistance of Staphylococcus aureus from its whole genome: genomic island SCC. Drug Resist Updat 2003; 6:41–52 [View Article] [PubMed]
     [Google Scholar]
  11. Deurenberg RH, Vink C, Kalenic S, Friedrich AW, Bruggeman CA et al. The molecular evolution of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect 2007; 13:222–235 [View Article] [PubMed]
     [Google Scholar]
  12. Chongtrakool P, Ito T, Ma XX, Kondo Y, Trakulsomboon S et al. Staphylococcal cassette chromosome mec (SCCmec) typing of methicillin-resistant Staphylococcus aureus strains isolated in 11 Asian countries: a proposal for a new nomenclature for SCCmec elements. Antimicrob Agents Chemother 2006; 50:1001–1012 [View Article] [PubMed]
     [Google Scholar]
  13. Hisata K, Kuwahara-Arai K, Yamanoto M, Ito T, Nakatomi Y et al. Dissemination of methicillin-resistant staphylococci among healthy Japanese children. J Clin Microbiol 2005; 43:3364–3372 [View Article] [PubMed]
     [Google Scholar]
  14. Ma XX, Ito T, Tiensasitorn C, Jamklang M, Chongtrakool P et al. Novel type of staphylococcal cassette chromosome mec identified in community-acquired methicillin-resistant Staphylococcus aureus strains. Antimicrob Agents Chemother 2002; 46:1147–1152 [View Article] [PubMed]
     [Google Scholar]
  15. Oliveira DC, de Lencastre H. Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2002; 46:2155–2161 [View Article] [PubMed]
     [Google Scholar]
  16. Boyle-Vavra S, Ereshefsky B, Wang C-C, Daum RS. Successful multiresistant community-associated methicillin-resistant Staphylococcus aureus lineage from Taipei, Taiwan, that carries either the novel Staphylococcal chromosome cassette mec (SCCmec) type VT or SCCmec type IV. J Clin Microbiol 2005; 43:4719–4730 [View Article] [PubMed]
     [Google Scholar]
  17. Kwon NH, Park KT, Moon JS, Jung WK, Kim SH et al. Staphylococcal cassette chromosome mec (SCCmec) characterization and molecular analysis for methicillin-resistant Staphylococcus aureus and novel SCCmec subtype IVg isolated from bovine milk in Korea. J Antimicrob Chemother 2005; 56:624–632 [View Article] [PubMed]
     [Google Scholar]
  18. Miragaia M, Couto I, de Lencastre H. Genetic diversity among methicillin-resistant Staphylococcus epidermidis (MRSE). Microb Drug Resist 2005; 11:83–93 [View Article] [PubMed]
     [Google Scholar]
  19. Hanssen A-M, Kjeldsen G, Sollid JUE. Local variants of Staphylococcal cassette chromosome mec in sporadic methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococci: evidence of horizontal gene transfer?. Antimicrob Agents Chemother 2004; 48:285–296 [View Article] [PubMed]
     [Google Scholar]
  20. Corkill JE, Anson JJ, Griffiths P, Hart CA. Detection of elements of the staphylococcal cassette chromosome (SCC) in a methicillin-susceptible (mecA gene negative) homologue of a fucidin-resistant MRSA. J Antimicrob Chemother 2004; 54:229–231 [View Article] [PubMed]
     [Google Scholar]
  21. Mongkolrattanothai K, Boyle S, Murphy TV, Daum RS. Novel non-mecA-containing staphylococcal chromosomal cassette composite island containing pbp4 and tagF genes in a commensal staphylococcal species: a possible reservoir for antibiotic resistance islands in Staphylococcus aureus. Antimicrob Agents Chemother 2004; 48:1823–1836 [View Article] [PubMed]
     [Google Scholar]
  22. Frénay HM, Bunschoten AE, Schouls LM, van Leeuwen WJ, Vandenbroucke-Grauls CM et al. Molecular typing of methicillin-resistant Staphylococcus aureus on the basis of protein A gene polymorphism. Eur J Clin Microbiol Infect Dis 1996; 15:60–64 [View Article] [PubMed]
     [Google Scholar]
  23. Schwartz DC, Cantor CR. Separation of yeast chromosome-sized DNAs by pulsed field gradient gel electrophoresis. Cell 1984; 37:67–75 [View Article] [PubMed]
     [Google Scholar]
  24. Matushek MG, Bonten MJ, Hayden MK. Rapid preparation of bacterial DNA for pulsed-field gel electrophoresis. J Clin Microbiol 1996; 34:2598–2600 [View Article] [PubMed]
     [Google Scholar]
  25. Reed KD, Stemper ME, Shukla SK. Pulsed-field gel electrophoresis of MRSA. Methods Mol Biol 2007; 391:59–69 [View Article] [PubMed]
     [Google Scholar]
  26. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995; 33:2233–2239 [View Article] [PubMed]
     [Google Scholar]
  27. Xie Y, He Y, Gehring A, Hu Y, Li Q et al. Genotypes and toxin gene profiles of Staphylococcus aureus clinical isolates from China. PLoS One 2011; 6:e28276 [View Article] [PubMed]
     [Google Scholar]
  28. Kondo Y, Ito T, Ma XX, Watanabe S, Kreiswirth BN et al. 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; 51:264–274 [View Article] [PubMed]
     [Google Scholar]
  29. Shopsin B, Gomez M, Waddington M, Riehman M, Kreiswirth BN. Use of coagulase gene (coa) repeat region nucleotide sequences for typing of methicillin-resistant Staphylococcus aureus strains. J Clin Microbiol 2000; 38:3453–3456 [View Article] [PubMed]
     [Google Scholar]
  30. Lina G, Piémont Y, Godail-Gamot F, Bes M, Peter MO et al. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 1999; 29:1128–1132 [View Article] [PubMed]
     [Google Scholar]
  31. Deurenberg RH, Vink C, Oudhuis GJ, Mooij JE, Driessen C et al. Different clonal complexes of methicillin-resistant Staphylococcus aureus are disseminated in the Euregio Meuse-Rhine region. Antimicrob Agents Chemother 2005; 49:4263–4271 [View Article] [PubMed]
     [Google Scholar]
  32. Chung M, Dickinson G, De Lencastre H, Tomasz A. International clones of methicillin-resistant Staphylococcus aureus in two hospitals in Miami, Florida. J Clin Microbiol 2004; 42:542–547 [View Article] [PubMed]
     [Google Scholar]
  33. Denis O, Deplano A, Nonhoff C, De Ryck R, de Mendonça R et al. National surveillance of methicillin-resistant Staphylococcus aureus in Belgian hospitals indicates rapid diversification of epidemic clones. Antimicrob Agents Chemother 2004; 48:3625–3629 [View Article] [PubMed]
     [Google Scholar]
  34. Pérez-Roth E, Lorenzo-Díaz F, Batista N, Moreno A, Méndez-Alvarez S. Tracking methicillin-resistant Staphylococcus aureus clones during a 5-year period (1998 to 2002) in a Spanish hospital. J Clin Microbiol 2004; 42:4649–4656 [View Article] [PubMed]
     [Google Scholar]
  35. Shukla SK, Stemper ME, Ramaswamy SV, Conradt JM, Reich R et al. Molecular characteristics of nosocomial and Native American community-associated methicillin-resistant Staphylococcus aureus clones from rural Wisconsin. J Clin Microbiol 2004; 42:3752–3757 [View Article] [PubMed]
     [Google Scholar]
  36. Enright MC, Day NPJ, Davies CE, Peacock SJ, Spratt BG. Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 2000; 38:1008–1015 [View Article] [PubMed]
     [Google Scholar]
  37. Nakamura S, Arima T, Tashiro R, Yasumizu S, Aikou H et al. Impact of an antimicrobial stewardship in a 126-bed community hospital with close communication between pharmacists working on post-prescription audit, ward pharmacists, and the antimicrobial stewardship team. J Pharm Health Care Sci 2021; 7:25 [View Article] [PubMed]
     [Google Scholar]
  38. Sasai N, Nakaminami H, Iwasaki M, Iwao M, Misegawa K et al. Clonal change of methicillin-resistant Staphylococcus aureus isolated from patients with impetigo in Kagawa, Japan. J Dermatol 2019; 46:301–307 [View Article] [PubMed]
     [Google Scholar]
  39. Diekema DJ, Richter SS, Heilmann KP, Dohrn CL, Riahi F et al. Continued emergence of USA300 methicillin-resistant Staphylococcus aureus in the United States: results from a nationwide surveillance study. Infect Control Hosp Epidemiol 2014; 35:285–292 [View Article] [PubMed]
     [Google Scholar]
  40. Tenover FC, Goering RV. Methicillin-resistant Staphylococcus aureus strain USA300: origin and epidemiology. J Antimicrob Chemother 2009; 64:441–446 [View Article] [PubMed]
     [Google Scholar]
  41. Lepuschitz S, Huhulescu S, Hyden P, Springer B, Rattei T et al. Characterization of a community-acquired-MRSA USA300 isolate from a river sample in Austria and whole genome sequence based comparison to a diverse collection of USA300 isolates. Sci Rep 2018; 8:9467 [View Article] [PubMed]
     [Google Scholar]
  42. Schlievert PM. Staphylococcal toxic shock syndrome: still a problem. Med J Aust 2005; 182:651–652 [View Article] [PubMed]
     [Google Scholar]
  43. Varshney AK, Mediavilla JR, Robiou N, Guh A, Wang X et al. Diverse enterotoxin gene profiles among clonal complexes of Staphylococcus aureus isolates from the Bronx, New York. Appl Environ Microbiol 2009; 75:6839–6849 [View Article] [PubMed]
     [Google Scholar]
  44. Rasmussen G, Monecke S, Ehricht R, Söderquist B. Prevalence of clonal complexes and virulence genes among commensal and invasive Staphylococcus aureus isolates in Sweden. PLoS One 2013; 8:e77477 [View Article] [PubMed]
     [Google Scholar]
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Molecular epidemiological and pharmaceutical studies of methicillin-resistant Staphylococcus aureus isolated at hospitals in Kure City, Japan
Access Microbiology 4, 000319 (2022); https://doi.org/10.1099/acmi.0.000319
/content/journal/acmi/10.1099/acmi.0.000319
/content/journal/acmi/10.1099/acmi.0.000319
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